Neck stuck in sleep on one side. Clinical case

Neck stuck in sleep

Male 28 years old, office worker. Complains of stuck neck pain on one side: severe pain when trying to turn his head to the left, to a lesser extent to the right. The problem started about a week ago, in sleep after waking up, with constantly increasing symptoms. Denied any injuries or sudden movements, this was the first time it had happened.

Objective examination: patient of normosthenic build, not pronounced stooping and forward position of the head. The amount of movement in the left side of the neck is almost completely absent (no more than 10°), limited by sharp and severe pain in the left side of the neck. Turning to the right about 35-40°, also causes pain on the left side. Flexing forward causes pain localized in the inferior cervical region. The paravertebral and supravertebral muscles on the left are painful on palpation, but less than one would expect. Mobilization of the 4-5 vertebral-motor segment allows for painless rotation.

Diagnosis: functional joint blocks and paravertebral muscle spasm of the mid-cervical region. Judging by the history and clinical picture of discogenic origin.

Treatment: mild and painless mobilization of the mid-cervical segments in the rotation direction, which ensured almost complete elimination of painfulness when turning the head to the left and right. Deep tissue massage for the paravertebral muscles. Elimination of mobility restrictions in the medial cervical spine which eliminated pain when tilting the head forward.

Results: after the first session head rotation to the left was restored up to 45° with significant pain reduction. After the second session - full range of motion with phenomena of residual painfulness but the neck is no more stuck. The patient was given recommendations regarding ergonomics, suggested independent exercises for maintenance of normal mobility, correction of forward head position and slouching.

Stuck neck pain on one side. Conclusions.

We are dealing with a fairly commonly observed disorder. My assumption about the discogenic cause of these functional disorders is based on the symptoms and the course of typical problems but requires additional verification using instrumental methods of examination, if necessary. In any case, as was said and patient, of great importance are the long-acting harmful factors that led to the fact that the head does not turn, and their elimination. These are primarily posture (the mentioned slouching and forward position of the head) and ergonomics (habitual postures and movements at work and at home).