Neck crepitus + Upper Back Pain (What to/not do before seeing a doctor)
March 30, 2023 12:12 PM Subscribe
I have scheduled a visit with a specialist, but that won't be for almost two weeks. Looking for any advice from people who have experienced something similar on what to do (or what not to do) between now and seeing the doctor. More details below the fold.
I went for an easy 3 mile hike on Monday, and noticed during the hike frequent cracking and popping noises, which sound a lot like the description of neck crepitus. By the end of the hike, my neck/upper back felt in pain. I doubt it was anything that happened on this hike - it's a very easy trail I've done countless times.
I've been doing a bit more yoga than usual, though I've been gradually building up to this, or at least I thought I was. Not doing anything particularly advanced, but certainly doing my share of back bends. I forget what I did Sunday (the day before I noticed the pain). In the last week, I also went for a short (1mile) jog for the first time in awhile, but I really just felt that in my legs towards the end of the jog.
Currently: pretty constant pain in my upper back - based on my amateur look at a muscle chart, I'm guessing my right trapezius in particular is sore. It hurts standing, sitting, etc. Turning my head to look in either direction generally results in various pops/crackling noises (though very small turns don't always do this), but this doesn't cause more pain per se. I'm bad at estimating pain levels, but I guess I'm a 3/10? It's not terrible, but it also doesn't feel great. Not impacting my sleep though.
Anyway, I realize best thing is to wait for a doctor to assess this, but I'm wondering if in the meantime if there is any particularly position I should be avoiding during the day (I work mostly from home so can do whatever the body needs), best sleeping position, etc. And if there are any low-risk stretches or massage techniques. Thanks.
I went for an easy 3 mile hike on Monday, and noticed during the hike frequent cracking and popping noises, which sound a lot like the description of neck crepitus. By the end of the hike, my neck/upper back felt in pain. I doubt it was anything that happened on this hike - it's a very easy trail I've done countless times.
I've been doing a bit more yoga than usual, though I've been gradually building up to this, or at least I thought I was. Not doing anything particularly advanced, but certainly doing my share of back bends. I forget what I did Sunday (the day before I noticed the pain). In the last week, I also went for a short (1mile) jog for the first time in awhile, but I really just felt that in my legs towards the end of the jog.
Currently: pretty constant pain in my upper back - based on my amateur look at a muscle chart, I'm guessing my right trapezius in particular is sore. It hurts standing, sitting, etc. Turning my head to look in either direction generally results in various pops/crackling noises (though very small turns don't always do this), but this doesn't cause more pain per se. I'm bad at estimating pain levels, but I guess I'm a 3/10? It's not terrible, but it also doesn't feel great. Not impacting my sleep though.
Anyway, I realize best thing is to wait for a doctor to assess this, but I'm wondering if in the meantime if there is any particularly position I should be avoiding during the day (I work mostly from home so can do whatever the body needs), best sleeping position, etc. And if there are any low-risk stretches or massage techniques. Thanks.
I have spinal cord damage from C4-C7, and this is my advice until you see a doctor: no bikes, no backbends, no chiropractors, no massages. Try sleeping flat with no pillow at all. Muscle tightness could be making a neck injury worse with tension, so try Voltaren Gel on your shoulder muscles-- that might help. Try ice and heat when the pain is at its worst.
You CAN do a Turtle Stretch, which gently stretches all of your cervical muscles. If it doesn't hurt, you can do it all you like. If it does hurt, stop! And don't do it any more until you see your doctor!
Basically, if you have impingement on a nerve or the spinal cord, anything you do to hyperextend your neck forward or back, can make it worse. So until you can see the doc, be gentle with your cervical spine. Hopefully, it's just a nerve thing and it can be fixed easily!
posted by headspace at 1:01 PM on March 30, 2023 [1 favorite]
You CAN do a Turtle Stretch, which gently stretches all of your cervical muscles. If it doesn't hurt, you can do it all you like. If it does hurt, stop! And don't do it any more until you see your doctor!
