You would be surprised how often patients tell me they went to bed feeling fine and woke up with an incredibly stiff and painful neck. Others will claim it was just the slightest movement that caused their neck to freeze in one spot. Whatever the causal factor, acute neck locks (NL) will prevent you from driving or turning your head to look over your shoulder.
An acute neck lock can have a devastating impact on a person's ability to move their head and neck. Neck locks, while painful throughout the entire region, manifest their symptoms predominantly on one side. That side will have less freedom of movement and will certainly be more painful.
In the neck (cervical spine), there are seven joints that guide motion in all directions. Each joint has a lining of special connective tissue that protects it from damage. This lining will begin to wear naturally around the third decade of life, and will ultimately be the cause for loss of motion in the seventh and eighth decades. This process will accelerate in the presence of trauma (usually repetitive trauma), such as multiple car accidents or in persons participating in high-risk sporting activity. Conversely, people who are conscious of their neck health will likely avoid symptoms of this problem altogether.
While there are scores of disorders that cause sudden joint locking in the cervical spine, NL's are most commonly the result of normal joint breakdown — a benign problem that can usually be fixed in a matter of days. The duration of treatment, however, is strongly dependent on the amount of breakdown and the degree to which the vertebral joints are misaligned, so it is conceivable that it is stretched out over the course of a couple weeks to ensure full resolution of the issue.
Stiff necks are easy to recognize, but understanding and deciphering which of the seven joints require treatment involves using a large battery of movement tests. These tests vary from plain head turning to more complex motions directed solely at individual joints.
The nature of the physical testing and treatment, although painful, is the best medium to provide patients with a long-term solution for an acute NL. The most effective form of treatment involves mobilization and manipulation of the cervical spine, into and through the restricted directions.
The difference before and after treatment is remarkable with regards to new range of motion. Most patients can count on near full movement of their neck after a few minutes of skilled mobilization, but there are people that will require several treatments to completely disengage the "stuck" joints and return them to their normal gliding movements.
While the axiom of seeking help sooner rather than later is always recommended, I strongly encourage patients with a history of neck problems to acknowledge the issue and act swiftly — this prevents further joint breakdown at an accelerated rate.
Occasionally, some people will try to "self treat" by moving their neck in all directions, or doing "head rolls" in a fully extended position. Although made in the spirit of recovery, some combinations of these motions will worsen the problem by further entangling and tightening already worn tissue. Alleviation of an acute NL requires a custom-designed program that focuses on the primary restrictions and complaints of the patient.
Acute neck locks are generally uncomplicated injuries that can be fixed with a few sessions of focused passive movement. If you're experiencing sudden sharp pain when moving your head and neck, consult a clinician experienced in mobilization - they'll help you get rid of that "pain in the neck."
Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He works in the outpatient division of Beverly Hospital and writes "On the Mend" weekly.¬ Questions may be submitted to On the Mend, c/o Salem News, 32 Dunham Road, Beverly, MA 01915 or e-mail firstname.lastname@example.org.