From Anne Asher,
Your Guide to Back & Neck Pain.
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Who hasn't woken up with a painful "crick in the neck", perhaps after a sleepless night? Is it anything to worrry about?

A. 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 the neck" is something they wake up with after a night of awkward pillowing or body positioning.

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, Daniel Riddle, PT, PhD and Professor 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.

What Should You Do for the Crick in Your Neck?
If you wake up with a crick in the neck and you have not had a serious neck injury previously, there are a number of at home therapies you could try. These include ice and/or heat, massage and more. But it's important to go easy on the area in the first few days at least, to avoid making it worse. If the pain persists for longer than a week, or it disrupts your functioning, Dr. Thomas suggests getting it checked by a doctor. There are other signs you need medical attention for your neck or back, as well.

_{Sources:
Andre Panagos, M.D., Spine Center, New York-Presbyterian Hospital. personal interview. March 2008.
Santhosh Thomas, M.D, Westlake Spine Center, Cleveland Clinic. personal interview. March 2008.
Daniel Riddle, PT, PhD, professor at Virginia Commonwealth University. personal interview. March 2008.}