Stiff Neck from the Flu

Stiff Neck Flu

Fever, neck pain and stiffness can be signs of meningitis - or the flu.

When you have a cold or the flu you’ll often find that your whole body aches, sometimes it’s even the first symptom,
before the congestion, cough, or nausea begin. Why does this happen? Why does your neck become stiff and swollen and why does it hurt?

There are a number of reasons why you may end up with a stiff neck that ache during a cold or flu infection. Firstly, your lymph nodes, an important part of your immune system, are likely to become enlarged and your neck is one of the places in the body where there is an abundance of lymph tissue. This swelling can often be felt under your jaw-line and cause both jaw pain itself as well as more widespread neck pain. Secondly, you might retreat to bed, or slouch on the sofa, propped up with pillows and promptly fall asleep in an awkward position waking up later with a crick in your neck. Obviously bed-rest is good, but keeping an eye on your posture, even when sick can stave off further aches and pains.

Another answer is simply dehydration, as when you have the flu, or even a particularly virulent cold, your body responds by producing a fever as an attempt to kill off any heat-susceptible invading bacteria and viruses. This means that each cell in your body will use significantly more water and full body dehydration can quickly occur unless you keep taking on fluids and electrolytes. Unfortunately, the flu can also have the effect of decreasing your appetite and thirst, making dehydration almost inevitable. As your illness progresses you may also experience nausea, vomiting, and diarrhoea, with further fluid and electrolyte losses.

What are electrolytes?

Put simply, electrolytes are the chemical substances in your body that are responsible for creating nerve impulses, muscle contractions, and are involved in basic metabolic processes of each cell. If you’re an athlete, or ardent exerciser, then you’ll know that replacing these electrolytes after a vigorous, sweaty, workout can save you from excruciating cramps, headaches, and muscle twitchiness later. Your major electrolytes are potassium, calcium, magnesium, and sodium and an imbalance of these can cause the muscle aches, low energy, headaches, and other flu-like symptoms (Durlach, et al, 2000).

An electrolyte drink can help if you’re dehydrated from the flu, and, whilst these can be bought at your local healthfood/fitness store, you can also easily replace lost minerals with careful food choices. Potassium is high in foods like avocados, leafy green veg (e.g spinach), and even bananas provide a fairly decent dose. Good magnesium sources are almonds, pumpkin seeds, rice, quinoa, and tofu. Eating these alongside potassium-rich foods will also help as low potassium levels can hinder magnesium status too.

As your throat is likely to become sore if you have the flu, are coughing a lot, and become dehydrated it makes sense to try to keep it lubricated by sucking ice chips, drinking water or snacking on lettuce, cucumber, and other foods with a high water content. Avoid anything milky, including ice cream, as these can make the mucus in your throat and sinuses feel thicker prompting you to actually cough more.

Any Other Nutrition Connections?

Another potential player in the neck-ache/flu scenario is vitamin D. This fat-soluble vitamin is implicated in the proper functioning of the immune system and so your stores are likely to be run down a little if you have an infection like a cold or the flu. As most people at higher latitudes have lower vitamin D levels than are recommended (particularly those with darker skin and little sun exposure), any extra demands on your body’s vitamin D stockpile has the potential to cause problems.

As vitamin D is also involved in the absorption and utilisation of calcium and magnesium (thereby affecting your electrolyte status) it can, therefore, lead to muscle cramps and spasms when low (Merck, 2007). Drugs like statins can also lower your vitamin D levels and the muscle aches and pains that commonly occur with statins may be due to vitamin D insufficiency.

Vitamin D’s effect on the immune system is also important in the production of inflammation during an infection such as a cold or the flu. If vitamin D (and other nutrient) levels are low the the body can respond improperly to an attack against the immune system and may continue to create excessive inflammation for a lot longer than is useful and at higher levels than necessary to counter the invaders. In extreme cases the immune system may fail to recognise the body’s own cells and trigger an autoimmune response implicated in conditions such as multiple sclerosis, fibromyalgia, and lupus, all of which can cause persistent neck ache along with myriad symptoms.

What If My Neck Hurts When I Cough or Sneeze?

The flu and neck pain

Be sure to stay hydrated during a spat with the flu

If you have a cold or the flu then it’s likely you’ll sneeze more than usual and cough a lot more and that can be quite painful for a number of reasons. Clearing your throat can cause localized inflammation and pain, and the added pressure in your sinuses due to congestion may make the whole of the front of your face and your ears hurt when coughing or sneezing.

Coughing and sneezing also cause contraction of muscles in the abdomen which may make the spine temporarily misaligned, alter weight distribution, and lead to neck pain. If you think of the action of sneezing it’s actually a lot like whiplash and the extra neck strain can be a real problem if you have pre-existing cervical stenosis or other spinal conditions. In extreme cases the action of sneezing or coughing can lead to herniated disc in neck or upper back due to sudden increases in pressure on the cervical spine. This is particularly true if you have a lot of inflammation in the neck during your cold with enlarged lymph nodes and stiffness of the neck. Some gentle stretching and neck exercises can help, as can ice-packs to take down the inflammation.

How to Remedy a Stiff Neck from the Flu

Plenty of cold and flu remedies contain Ibuprofen, acetaminophen, and other analgesics which can mask your pain and neck ache but do little to solve the underlying problem. Instead, if you have a fever, make sure you take on lots of fluids and snack on foods that contain good mineral levels, such as bananas, nuts, seeds, spinach, and even a bowl of rice if you can’t face much else. Electrolyte drinks can help too, although those that are sugar-heavy should be avoided as excess sugar can compromise your mineral status too. If you can get out in the sun a little, even for fifteen minutes or so each day, then your body will get a chance to boost its vitamin D synthesis (assuming you have a little skin exposed!). Otherwise, fortified foods such as cereals, margarine, and even some milk replacements or fruit juices, often contain vitamin D. Taking a good multivitamin is also helpful as an insurance against deficiency.

Above all, keep your fluids up, try to control your temperature through cold flannels (or even a cold bath), try to eat a little of something nutritious or sip an electrolyte drink throughout the day. Pineapple juice (which contains bromelain) can be helpful, as can ginger, as natural anti-inflammatories, although ginger can also raise your temperature if you take too much. Don’t just mask the pain with caffeinated, analgesic OTC cold and flu remedies as these may prolong suffering from an undiagnosed underlying condition, could cause their own problems and may actually make pain worse. Also, make sure that you move from the sofa once in a while, get out from under the duvet, and stretch out your neck a little to avoid it aching through simple lack of use.


Durlach J. Bac P. Bara M. Guiet-Bara A. Physiopathology of symptomatic and latent forms of central nervous hyperexcitability due to magnesium deficiency: a current general scheme. [Review] [64 refs] [Journal Article. Review] Magnesium Research. 13(4):293-302, 2000


Guo R, Canter PH, Ernst E. Herbal medicines for the treatment of rhinosinusitis: a systematic review. Otolaryngol Head Neck Surg. 2006 Oct;135(4):496-506. Review.

Helms S, Miller A. Natural treatment of chronic rhinosinusitis. Altern Med Rev. 2006 Sept;11(3):196-207.

Klein G, Kullich W, Schnitker J, Schwann H. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip. A double-blind, randomised study comparing oral enzymes with non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol. 2006 Jan-Feb;24(1):25-30.

Merck Manuals, Vitamin D, 2007,

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