Basically, if you have impingement on a nerve or the spinal cord, anything you do to hyperextend your neck forward or back, can make it worse. So until you can see the doc, be gentle with your cervical spine. Hopefully, it's just a nerve thing and it can be fixed easily!
posted by headspace at 1:01 PM on March 30, 2023 [1 favorite]
I occasionally take a Valium before bed for neck and shoulder muscular pain and it makes all the difference in the world. YMMV.
posted by DarlingBri at 1:19 PM on March 30, 2023
posted by DarlingBri at 1:19 PM on March 30, 2023
Best answer: Uh, to me I would have assumed that is tight muscle pain in my shoulders (I wouldn't have thought it was the spine itself, from description, and I would obviously be more careful if there had been any unusual motions or impact or falls, but it doesn't sound like there was?).
I get crepitus sounds when the muscles are tight and in pain, because the muscles are pulling things just sliiiightly out of alignment, and so when things move, that creates the slight vacuum when things go into their full range of movement that creates the popping noise, which is kind of a good sign because it is things actually going more into the places they should be -
But if the muscle isn't relaxed, it'll create that slight pull meaning it will repeat again very rapidly.
So I need to relax the muscles. A hot bath and a shoulder massage from someone who really knows what they're doing does help me a lot in this instance.
If you really think it's anything to do with the spine, then stay away from the spine, but massaging the big shoulder muscles and trapezius, and on the other side, the pectorals (people don't notice/think to go for these, but tension here causes compensatory tension in the shoulders/traps!), and this is well out of the way.
So yeah, gentle shoulder/traps/pectoral massage, with hot soak, & sometimes some extra magnesium helps encourage muscle to relax.
posted by Elysum at 2:28 PM on March 30, 2023 [4 favorites]
I get crepitus sounds when the muscles are tight and in pain, because the muscles are pulling things just sliiiightly out of alignment, and so when things move, that creates the slight vacuum when things go into their full range of movement that creates the popping noise, which is kind of a good sign because it is things actually going more into the places they should be -
But if the muscle isn't relaxed, it'll create that slight pull meaning it will repeat again very rapidly.
So I need to relax the muscles. A hot bath and a shoulder massage from someone who really knows what they're doing does help me a lot in this instance.
If you really think it's anything to do with the spine, then stay away from the spine, but massaging the big shoulder muscles and trapezius, and on the other side, the pectorals (people don't notice/think to go for these, but tension here causes compensatory tension in the shoulders/traps!), and this is well out of the way.
So yeah, gentle shoulder/traps/pectoral massage, with hot soak, & sometimes some extra magnesium helps encourage muscle to relax.
posted by Elysum at 2:28 PM on March 30, 2023 [4 favorites]
Magnesium is a muscle relaxant. If muscle tightness is cause or contributing it could help with that, if not, the main adverse effect is that it can loosen your stool if you take too much. My GP recommended I try magnesium before going on prescription muscle relaxant. I was told to increase the dose until it does that and then dial back a bit. I find it goes a long way to loosening my back and neck when I feel them tightening.
posted by koahiatamadl at 4:03 PM on March 30, 2023 [1 favorite]
posted by koahiatamadl at 4:03 PM on March 30, 2023 [1 favorite]
You can get heating pads for your neck and shoulders or upper back that might help.
posted by ellieBOA at 4:15 PM on March 30, 2023 [1 favorite]
posted by ellieBOA at 4:15 PM on March 30, 2023 [1 favorite]
Response by poster: Thanks for all the answers so far, that's interesting that the crepitus sounds might be coming from the upper back muscles - I definitely haven't had any falls or injuries, but I guess I can't be confident I didn't do something without realizing it during a yoga practice. Really, I'm a bit mystified since while I have had occasional upper back pain from bad posture in the past, but in the last couple of years I've generally improved and gotten better about taking breaks from sitting and what not. And I've never experienced crepitus sounds when moving neck as consistently as recently - I found them distracting when doing that short hike. Anyway, I'll try some magnesium and sleeping without a pillow for a few nights.
