Loss of the ability to move the neck normally means that the capsules of the facet joints, sensitive ligamentous bags around the joints, are exposed to the risks of over-stretching. A sudden turn or twist of the head without thinking can lead to the ends of the joint movements being reached, when an overstrain injury and fibre damage happens. Joint pain and increasing joint tightness then follows as the capsules tighten further with the scarring of healing and the neck is held in a guarded position. Increasingly less able to cope with stretching, the stiffness can spread throughout the neck and this only becomes obvious when suddenly we can't do something we want to.
The pain sources from facet joint arthropathy are due to various reasons: the local musculature responds to pain by developing muscle spasm; the local facet joint is suffering from pathological changes and there is referred pain. Localised neck pain, the centre of which is often identifiable by feeling with the fingers, comes from the irritated facet itself while the referred pain is much less clear in nature, expressing itself as a vaguer general feeling of ache in the arm or shoulder. As the neck problems increase it can interfere with important abilities such as sleeping which can lead to side effects such as depression and anxiety.
The facet joint can suffer a sudden, painful and relatively minor injury resulting in what is called an acute wry neck, perhaps from vigorous hair drying with a towel, jarring oneself or looking suddenly round to one side. If we sleep in an odd position for a while we can also wake up with this neck pain problem. The onset is usually quick and unexpected as our facet joint locks as the movement surprises our controlling muscular systems, perhaps spraining the easily irritated facet joint capsule or pinching the synovial membrane between the surfaces. Sudden, intense neck pain from this induces strong spasm of the neck muscles and secondary pain.
An acute wry neck is an unpleasant experience with acute pain on one side of the neck and a loss of neck movement. There may be very strong muscle spasm holding the neck in an odd posture to one side. Careful guarding of movements and avoidance of jarring or sudden motions is evident to avoid any sudden movement which might increase the muscular spasm and the forces of neck compression. It can be a challenge merely to get into and out of, with holding of the head typically needed as the movement down or up is performed to minimise muscle activity in the neck.
An osteopath, physiotherapist or chiropractor can manipulate a locked facet joint early on in the problem with complete relief in some cases. The mechanism may be that the separation of the joint surfaces by the manipulation allows the realignment of the joint or releases the trapped tissue. More often the time to recovery is longer with anti-inflammatories and painkillers necessary for some days until the pain reduces and movements can be restarted. A less severe therapy technique, joint mobilisations, can be used later to clear the joint of any long-term abnormalities of its movement which could make the pain come back again later.
A fast onset of neck pain is not always due to facet lock but can, with a gradual onset taking several days, be indicative of a disc related or inflammation related nerve root insult. An initial facet joint injury may in some cases not settle down well, allowing fluid to collect around the nerve root exit from the spinal canal which slowly thickens and forms into scar tissue and can stick down the nerve to the surrounding structures. Tethering the nerve exposes it to risk of injury due to the fact that nerves are very sensitive to stretch in particular, which can result in an agonising pain syndrome developing in the shoulder, arm and neck.
The most prominent part of the syndrome is often not neck pain, but patients typically recount some warnings from the arm and neck with the joints giving some indications of weakness or transient pains on activities. Bringing on the full blown problem may occur after a trivial activity just happens to stress the nerve in the correct way. - 14130
The pain sources from facet joint arthropathy are due to various reasons: the local musculature responds to pain by developing muscle spasm; the local facet joint is suffering from pathological changes and there is referred pain. Localised neck pain, the centre of which is often identifiable by feeling with the fingers, comes from the irritated facet itself while the referred pain is much less clear in nature, expressing itself as a vaguer general feeling of ache in the arm or shoulder. As the neck problems increase it can interfere with important abilities such as sleeping which can lead to side effects such as depression and anxiety.
The facet joint can suffer a sudden, painful and relatively minor injury resulting in what is called an acute wry neck, perhaps from vigorous hair drying with a towel, jarring oneself or looking suddenly round to one side. If we sleep in an odd position for a while we can also wake up with this neck pain problem. The onset is usually quick and unexpected as our facet joint locks as the movement surprises our controlling muscular systems, perhaps spraining the easily irritated facet joint capsule or pinching the synovial membrane between the surfaces. Sudden, intense neck pain from this induces strong spasm of the neck muscles and secondary pain.
An acute wry neck is an unpleasant experience with acute pain on one side of the neck and a loss of neck movement. There may be very strong muscle spasm holding the neck in an odd posture to one side. Careful guarding of movements and avoidance of jarring or sudden motions is evident to avoid any sudden movement which might increase the muscular spasm and the forces of neck compression. It can be a challenge merely to get into and out of, with holding of the head typically needed as the movement down or up is performed to minimise muscle activity in the neck.
An osteopath, physiotherapist or chiropractor can manipulate a locked facet joint early on in the problem with complete relief in some cases. The mechanism may be that the separation of the joint surfaces by the manipulation allows the realignment of the joint or releases the trapped tissue. More often the time to recovery is longer with anti-inflammatories and painkillers necessary for some days until the pain reduces and movements can be restarted. A less severe therapy technique, joint mobilisations, can be used later to clear the joint of any long-term abnormalities of its movement which could make the pain come back again later.
A fast onset of neck pain is not always due to facet lock but can, with a gradual onset taking several days, be indicative of a disc related or inflammation related nerve root insult. An initial facet joint injury may in some cases not settle down well, allowing fluid to collect around the nerve root exit from the spinal canal which slowly thickens and forms into scar tissue and can stick down the nerve to the surrounding structures. Tethering the nerve exposes it to risk of injury due to the fact that nerves are very sensitive to stretch in particular, which can result in an agonising pain syndrome developing in the shoulder, arm and neck.
The most prominent part of the syndrome is often not neck pain, but patients typically recount some warnings from the arm and neck with the joints giving some indications of weakness or transient pains on activities. Bringing on the full blown problem may occur after a trivial activity just happens to stress the nerve in the correct way. - 14130
About the Author:
Jonathan Blood Smyth is the Superintendent of Physiotherapy at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for physiotherapists in Oxford visit his website.
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