Detailed guides to painful problems, treatments & more

All Archived Updates for:

The Complete Guide to Neck Pain & Cricks

This page lists all 136 updates for one book on, The Complete Guide to Neck Pain & Cricks For a more general summary of everything new around PainScience — recent updates for all articles, new articles, blog posts, and new study summaries, see What’s New on

  1. Jan 13, 2022 — Added footnote, “woke up with it” neck pain — Explained and justifed my opinion that morning onset cricks may often be related to the combination of chilling neck skin at night.
  2. Nov 8, 2021 — Science update, dry needling chapter — Almost an echo of last year’s science update on this topic: a second study of needling for neck pain, also quite good, and also quite negative.
  3. Nov 3, 2021 — New red flag — Added “facial numbness,” based on Ugradar et al.
  4. Oct 14, 2021 — New silly treatment, frenuloplasty — Added frenuloplasty to the hall of treatment shame.
  5. Jun 5, 2021 — Improvements, strain-counterstrain chapter — More detail and polish.
  6. Mar 11, 2021 — Upgrades — More and better information, mostly achieved in this case by consolidating information from other books in the PainSci library.
  7. Nov 10, 2020 — New section, positional release — Adapted and expanded from an old chapter in my muscle pain book, with more detail and a neck pain example.
  8. Aug 21, 2020 — Science update, — No obvious changes, but I carefully reviewed and upgraded and fine-tuned some of the referencing in this section. I also added a bit about the history of prejudice against whiplash patients.
  9. Jul 11, 2020 — New chapter, coat hanger pain —
  10. May 22, 2020 — Improved — A thorough editing and cleanup, with some information added, most notably the most positive science on the topic.
  11. May 2, 2020 — Science update, — A nail-in-coffin study of needling for neck pain has been published. I may never have to update this chapter ever again. (Ha, fat chance!)
  12. May 2, 2020 — Added case study — An interesting and credible case study about a clear case of spinal degeneration with counter-intuitive consequences.
  13. Apr 6, 2020 — COVID-19 update — Added information about headaches as a symptom of COVID-19.
  14. Dec 13, 2019 — Science update — Added several interesting details about nerve root compression symptom pattern variability, with references.
  15. Nov 27, 2019 — New section, Muscle relaxants (Robaxin, Robaxacet, etc), psychoactives, and sedatives — Previously coverage of muscle relaxants was limited to a small section of the medications chapter. This new chapter provides about 10x more information.
  16. Nov 22, 2019 — New section, cannabinoids (finally) —
  17. Oct 31, 2019 — Significant revision — To be candid, my comparisons of neck and back pain seemed a little boring and not all that helpful when I reviewed them recently, so I put in some work to make the chapter more useful and interesting.
  18. Oct 18, 2019 — Minor addition — Adding a little information about inversion tables for neck traction.
  19. Jul 23, 2019 — Optimized — A rewrite inspired by recent work on a dedicated article about vulnerability to chronic pain. This chapter is now both shorter and yet actually broader in scope.
  20. Jul 23, 2019 — Science update — Added a citation to Mäntyselkä about the relationship between neck pain and being out of shape.
  21. May 21, 2019 — Science update, muscle pain chapter — Updated references related to the relationship between trigger points and headache.
  22. Apr 26, 2019 — Expanded — Miscellaneous improvements, and I added discussion of the “space making” surgeries (e.g. posterior cervical laminoforaminotomy).
  23. Mar 24, 2019 — Minor upgrade — Added some information about the craving for stretch, its implications, and the problem with trying to stretch the suboccipitals.
  24. Feb 19, 2019 — New section, about reassuring explanations for why neck pain is so common —
  25. Jan 23, 2019 — New section, “The usual suspects: tackling the things that make all kinds of pain worse” —
  26. Dec 15, 2018 — Upgraded — There’s a new sub-section about the role of stress in any kind of chronic pain, and bunch of revision so that the section is more focused on the concept of vulnerability. This is a setup for more practical advice, still to come, about how to attempt to be less vulnerable.
  27. Oct 24, 2018 — Expanded, dry needling chapter — Added quite a lot of information, especially about risks and harms and how needling supposedly works. This is now a fully-fledged topic summary.
  28. Oct 12, 2018 — Major addition, ‘core’ strength section — Added a substantial new sub-topic: “What if it’s about the coordination, not strength/endurance?” And a minor but fun addition about the DCFs being the “psoas of the neck.” Added anatomy diagram.
  29. Oct 9, 2018 — Rewritten — I started over from scratch on the topic of “spasm.” What I’d written previously was much too simplistic. This chapter is now bigger and more interesting.
  30. Sep 27, 2018 — Substantial editing, neuropathy sections — Merged content from the back and neck pain tutorials, resulting in major upgrades to two important sections in both books.
  31. Sep 27, 2018 — Substantial editing, neuropathy sections — Merged content from the back and neck pain tutorials, resulting in major upgrades to two important sections in both books.
  32. Aug 3, 2018 — Complete book edit — Top-to-bottom edit of the book, the first ever. Described in more detail in a blog post.
  33. Aug 1, 2018 — Minor update — Added the revelation that literally all of the very weak studies supporting DCF training are probably fraudulent.
  34. Jul 25, 2018 — New section — A new standard chapter for most tutorials summarizing several key concepts about placebo.
  35. Jun 29, 2018 — New section, “Training the deep cervical flexors” —
  36. Jun 14, 2018 — Revised, ergonomics section — Substantial miscellaneous modernization. In particular, much more useful information on the critical distinction between “poor posture” and “postural stress.”
  37. Jun 1, 2018 — Science update — Added several references about the long term risks of joint popping, a paragraph about the short-term risks, and a citation about what causes joint popping.
  38. Jun 1, 2018 — Revision, spinal manipulation section — Clarified the important distinction between hazard and risk.
