Dr. Andrew Crellin – West Warwick
After 30 years of treating neck and back pain, you might expect that I’ve heard some good stories regarding how people manage to hurt themselves. Make no mistake—many of them are exactly what you would expect. Motor vehicle crashes where people are most often rear-ended, resulting in soft tissue injuries to the spine, shoulder, wrists and knees, as well as the occasional concussion. There are also lifting injuries wreaking havoc on the muscles and discs of the low back, and, of course, sports injuries that damage the cartilage, muscles and tendons. All of these come with a story of action and consequence. People often know what they did or what happened to them, and so they can understand why they can’t move without pain.
However, one of the most common stories I hear is “I don’t know what happened; I just woke up with it.” They are generally unhappy not knowing what terrible thing has happened to them to cause such pain, for if they could understand what they did, they would not do it again, and thus avoid this most uncomfortable experience. Plus, it is anti-climactic, anti-dramatic and does not adequately convey the level of discomfort the individual is experiencing.
The conversation goes like this:
“You look terrible. What happened?”
“I don’t know. I just woke up with this awful pain and I can’t turn my neck.”
“That’s too bad. So we are still on for lunch, right?
Unless you had this happen to you, you probably don’t get it. So what does happen to these poor individuals during the night to causing such a crappy morning?
Have you ever seen those time elapsed films of people sleeping? People move all over the place; they twist, turn, and roll all over the bed. Some folks are worse than others and you know who you are. All that motion serves a purpose. For one thing, it stops us from settling into one position for too long, putting us at risk of getting bed sores (Decubitus Ulcers). This can happen very quickly and people on prolonged bed rest or in wheelchairs have to be ever on their guard in order to prevent this from happening.
Another reason for all that movement is to prevent prolonged stress on any one internal tissue over an extended period of time. Tissue damage can happen all at once, as in a motor vehicle crash, or it can happen very slowly where a small amount of stress over a longer period of time will cause soft tissues to deform. This is called the creep effect. As tissues (muscles, ligaments, tendons, and joint capsules) lengthen under a prolonged load, they can lose their ability to stabilize the joints of the spine. They get sloppy. Upon waking, you lift your head and because of the deformed tissue that was supposed to tell your nervous system to prepare for that movement, the neurologic feedback mechanism misfires, the movement is not coordinated, and you pinch a bit of sensitive tissue between two hard, bony surfaces. This of course hurts like @!#$ and consequently your muscles go into a true spasm in order to protect the tissues from any further damage. And there you have it: joint pain and muscle spasm.
Of course there are variations of this scenario. People who sleep on their stomach are often prone to this because of the backward bending moment on their lumbar spine, which causes a constant pressure on their facet joints and does not allow an opportunity for the disc to rehydrate. In addition, there is the twisting effect on your neck as you turn your head to the side (in order to breath), which stresses and compresses the joints and soft tissues.
Some people fall asleep on the couch, or crank their neck up on the armrest in a forward-bent position to read or in a side-bent position to watch TV;. it’s only a matter of time before something bad happens.
The good news is that these conditions are effectively treated in a chiropractic office with soft tissue work including massage, stretching and spinal adjusting. Massage and stretching address the tight muscles and the adjusting corrects the joint misalignments and restrictions. Although the pain can be severe, when managed correctly, it often resolves within 7 to 10 days and relief usually happens with the initial treatment.
Sleep safely my friends.
Dr. Andrew Crellin is both a physical therapist and Doctor of Chiropractic. He is a past president of the Chiropractic Society of Rhode Island and is currently on staff at Women and Infants Hospital. Dr. Crellin utilizes skills sets from both PT and chiropractic in treating his patients. He can be reached at 821-6091.