BI Answers: Why do you wake up with a crick in the neck?
If you've never woken up unable to turn your head without pain, those of us with an intimate understanding of the term "crick in the neck" are extremely jealous.
But why does it happen? Why are there days we wake up unable to turn our heads to the left or right?
"It's an age-old question that has probably plagued mankind since its existence," says Dr. Charles Kim, a musculoskeletal expert and assistant professor in the departments of rehabilitative medicine and anesthesiology at NYU School of Medicine who specializes in integrative pain management, physiatry, sports medicine, and medical acupunture.
So what is a crick in the neck in the first place?
Kim says it can be caused by a variety of things, but most involve a minor injury to the system of muscles, joints, ligaments, and tendons that hold your head on top of your body. A muscle or ligament strain is the usual culprit in younger people, while arthritis is more likely to be a factor for older patients.
The Causes
We put extra strain on the muscles and ligaments in our neck whenever we have our heads or necks twisted or bent out of a neutral, natural position.
Sadly, this mostly happens during the activities we spend most of our time engaged in: working and sleeping.
At work we frequently spend much of the day with our heads bent forward, looking down at a screen or a desk. This is the exact same effect that we've seen recently described as "text neck." Since our head weighs 10-12 pounds, the muscles in our neck have to work extra hard to hold it up whenever it isn't in a neutral position, as shown in the graphic below.
New York Spine Surgery & Rehabilitation Medicine
Kim explains that though it's frequently described as a new phenomenon, "text neck" is just another name for an overuse injury, where one part of our body is strained beyond its capacity. The muscles in our neck can be compared to a rope-and-pulley system, he says, and if we lean forward all day we may put too much strain on one part of that system.
Stress can also be a contributing factor, either at work or at home.
We have a fight-or-flight response to stress that causes muscles to tense and posture to stiffen, but while that response would have been helpful when escaping a lion on the savanna, it now sabotages us.
Since we can't always "escape" the thing that causes this stress response - a job, for example - the constant tension can lead to our musculoskeletal system being strained beyond its capacity.
Even when we sleep, we aren't home free. We tend to move around during much of the night, rolling from one side to another and onto our backs or stomachs. While doing so, it's easy to tilt the head too far forwards, backwards, or to the side, which means that some other body part has to compensate for that unnatural position.
How To Treat It
It's not all bad news. Even though a neck crick is pretty awful when it first shows up, it usually subsides within a few days.
In the meantime, Kim recommends light stretches to ease pain. He says you should generally be able to loosen some of the tension that way. Gently massaging that sore part of your neck in a hot shower can help, especially if the injury caused some inflammation. A short course of acetaminophen or ibuprofen should reduce your discomfort in that case, too.
Bad inflammation can make the pain easily last a week.
You should see a doctor if the pain lasts longer than a couple weeks, or if it's accompanied by numbness, tingling, or arms falling asleep - that's potentially a sign of a pinched nerve, an injury that can cause especially sharp and lasting pain. In those extreme cases, a doctor will sometimes prescribe muscle relaxants.
How To Avoid It In The Future
If this happens more than occasionally, it may be a sign that you need to make some changes.
To start, set up a workstation that allows you to keep your spine in a neutral position. Have your computer monitor at eye level.
"Your workspace should fit you like a shoe," Kim says.
Focusing on posture is important, too. A standing desk can help, but even better is a workstation that allows you to alternate between sitting and standing.
In bed, changing pillows can help. If you use too many pillows, your head will bend one way, while one very soft pillow might not provide enough support.
A specifically designed ergonomic pillow is probably not necessary, according to Kim. It may help, but that improved situation could probably have been achieved with another pillow change too, and one that wasn't quite as expensive.
Finally, exercise is key. While athletes generally strain their muscles more than the rest of us, they're usually well conditioned enough that their muscles are less likely to suffer these office-derived overuse injuries. Spend some time strengthening your back, neck, and core, and your body will thank you.
Unfortunately, the problem may simply be a common consequence of the modern lifestyle.
"We're not designed as humans to be sitting in front of a computer all day, we need to be active," says Kim. "You may think that inactivity doesn't cause pain, but it causes a lot of pain."
This post is part of a continuing series that answers all of your "why" questions related to