posted by coffeecat at 4:40 PM on March 30, 2023
posted by coffeecat at 4:40 PM on March 30, 2023
If it were me, I would be avoiding things that cause me to keep tension in me muscles. In my case, this would include caffeine and refined sugars.
posted by aniola at 5:29 PM on March 30, 2023
posted by aniola at 5:29 PM on March 30, 2023
Best answer: Sorry, to clarify -
This is from personal experience, as I have fairly noisy joints, as I have a bit of hyperflexibility. Snap crackle pop, and sometimes I ask if people could give me a tight hug juuuust... *here* (where I can already feel its out slightly) and they freak out at the pop noise, so clearly this isn't a thing everyone experiences constantly.
So the popping noises *are* coming from the joints/spine etc, (it's called 'joint cavitation', look up diagrams), but that doesn't explain why joint cavitation *happens*.
So if I understand this correctly, it is when the joints have an amount of space that isn't usual for them and that creates a slight vacuum, and then when it moves enough that collapses creating a popping noise. And apparently sometimes there's microadhesions as well?
I get the impression sometimes this noise is because people have gone *past* normal range of motion, like cracking knuckles (I actually don't ever get this or do this), or -
what I was talking about - it's also really common when you're doing something that should have been in your normal range of motion, but! Your muscles are tight enough on one side that they have been pulling your joints just sliiiightly out of place, enough to create that vacuum, and then snap noise when you move and the joint *does* fit exactly where it should be.
So you usually get that popping noise when the joint is kind of 'popping back into place' (that is kinda what it feels like, and why people say that casually, but to be clear, I'm not talking about a full joint dislocation here of course! Just that a moveable stretchy joint is at a slight angle to what it should be, and apparently joint cavitation is the popping noise from the vacuum that produces - sometimes I can feel it going back into the perfect place without any noise, the noise is just frequent, but not always present side-effect/symptom of the movement causing joint to have more normal spacing/angle/range of movement etc).
So y'know, obviously chiropractors are often making that popping sound all the time when they're putting a joint into the normal range of motion that it should already have? *But* why chiropractors often aren't great - even in my country where it's way more science based and less kooky than in the US (I know there's a whole thing there where it's drifted further from accepted science there, even for joints which is what they're specialising in??) ok, so while sometimes just getting back into the alignment the joints should have, causes the tense muscles around those joints to relax, in which case, problem solved, nothing further to do.
However, other times, a say, chiropractor will just manually move the joint into the motion it should have, it clicks, there's a brief feeling of relief, cool, but if it was caused by muscle tension, then they don't actually massage or treat the tense muscles around that joint, which means in a *very* short space of time, the muscles are pulling you out, and the process needs to be repeated.
So, given that you *have* constant popping noises already, when you are in what should be normal modem movement, that's why I was suggesting to leave the spine and neck alone until a specialist can look at it, but see if it's just tight muscles along shoulders that are pulling you out of whack and therefore causing the joint cavitation.
If relaxing the tight shoulder muscles, pecs etc, resolves the problem, or 90%of the problem because you've been working just the big muscles further from the spine, then you know that was the cause.
For me, when I'm getting constant neck popping noises, it's because the muscles are causing it for me.
If if doesn't resolve it, then you've only been working on the big muscles, and haven't interfered with anything a specialist would be looking at.
Hope that's slightly clearer?
posted by Elysum at 6:15 PM on March 30, 2023 [2 favorites]
This is from personal experience, as I have fairly noisy joints, as I have a bit of hyperflexibility. Snap crackle pop, and sometimes I ask if people could give me a tight hug juuuust... *here* (where I can already feel its out slightly) and they freak out at the pop noise, so clearly this isn't a thing everyone experiences constantly.
