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A Pain in the Neck

At least once in your life you will experience with an acutely painful blocked neck. Often this occurs on wakening or a few minutes later. If you know what to do, in most cases you can fix this yourself.

In acute neck strain, the neck becomes suddenly blocked, unable to move in one or more directions. The most usual reason for this is a sudden catch within one of the tiny spinal joints of the neck. The surfaces of these joints between one vertebra and the next are meant to lie parallel to each other. For whatever reason, a jolting movement such as in a dream, suddenly lifting your head off the pillow, or moving around in the shower can cause one of these joints to move awkwardly.

Local muscles respond by doing what they are designed to do; they go into spasm to prevent damage or injury. The idea is that the muscle spapm over-rides motion and stops further injury. When a muscle cramps, the fibres of the muscle work in a sustained fashion until the cramp releases.

Though the underlying neck problem is a joint, dealing with the muscle cramp as a first strategy is best for relieving pain.

As any muscle works it needs blood flow through. Blood in and out is like fuel for the muscle. While the muscle is in spasm the amount of blood flowing in and out of the muscle is severely restricted as the cramp reduces the size of the blood vessels, preventing more blood from helping the process recover. Residual toxins, by-products of muscle work build up in the cramping muscle. The presence of these toxins is what leave the muscle sore for many hours after the cramp ebbs away.

So to relieve pain, you need to do is to get blood flow going again, getting the toxic blood out of the muscle and drawing fresh clean blood in. Just as you would with a leg cramp, simple tactics work. Start by trying to massage the sore region. Though sometimes exquisitely painful at the start, massaging the muscles starts to get blood flow moving and can be enough to kick-start pain relief. It is sometimes easier to ask another person to do the massage, as doing it to yourself can be just too painful.

Another way to deal with spasm is to apply heat or cold to the area for 15 minutes or so. A hot shower trained on the muscle spasm can work wonders, as can a wrapped hot water bottle. Alternatively ice in the form of a wrapped ice pack or a bag of frozen peas, or a proprietary cold sports spray can also assist. Sometimes using a combination of hot and cold one after the other for 10-15 minutes each gives good results.

Don’t delay before taking over –the-counter painkillers or anti-inflammatories. These are worth taking as quickly as possible as often medication can take 20-30 minutes to work.

The next step is to try to move the injured neck joint. This is best performed lying on your back on a bed, sofa or at worst on the floor. The idea is that the weight of the heavy head on the neck in the upright position acts as a compressive force on the already painful neck joints. Lying down removes the weight and the compression, so the small joints of the neck can move less painfully.

Start with small movements, initially rotating away from the pain. Try to count at least 20 repetitions, it gets easier as you do more. As you progress make the rolling movement bigger and bigger, turning into the pain more and more. When this begins to show signs of releasing the blocked joint, sit up and begin to move the ear to the shoulder firstly away from pain and then back towards the painful joint. This movement stretches and relaxes the spasmic muscle so can be extremely sore in the beginning but brings great relief the more you do it.

By now the pain should be coming under control and movement restriction should be letting up.

As with most injuries, the more normally you move the affected region, the faster it returns to right, so even on the day you wake with acute neck strain chartered physiotherapists will often recommend that you go on about your everyday activities. A simple note of caution is to avoiding lifting or carrying heavy objects fro the remainder of the day (don’t carry your laptop, handbag or schoolbag on that side for a day or two). Be careful about prolonged extreme positions of the neck (turn your chair towards a speaker rather than turning your head as you might usually do). It might also be wise to put off contact sports for a day or two as the sore area will be extra sensitive to getting hurt.

Mind your head position in bed the next night so that when you wake next day all signs and symptoms should be like a bad memory!
Mairead O’Riordan, MSc, MISCP is a senior Chartered Physiotherapist & CEO of TherapyXperts, an allied health network dedicated to clinical excellence.
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