NECK PAIN: The cause of the "crick"

It's very common, and it almost always presents the same way:

"I woke up, turned my head a bit, and got this sharp pain in my neck.  What's up with that?  Now I can't turn or tilt my head to the left, and I get a sharp pain down into my shoulder blade!"

If this sounds like something you've experienced, you probably had a condition called 'torticollis'.  Torticollis covers a range of neck conditions, but the particular version we're talking about here is usually caused by damage to ligaments in your neck.

Ligament damage is called a sprain (just like when you sprain your ankle), and can happen from a sudden trauma -- like a whiplash injury -- or by a slow overstretch of the ligament -- like sleeping with your head turned awkwardly to the side.

Here's how it can happen.

Your neck supports your 10-15 lb. head by way of 7 bony vertebra, which are all connected together by ligaments.  Ligaments are like tough, fibrous ropes -- not very flexible, but great for holding bones together.  Quickly overstretching these ropes can cause them to fray or snap (think whiplash), but a slow stretch over time can also cause them to weaken.

When you fall asleep on the couch with your head bent to the side, or if your pillow is too thick, this slow overstretch causes the ligaments to become weakened, inflamed, and painful.  As soon as you try to lift your head off your pillow, these damaged ligaments are now asked to hold the weight of your head, and that's when you feel the pain.  Not a nice way to start your day.

And on top of that, your muscles may go into spasm.  This is a natural response by your body, and it's called muscle splinting.  Splinting happens when your body senses an injury, and tightens up the muscles around the injured joint to protect it from further harm (much like you'd splint a jammed finger).  Only thing is, muscle splinting HURTS.  Ever had a 'charley horse'?

So, how do you fix it?

The key is re-introducing safe & comfortable movement to the injured joint.  We use supported range-of-motion exercises, low-force manual joint mobilization, and isometric neck exercises to start.  Axial traction can be particularly helpful, too, and pain-relieving therapies like interferential current or ultrasound may also be used.  For most cases, we're able to get 80-90% improvement in a week.  Left untreated or undertreated, torticollis can linger much longer, or heal incompletely.

As painful and inconvenient as it may be, torticollis is fixable.  If you think you may have torticollis, give it a couple days to get better.  If you're still hurting, come see me or another health care professional. 

-Daniel Bockmann, DC

To see a list of possible causes of neck pain, click here:http://www.mayoclinic.com/health/neck-pain/DS00542/DSECTION=causes

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