Crick in the Neck

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What Is a ‘Crick in the Neck? What if it last longer than a week?  How long do I need to wait to see someone before I seek help.

We have all been here waking up with a painful “crick in my neck”, perhaps after a sleepless night? Is it anything to worry about?

A “crick in the neck” is not an official medical diagnosis, and therefore the term means different things to different people. For many, a “crick in my neck” is something they wake up with after a night of lillow tossing or sleeping the wrong way.  But what ever the case having a “crick” in your neck is no fun.  Or as Hispanics would say, NO BUENO!  So what if you do wake up with a “Crick”?  What do I do?  How long will it last?  What if it wont go away?  Am I being to impatient if I wanna go see a doctor when I wake up, or do I need to wait a certain amount of time?

As many questions there are even more answers to all these questions.  First and foremost it all depends on the person.  Pain is a subjective thing.  What is a “bad crick” may not be for another person.  One pain that should not be ignored and all people should take to a health professional as soon as possible is radiating and or burning pain.  Anything that tingles or does the former should be taken with great seriousness.  Although these are very rare and uncommon occurrences while sleeping we know nothing is impossible these days.  Well maybe passing a CA State Budget may fall into that category but that’s a different blog all together.

So lets break it down from a conservative chiropractors point of view.  My rule of thumb for my patients is, “If it last more than a week” then you should have it checked out.

Checklist of what to do if you wake up with a “Crick” in your neck.

• Move it around:  Babying it will only prolong the pain and lack of motion.  The more you “loosen it up”  the faster it will recover.
• Apply heat: Many people say apply ice withing the 1st 72hrs, while this is usually true, in this case heat is what you need to aid in the relaxation and heating of the tendons, ligaments and muscles to increase your range of motion.
• Try OTC meds.  I usually don’t recommend these unless is serious but they can help with inflammation and or relaxing the muscle as well.  For many people with mild to moderate neck or back pain, the medicine chest is their first stop. As far as strength goes, an over-the-counter pain medication will do the job most of the time. The dosage of an OTC drug is less than what you would get with a prescription drug, still doctors generally suggest starting there. OTC pain medications come in two types — acetaminophen and NSAIDs (such as Motrin and Aleve). NSAIDs have an advantage over acetaminophen in that they also help control the inflammatory process  that is contributing to the pain. Both types of OTCs may have side effects, so read the label before taking any drug for your back or neck pain.
• Apply Ice: Applying ice to the painful area for up to 48 to 72 hours after it starts is another way to control inflammation. The inflammation causes pain and, left unchecked, can contribute to a chronic problem in your neck or shoulders.  There are a number of ways to give yourself ice, as suggested by doctors and physical therapists. For example, consider this method from the American Physical Therapy Association: fill a plastic bag with crushed ice, place a towel around the area of your neck that has the pain, and put the homemade ice bag on the towel. Ice for 15 to 20 minutes, take a 40 minute break, then repeat. (Never apply ice directly to your skin.)
• Dr. Wilchek also recommends massage for muscle spams that are attributed to a “crick in the neck.” For neck and low back pain, the massage should be very gentle during the first few days to avoid making it worse. You may even choose to wait until the acute phase of the injury has past. Massage moves fluid around, which may help to prevent scar tissue.   After the first few days, massage can help work out tension and knots in your muscles. At this point, there are even a few moves you can do on yourself.
• Stay Active: Years ago, doctors advised people with back pain or injury to lay down and become immobile. Medical research has shown that patients with acute low back pain who stop activity actually have more pain than those who don’t. Sometimes laying on your back with your knees bent and legs resting on a chair or bed can temporarily relieve the pain, making it a good thing to do periodically. But in general, researchers and doctors now know that staying active within your pain limits is the most effective way to deal with pain,  it is as effective as bed rest for back pain accompanied by sciatica.
• Know When to go see Doctor: Technically speaking, there are no established guidelines for when to see a doctor about mild back or neck pain. But according to Thomas, if the pain persists for a week or longer and especially if it interrupts your daily functioning, it is time to get it checked. Sometimes pain you think may be due to a simple “crick in the neck” or low back strain can indicate something more serious, such as an infection or tumor. A medical doctor has the diagnostic skills to determine if your pain indicates a serious problem not directly related to the pain. Thomas also says that sometimes conditions such as disc herniation or spinal stenosis can mimic the symptoms of a “crick in the neck” — another reason to get it checked.

I asked two different physiatrists, doctors who specialize in physical rehabilitation, what a crick in the neck is in medical terms. Both of them said about 75% of “cricks in the neck” are due to a muscle spasm. Other causes cited were:

• arthritis
• myofascial pain syndrome and/or trigger points
• cervical radiculopathy, which is pain that radiates from the neck
• disk related pain

Two Views on a Diagnosis for ‘Crick in the Neck’

The one thing that is certain when it comes to understanding a crick in your neck is that health professionals from different fields (and also lay people) don’t agree on what it is.

For example at Virginia Commonwealth University, says that while consensus is lacking, many times it can be attributed to a problem in the facet joint. But Dr. Santhos Thomas, physiatrist and medical director at the Westlake Spine Center at the Cleveland Clinic says “the only way to really tell if the ‘crick in your neck’ is due to a facet joint problem is to perform a diagnostic injection into the area to confirm or rule out the facet joint as the origination of the pain.”

Dr. Thomas says that in general, “cricks in the necks” of younger patients tend to be muscle spasms. Riddle agrees that muscle spasm is often present in “cases” of “crick in the neck”, but that they may be a result of a problem in the facet joint.

Older patients, Dr. Thomas says, tend to describe the problem as a creak in the neck, and it is usually due to arthritis (another joint problem), not muscle spasm. In older people, he adds, a decreased range of motion that may also contribute to the pain.

If you go to Midus you’ll get a muffler” That’s what my dad used to always say and its not till being an adult i realized what that obscure and weird comment meant.  If you have a crick in the neck and go to a pain doctor, he is going to want to inject you.  If you go got a Chiropractor he is going to want to adjust you. If you got to an Acupuncturist he is going to want to still needles in you.  So take control of you’re own health and make the proper choice.  Never hurts to get a second opinion as well.  Maybe not for something as simple as a crick in the neck but certainly for other serious conditions.