What is the difference between the neck pain in meningitis and a simple muscle strain?

Tension signs. With meningitis one also sees a positive kernig sign. The patient is on their back and the leg is lifted up and straightened. This stretches the dura. If it is inflammed from meningitis lifting the the leg will cause neck pain while in a neck strain it should not. If there is fever, chills, light sensitivity oyou would also suspect meningitis. If present take this person to the er.