So the popping noises *are* coming from the joints/spine etc, (it's called 'joint cavitation', look up diagrams), but that doesn't explain why joint cavitation *happens*.
So if I understand this correctly, it is when the joints have an amount of space that isn't usual for them and that creates a slight vacuum, and then when it moves enough that collapses creating a popping noise. And apparently sometimes there's microadhesions as well?
I get the impression sometimes this noise is because people have gone *past* normal range of motion, like cracking knuckles (I actually don't ever get this or do this), or -
what I was talking about - it's also really common when you're doing something that should have been in your normal range of motion, but! Your muscles are tight enough on one side that they have been pulling your joints just sliiiightly out of place, enough to create that vacuum, and then snap noise when you move and the joint *does* fit exactly where it should be.
So you usually get that popping noise when the joint is kind of 'popping back into place' (that is kinda what it feels like, and why people say that casually, but to be clear, I'm not talking about a full joint dislocation here of course! Just that a moveable stretchy joint is at a slight angle to what it should be, and apparently joint cavitation is the popping noise from the vacuum that produces - sometimes I can feel it going back into the perfect place without any noise, the noise is just frequent, but not always present side-effect/symptom of the movement causing joint to have more normal spacing/angle/range of movement etc).
So y'know, obviously chiropractors are often making that popping sound all the time when they're putting a joint into the normal range of motion that it should already have? *But* why chiropractors often aren't great - even in my country where it's way more science based and less kooky than in the US (I know there's a whole thing there where it's drifted further from accepted science there, even for joints which is what they're specialising in??) ok, so while sometimes just getting back into the alignment the joints should have, causes the tense muscles around those joints to relax, in which case, problem solved, nothing further to do.
However, other times, a say, chiropractor will just manually move the joint into the motion it should have, it clicks, there's a brief feeling of relief, cool, but if it was caused by muscle tension, then they don't actually massage or treat the tense muscles around that joint, which means in a *very* short space of time, the muscles are pulling you out, and the process needs to be repeated.
So, given that you *have* constant popping noises already, when you are in what should be normal modem movement, that's why I was suggesting to leave the spine and neck alone until a specialist can look at it, but see if it's just tight muscles along shoulders that are pulling you out of whack and therefore causing the joint cavitation.
If relaxing the tight shoulder muscles, pecs etc, resolves the problem, or 90%of the problem because you've been working just the big muscles further from the spine, then you know that was the cause.
For me, when I'm getting constant neck popping noises, it's because the muscles are causing it for me.
If if doesn't resolve it, then you've only been working on the big muscles, and haven't interfered with anything a specialist would be looking at.
Hope that's slightly clearer?
posted by Elysum at 6:15 PM on March 30, 2023 [2 favorites]
I agree with all the advice to be careful with what movements you do until you can see a doctor.
For upper back/neck/shoulder pain, I've found mobilizations much more helpful than massage or muscle relaxants. The idea is to do lots of repetitions of gentle movements, keep the movement small enough that you can do it pain free. I've found relief moving my head side-to-side (like shaking your head no) 50 repetitions several times a day.
Here's a website with more information and a list of mobilizations: https://www.painscience.com/articles/mobilizing.php
posted by orchidee at 1:31 AM on March 31, 2023 [2 favorites]
For upper back/neck/shoulder pain, I've found mobilizations much more helpful than massage or muscle relaxants. The idea is to do lots of repetitions of gentle movements, keep the movement small enough that you can do it pain free. I've found relief moving my head side-to-side (like shaking your head no) 50 repetitions several times a day.
Here's a website with more information and a list of mobilizations: https://www.painscience.com/articles/mobilizing.php
posted by orchidee at 1:31 AM on March 31, 2023 [2 favorites]
Best answer: I am not a doctor, I am not your doctor, be careful, etc. Your pain is similar enough to pain I’ve experienced that I felt it was worth sharing what I’ve learned.
