Waking up with a Jerk (in the neck)
Steve Daisey MPT, CSCS

Very often, I see patients who present with an inability to turn the head to one side. This occurs either from a sudden turn of the head, or sleeping in an awkward position.

Patients will often mistake this for a "pinched nerve" when in fact, a part of the neck vertebrae call the facet joint is being pinched. In this case, a small meniscoid or piece of the facet joint capsule has become lodged in the joint and any attempt to turn to this side results in compression of the obstruction.

The sooner this is addressed the better. There are two common techniques that require a skilled maneuver. Both are painless, and very quick.

First, a traction technique can be used to create a gap in the facet joint, allowing the obstruction to fall out. This entails bending away from the obstruction and creating a mild pulling force on the head and neck. If successful, movement will be restored immediately, though there will still be pain throughout the movement as there is swelling within the facet joint. This resolves within 1-3 days generally.

A second technique involves using your own muscles to create a pull on the facet joint capsule. The head and neck are again placed in a less painful position while the patient attempts to turn the head and neck against resistance. The muscle that contracts (called the cervical multifidus) pulls on the joint capsule and helps to yank it out. Again, movement will be immediately restored, but painful for a few days due to swelling.

Both of these techniques can be taught to a patient, but should be tried first by a skilled clinician with experience performing them.

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