Dear TAI Experts:

This is the third time in about eight years that I have woken up with debilitating neck pain. I haven’t been in any crashes and cannot think of any trigger.

I can hardly get out of bed and must hold my head straight to stand up. Once standing I can only move my head a slight bit left, right, up, down, etc, without intense pain. Ibuprofen and heat loosen it up but not enough to function properly. After about five days it subsides, but I cannot return to sports until almost two weeks. The first time this happened, I saw a chiropractor and massage therapist and both said I had poor posture and stress but could not say what brought this about suddenly and with such severity. I woke up yesterday with the same thing. What should I do and how can I prevent this? Thanks!


Without doing an examination I am unable to comment specifically on your neck pain, but I can make some general statements that may help. Sudden onset of neck pain that comes without any specific injury and is worse in the morning can be the result of inflammation. Inflammation can be caused by irritation of discs, joints, or other neck tissues. This inflammatory process can be caused by poor posture, muscle length imbalance(s), poor body mechanics or ergonomics, and muscle weakness. The inflammatory process frequently takes 10 days to resolve. Early management for a flare-up may include gentle motion within a pain-free range of motion, arm and lower body exercise, use of a cold pack for 10-20 minutes periodically throughout the day, and a gradual return to currently painful activity. Healthy, long-term strategies generally include making sure that the neck is in neutral while sleeping and using proper body mechanics during activity. It may even include a preventative exercise program. A physical therapist would be able to examine your neck and help you develop a treatment program that might include ergonomic education and therapeutic exercise, as well as hands-on treatments to the joints and muscles. Frequently this helps prevent or minimize future occurrences of this problem.

If you have any of these additional signs I would recommend returning to the doctor, as they are signs of more severe dysfunction:

1. Fever/nausea/vomiting

2. Numbness and/or tingling in both arms and legs or face

3. Loss of bowel or bladder function

4. Severe headache/dizziness/blurred vision

Matthew Rogers PT, DPT