A “crick in the neck” is the common term for acute torticollis, a sudden onset of pain and stiffness often caused by a muscular spasm in the neck. This condition frequently occurs overnight due to awkward sleeping positions or a sudden, unguarded movement, resulting in the head being held at a painful, rotated angle. Finding a position to rest or sleep without aggravating the spasm is crucial for recovery. Maintaining a neutral spinal alignment minimizes strain on the inflamed muscle tissue and helps reduce pain.
Recommended Positions for Minimal Strain
The primary goal when lying down with a neck spasm is achieving and maintaining a neutral spine. Sleeping on your back is frequently the most effective position to achieve this alignment, as it allows the entire spine to rest in its natural curve. When lying supine, use a relatively thin pillow to avoid pushing the head forward, which can flatten the neck’s natural lordotic curve.
To provide targeted support, consider placing a small, tightly rolled hand towel or a very thin pillow directly under the curve of the neck, rather than fully supporting the head with a thick cushion. This setup ensures the head rests slightly lower than the neck, keeping the cervical vertebrae in a relaxed, anatomical position. The head should be supported just enough to prevent extension, but not so much that the chin tucks toward the chest.
If side sleeping is the only comfortable option, it is important to use a pillow with sufficient height to fill the gap between the ear and the outer edge of the shoulder. This elevation is necessary to keep the head level with the rest of the spine, preventing the neck from bending downward and stretching the painful muscles. When side sleeping, try to lie on the side opposite the one experiencing the most intense pain to avoid direct compression of the affected structures.
Entering and exiting the bed should be done slowly, using a technique known as log-rolling to prevent sudden, twisting movements of the neck. To get up, bend your knees, roll your entire body onto your side, and then use your arms to push yourself up to a seated position while keeping your neck stable. Sleeping on your stomach is the least recommended position, as this forces the head into a full rotation, which severely strains the cervical ligaments and muscles.
Optimizing Neck Support Systems
The right support system complements proper body positioning, ensuring neutral alignment is maintained throughout the night. Pillow selection must be based on loft, as this directly affects the neck’s angle relative to the mattress. Side sleepers require a higher loft, generally five to seven inches, to bridge the gap between the head and the mattress created by the shoulder.
Back sleepers need a lower to medium loft, usually four to five inches, to support the natural curvature without causing the head to flex too far forward. Specialized cervical pillows are helpful, as they feature a contoured design with a depression for the head and a raised bolster to cradle the neck. These designs, often made from memory foam, help maintain the cervical curve and reduce muscle tension by evenly distributing pressure.
If a specialized pillow is unavailable, a temporary cervical roll can be fashioned from a small hand towel or t-shirt, rolling it tightly and slipping it into the pillowcase at the bottom edge. This provides focused support to the neck’s curve while allowing the head to rest on a flatter surface. The firmness of the mattress also influences neck alignment; a mattress that is too soft can cause the body to sink unevenly, pulling the shoulders and hips out of alignment and indirectly placing strain on the neck.
Gentle Preparation and Safety Guidelines
Taking a few preparatory steps before lying down can help relax the area and make finding a comfortable position easier. Applying heat or ice to the painful area for 10 to 15 minutes before bed can temporarily reduce muscle spasm and inflammation. Heat can promote blood flow and muscle relaxation, while ice can numb the pain and decrease local swelling.
Gentle, pain-free range-of-motion exercises, such as slow chin tucks or shoulder blade squeezes, may be performed, but only if they do not increase the existing pain. The goal of these movements is to encourage minor mobility without stressing the inflamed tissue. Any movement that causes a sharp increase in discomfort should be immediately stopped.
While most cricks in the neck resolve with self-care and proper rest, some warning signs require immediate medical evaluation. Seek professional help if the pain is accompanied by symptoms of neurological compromise, such as numbness, tingling, or weakness that radiates down into the arm or hand. Other concerning symptoms include pain severe enough to wake you from sleep, a high fever, or pain that does not begin to improve within a few days of conservative management.