A stiff neck and sore throat can occur together for many reasons, often due to an infection. Symptoms are typically acute (temporary) but can become chronic (long-term).

Viral infections that cause stiff neck and sore throat, like the common cold (rhinovirus) or the flu (influenza), are widespread. Adults in the United States have an average of 2-3 colds a year, with children experiencing 8-12.

If you’re experiencing a stiff neck and sore throat, determining the cause can be critical for treatment.

When someone has a stiff neck and sore throat, they may feel pain, tension, and discomfort in the throat, neck, and shoulders. These symptoms can vary based on the underlying cause.

A sore throat typically feels like scratchiness, stinging pain, and dryness. These symptoms often get worse when you swallow or talk. Some people may have inflamed tonsils (the round masses in the back of the throat), white spots or red streaks in the throat, and red spots on the roof of the mouth.

Neck stiffness usually involves muscle tension or dull aches in the neck and pain or an inability to make certain movements. Some people may have difficulty looking up or down. Other symptoms may include dizziness, neck muscle spasms, and, in rare cases, numbness or weakness in the limbs.

When an infection or allergy is the cause, a stiff neck and sore throat are often accompanied by other symptoms. Typically lasting about a week, these include chronic cough, sneezing fits, runny nose, sinus pressure, headache, swollen lymph nodes, and hoarse (scratchy, raspy) voice. Fever, body aches, fatigue, nausea and vomiting, and conjunctivitis (eye redness and irritation) are additional signs.

A wide range of health conditions can cause a stiff neck and sore throat. Everything from infections or allergies to certain injuries can be at the root of symptoms.

Infections

Viruses or bacteria infecting the upper respiratory tract (the airways) often affect the throat first, causing soreness. From there, the inflammation (swelling) can spread to the neck, causing pain and leading to a stiff neck. These infections include:

• Common cold: An infection caused by rhinovirus, colds often start in the throat before spreading to the lungs, sinuses, lymph nodes, neck, and other areas. Common signs include nasal congestion, runny nose, cough, sneezing, headache, and low-grade fever.
• Influenza: Influenza, or flu, viruses can cause sore throat, leading to body aches. Additional symptoms include runny nose, congestion, headache, fatigue, cough, and, in some people, fever or chills.
• Tonsillitis: When viruses or bacteria infect the tonsils—part of the immune system—it causes tonsillitis. Tonsils become swollen, turn red, and can develop a white or yellow coating, leading to severe sore throat, swollen glands in the neck, fever, and bad breath.
• Mononucleosis: Mononucleosis, or “mono,” is an infection often caused by the Epstein-Barr virus. Arising 4-6 weeks after exposure, common symptoms include sore throat, swollen lymph nodes, and head and body aches. Other symptoms include severe fatigue and a rash.
• Strep throat: Caused by Streptococcus A bacteria, strep throat causes a severe red, sore throat with white patches and painful neck glands. Additional signs include sudden fever, chills, and painful swallowing.
• Oral gonorrhea: A sexually-transmitted infection (STI), gonorrhea primarily causes symptoms in the penis or vagina, but it can also affect the throat. When it does, swelling and redness in the throat, swollen lymph nodes, and flu-like symptoms are common.
• Meningitis: Meningitis is a bacterial or viral infection that causes swelling in the tissues surrounding the spinal cord and skull. Neck stiffness is a central feature, with other symptoms including sore throat, fever, headache, nausea, and sensitivity to light.

Allergies

Another potential cause of sore throat and neck pain is an allergic reaction. In those with sensitivities, allergens like pollen, pet dander, or certain foods trigger an immune system reaction. This can cause inflammation in the throat, leading to pain. As with a cold or flu, throat irritation can cause neck stiffness.

Other symptoms depend on whether the allergen is airborne or in food. Common symptoms may include runny nose, congestion, itchy or watery eyes, coughing, sneezing, itchy mouth, redness and swelling on the lips, hives (bumps on the skin), wheezing, and nausea.

Injury and Strain

Injuries or muscle strain in the throat and neck can also cause sore throat and stiffness.

Talking a lot or for a long time, trying to sing notes outside your range, or yelling can strain the throat’s muscles and vocal cords. This can lead to throat pain, itchiness, difficulty swallowing, hoarseness, and voice loss.

Swallowing something that’s too large or irritating can also damage the esophagus (the tube connecting the stomach and mouth) and throat. This can cause pain and discomfort in the area, making swallowing difficult.

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) occurs when stomach acids flow back into the esophagus and throat, causing heartburn (a burning sensation in the middle of the chest). Stomach acids can inflame tissues in the throat, causing soreness, chest pains, nausea, difficulty swallowing, chronic cough, and hoarseness.

Tumors

Cancers of the head and neck can also cause neck stiffness and pain around the throat. They can form in the cells lining the mouth and throat, salivary glands, sinuses, or muscles and nerves. 

Sore throat, difficulty swallowing, voice hoarseness, and a persistent lump in the neck are common signs. Depending on the type of cancer, other symptoms can include sores in the mouth, bleeding gums, ringing in the ears, headaches, chronic sinus infection, nose bleed, and facial paralysis (frozen muscles in the face).