There’s a very small muscle called levator scapulae (lev scap for short) that stretches from the corner of your shoulder blade up your neck to the base of your skull. It normally isn’t supposed to carry heavy loads for a long time — it s just a little guy that helps to lift the shoulder blade and stabilize the spine — but the activities we do can put a lot of stress on it. If you’re spending long periods of time with your shoulders a bit hunched and your head hanging down, (like when you’re looking at your phone, using a laptop sitting on a desk, wearing a hiking backpack and looking down a lot), then your lev scap may be in under a lot of strain (you’re asking it to be “long and strong” instead of “compressed and strong” the way our muscles are mostly designed to work). And again, because we’re often in this position all dang day, just a little extra can sometimes push us over the edge.
If any of this sounds like you, you might try some of the things that have helped me.
1. Ergonomics. Get a laptop stand and an external keyboard so you can put your screen at an ergonomic height. Elevate your monitor to an ergonomic height. Take a break from looking at your phone in that hunched position for a while (for instance, watching movies on your phone). Take a break from anything else that might put you in that hunched position (some yoga might do it; backpacking might do it).
2. Stretch your pecs, not your back. If you’re suffering in that hunched position, your pecs are probably really tight and lev scap is probably way too stretched already. By stretching your pecs, you can fight the hunch and give lev scap a break.
3. Gentle mobilization (be careful with this one if it seems like it’s giving you pain). Shoulder circles in one direction then another, looking a little left then a little right, etc. Gently, gently.
I hope that’s useful! If you pick just one thing to try, I’d make it the ergonomics — For me, just getting my laptop off of my desk made a HUGE difference in my neck and back pain. Spending 8-12 hours a day in an ergonomic vs. non-ergonomic position was a life-changer.
posted by ourobouros at 3:52 AM on March 31, 2023 [3 favorites]
There’s a very small muscle called levator scapulae (lev scap for short) that stretches from the corner of your shoulder blade up your neck to the base of your skull. It normally isn’t supposed to carry heavy loads for a long time — it s just a little guy that helps to lift the shoulder blade and stabilize the spine — but the activities we do can put a lot of stress on it. If you’re spending long periods of time with your shoulders a bit hunched and your head hanging down, (like when you’re looking at your phone, using a laptop sitting on a desk, wearing a hiking backpack and looking down a lot), then your lev scap may be in under a lot of strain (you’re asking it to be “long and strong” instead of “compressed and strong” the way our muscles are mostly designed to work). And again, because we’re often in this position all dang day, just a little extra can sometimes push us over the edge.
If any of this sounds like you, you might try some of the things that have helped me.
1. Ergonomics. Get a laptop stand and an external keyboard so you can put your screen at an ergonomic height. Elevate your monitor to an ergonomic height. Take a break from looking at your phone in that hunched position for a while (for instance, watching movies on your phone). Take a break from anything else that might put you in that hunched position (some yoga might do it; backpacking might do it).
2. Stretch your pecs, not your back. If you’re suffering in that hunched position, your pecs are probably really tight and lev scap is probably way too stretched already. By stretching your pecs, you can fight the hunch and give lev scap a break.
3. Gentle mobilization (be careful with this one if it seems like it’s giving you pain). Shoulder circles in one direction then another, looking a little left then a little right, etc. Gently, gently.
I hope that’s useful! If you pick just one thing to try, I’d make it the ergonomics — For me, just getting my laptop off of my desk made a HUGE difference in my neck and back pain. Spending 8-12 hours a day in an ergonomic vs. non-ergonomic position was a life-changer.
posted by ourobouros at 3:52 AM on March 31, 2023 [3 favorites]
This thread is closed to new comments.
The strategist has some recommendations.
posted by CleverClover at 12:46 PM on March 30, 2023 [1 favorite]