, Gloucester, MA

March 22, 2013

Neck locked? What you should know

On the Mend
Joe DiVincenzo

---- — If you find that you typically have a stressful life, wake in the morning sore or engage in vigorous physical activity over the course of the day, there’s a good chance you’ll end up with a crook in the neck.

Sometimes called wry-neck, a sudden neck-lock that can be quite unpleasant. Facet joints, which are joints lining the sides of your neck, are subjected to various physical stresses that may cause a sudden “locking,” thus preventing you from turning or bending your neck.

They’re notoriously painful and can be equally as debilitating if left untreated for lengths of time. So while most cases resolve without formal treatment, they are something that needs monitoring to ensure that it isn’t getting out of hand.

So if you’re having neck pain or if you’re having trouble turning your head to see oncoming traffic, it might be a good idea to read about the signs and symptoms to see if you should get checked out.

Neck locks usually affect one side at a time. The whole neck will feel stiff, but a lock produces a sharp, movement-arresting pain when turned in the direction of the lock. As a general observation, most patients who have a facet lock can turn their head about 45 degrees toward the restriction before pain sets in.

Common household tasks you take for granted will be difficult. This includes holding the phone to your shoulder with your ear, looking behind you or lifting your head up to shave. All of the items on that checklist involve compressing the sensitive facets together. If there’s any inflammation or irritated tissue present, you’ll know about it soon.

Facet locks are most common in the mid and lower portions of the cervical spine. The mid and lower facet joints are most prone to arthritic wear and tear — one of the main causes of joint locking. Pain that originates behind the ear or higher up in the neck is likely not a facet joint and may require a different form of conservative therapy.

Neck locks do not refer pain into the arms or shoulder blades. Those symptoms are more closely associated with a pinched nerve than they are a neck lock and are treated with different exercises, mobilizations and modalities. As a general rule, pain that spans multiple regions should be evaluated at the first available opportunity.

Your headaches could be coming from your neck but probably not from a facet lock. Facets tend to refer down, not up. Anything that refers pain into the head typically has a strong neural component to it — a component that is almost invariably absent in wry-neck conditions such as facet locks.

If you wake with it, your pillow is a likely culprit. While many people have a particularly strong attachment to what they rest their head on at night, the quickest fix may lie in getting some more support underneath you. A lumpy, collapsible pillow can be as much a cause of neck locks as any other factor, so don’t be afraid to trade up — it may fix the problem in as little as a night or two.

A locked-neck will respond excellently to mobilizations and manipulations performed by a physical therapist or chiropractor. Once the pressure has been alleviated from the joint, it should begin to heal and the pain will subside shortly after.

Gloucester resident Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes “On the Mend” weekly. Questions may be submitted by email to