If you have a stiff neck and sore throat, there are several signs you should call your healthcare provider:

• Rapid, labored breathing
• Dry mouth, decreased urination or sweat, dark-colored urine, dry skin, and dizziness
• Fever lasting four or more days
• Sore throat, pain, and other symptoms not improving after 10 days
• Chronic cough, fever, or other symptoms return after going away
• Swollen glands in the neck that don’t go away 
• Chest pain or pressure with neck pain
• Pain or numbness radiating from the neck to the limbs
• Loss of bowel or bladder control with neck pain
• Worsening neck pain at night or when lying down
• Neck pain following a fall, blow to the head, or injury

Your primary healthcare provider can often diagnose your condition. Depending on what they find, they may refer you to a orthopedic specialist (for neck or joint issues), infectious disease specialist, or oncologist (cancer doctor) for evaluation and treatment.

Your provider will likely perform a physical evaluation. They may do a biopsy (testing a tissue/skin sample), blood or saliva tests, tests for viruses or bacteria, and imaging (X-ray or other types) to detect the cause and assess the severity of the case.

The treatment for stiff neck and sore throat depends on the underlying cause. Certain conditions, like tonsillitis and mononucleosis, or injuries may require more extensive therapy.

Treatments focus on easing symptoms and typically involve home remedies or medications.

Home Remedies for Sore Throat

In most cases, the underlying causes of sore throat resolve on their own. In the meantime, common home remedies to soothe a sore throat include:

• Rest and take time off of work, avoiding others if you have symptoms
• Boost fluid intake and drink hot beverages
• Use a humidifier or air moisturizer
• Gargle with a solution of about one-half teaspoon of salt in 8 ounces of warm water
• Take over-the-counter (OTC) pain relievers, such as Motrin (ibuprofen) or Tylenol (acetaminophen)
• Suck on lozenges or cold foods, like popsicles

Home Remedies for Stiff Neck

Several strategies help relieve neck pain and stiffness at home. Here’s what you can try:

• Take OTC pain-relievers
• Apply cold packs or wrapped ice packs to the area for 10 minutes at a time for the first 48-72 hours
• Apply heat pads to affected areas regularly after the first 72 hours, or take hot showers
• Have someone massage the affected area
• Sleep with proper neck support
• Reduce activity that could strain the neck, such as sports or heavy lifting, until symptoms improve

Medications

If OTC options aren’t effective in managing your symptoms, your healthcare provider may prescribe medications. For severe sore throats, they may prescribe corticosteroids, sometimes alongside antibiotics.

For persistent or severe neck pain, your provider may prescribe muscle relaxers like Flexeril (cyclobenzaprine) or Norflex (orphenadrine) and prescription pain medications, such as Ultram (tramadol).

There are many ways to prevent both sore throat and stiff neck. For sore throat, prevention mainly involves avoiding infection. Steps to take include:

• Regularly wash your hands for 20 seconds at a time with soap and water
• Avoid touching your face or eyes or rubbing your nose
• Avoid close contact (kissing, hugging, sharing drinks or food, handshakes) with symptomatic people (or if you have symptoms)
• Clean and disinfect surfaces like table-tops, refrigerator or door handles, and others

Lifestyle changes and exercises may help with stiff neck. Try the following prevention methods:

• Stretch your neck and take breaks if you work at a desk
• Keep computer screens or reading materials at eye level
• Sit in chairs that have adjustable backs and seats and include arm rests
• Avoid standing for long periods; take hourly breaks when driving long distances
• Wear well-cushioned shoes; avoid wearing high heels
• Use a firm mattress and supportive pillows
• Try relaxation methods, such as deep breathing, meditation, or stretching activities (like yoga)

Complications of stiff neck and sore throat primarily occur if the underlying infection or injuries worsen. Viruses or bacteria that cause sore throat can spread and lead to more severe conditions, especially in people with weakened immune systems or other chronic diseases. Potential complications include:

• Middle ear infection
• Pneumonia, a life-threatening infection of the lungs
• Asthma attacks, fits of difficult breathing and wheezing
• Bronchitis, infection of larger airways
• Bronchiolitis, infection of smaller airways
• Complications of chronic diseases, like heart failure
• Septicemia, a potentially fatal bacterial infection of the blood

Depending on the cause of neck stiffness, symptoms can become chronic or lead to permanent disability and radiculopathy (nerve damage). 

Adopting lifestyle changes to avoid neck injury or strain and promptly treating infections can help prevent complications of stiff neck and sore throat.

Stiff neck and sore throat can be caused by viral or bacterial infections, allergies, injuries, and muscular strain.

Home remedies can manage most cases of sore throat and stiff neck, but prescription medications may sometimes be needed to treat the underlying cause of symptoms.

Prevention methods include avoiding infection and taking regular breaks when sitting for long periods. Seek medical care if you suspect your symptoms are due to an injury or infection.