  39. May 12, 2018 — New section — More information about dry needling in its own chapter now, a neglected sub-topic; it has always been covered in the companion book about trigger points, but a good summary here in the neck pain book is long overdue.
  40. May 1, 2018 — Revision, microbreaking section — Substantial improvements, harmonizing with the ergonomics revision. Much stronger focus on the scientific case for microbreaking despite the lack of evidence that stagnacy is a problem in the first place. Added a practical tip, and a comic.
  41. Apr 5, 2018 — Upgrade — Added much more detail about the crisis in orthopedic surgeries — very important context — and more detail to the descriptions of surgical options.
  42. Feb 22, 2018 — Major improvements — Extensive new material about the relationship between neuropathy and neck pain, focused on clues that neuropathy is a factor in a case of chronic neck pain.
  43. Feb 14, 2018 — Minor improvement — Added a footnote about the long-term risks of poor neck posture and text neck.
  44. Feb 6, 2018 — Re-write — I threw 90% of this section away and started over with a much stronger focus on the interesting question of whether or not “cervicogenic headache” is even a thing. It’s a like-new section, now with much more useful diagnostic clues.
  45. Jan 8, 2018 — Minor science update — Added some references about the reliability of subluxation diagnosis.
  46. Dec 13, 2017 — Science update — Cited Chumbley et al on traction for neck pain in … fighter jet pilots!
  47. Dec 10, 2017 — New section —
  48. Dec 7, 2017 — Change of position, on diagnostic nerve blocks — After reviewing the same scientific papers previously cited more carefully, I decided that they were much less promising than I originally thought. The section has flip-flopped from optimism to pessimism about nerve blocks without a single change in what’s actually cited, just a change in the level of diligence in interpreting the science. I’ve also added more detail and references.
  49. Dec 2, 2017 — Science update, stretching section — Brought some more science to this discussion, especially Sandler et al on a link between stretching and back pain, and Tunwattanapong et al with modestly good news. Plus a bunch of editing.
  50. Nov 10, 2017 — Upgraded, discussion of massage and nerve trauma — Added much more information about massage “endangerment sites,” discussion of the potential relevance of neuritis, extensive clarifications and editing.
  51. Nov 7, 2017 — Science update — Finally added some basic information about “text neck” — mostly that it’s not actually a thing, and a good example of bogus information about neck pain.
  52. Oct 24, 2017 — Science update — Finally brought a little science to support the claim that trigger points complicate injury. More needed, but it’s a start.
  53. Oct 24, 2017 — Revision, the role of trigger points in neck pain — This section was aging poorly. Reviewing it recently, it seemed too much like I was defensively explaining a pet theory (and I suppose I was). So I’ve done some thorough revision to bring it up to my current standards: less overconfidence, more science.
  54. Sep 22, 2017 — Upgraded, tool massage section — Added some more detailed safety advice and discussion of vibrating massage tools. Removed and de-emphasized a couple tools. Better images. Thorough editing the whole section.
  55. Sep 20, 2017 — New tip — Added a weird bonus strengthening tip based on Smith et al, which showed that clenching leg muscles reduced pain everywhere in patients with chronic neck pain.
  56. Sep 5, 2017 — Science upgrade — More evidence on how much (or little) pain is caused by cervical disc herniations, plus other miscellaneous citations and clarifications. Removed the claim that herniations actually decrease with age — the reference for that was no longer persuasive.
  57. Aug 14, 2017 — Revision — Added an example of SMT injury and a footnote about fearmongering, and then found myself editing the whole section.
  58. Jul 28, 2017 — Minor update — Widespread minor improvements to complete the integration of central sensitization into the book. The neck pain book is now fully sensitive about sensitization!
  59. Jun 20, 2017 — Minor update — Integrated discussion of central sensitization, reframing the “confidence cure” as treatment for central sensitization.
  60. Jun 16, 2017 — Science update, trigger points intro — Light editing, plus a new paragraph and citation to Morikawa et al, an odd little study showing that neck massage is relaxing, or possibly more.
  61. Jun 3, 2017 — Edited, medications section — Several minor miscellaneous clarifications and elaborations, and some additional references.
  62. May 3, 2017 — Revised, section on nerve blocks etc. — Thoroughly revised section and, unfortunately, a reversal from optimism to pessimism about the efficacy of nerve blocks.
  63. Apr 28, 2017 — Expanded — Added important red flag information about artery tears with pain as the only symptom.
  64. Mar 15, 2017 — Revision — Modernization and expansion; added more information about surgical options in particular.
  65. Mar 9, 2017 — New section — Tips and a checklist for trying to estimate how much your neck pain might be about sensitization.
  66. Feb 24, 2017 — Correction — An evidence-based correction regarding computer display position.
  67. Feb 23, 2017 — Big upgrade — Continued to beef up the science of psychological risk factors, and also added much more about other kinds of risk factors. The section almost doubled in size.
  68. Feb 23, 2017 — Science update — Two key new citations to support the idea that the state of muscle tissue is a big factor in neck pain.
  69. Feb 20, 2017 — Science update — A paragraph about genetic vulnerability to persistent neuropathic pain.
  70. Feb 9, 2017 — New section — Substantial new section about sensitization, an important perspective on chronic neck pain.
  71. Feb 1, 2017 — Science update — Solid little science update based on Nakashima et al, showing huge numbers of intervertebral disc bulges in healthy people.
  72. Jan 19, 2017 — Upgraded — Several good red flag clarifications and a couple interesting new references about spinal cord compression.
  73. Dec 31, 2016 — Science update — Significant revision and some important new citations more firmly establishing the link between psychological and lifestyle factors and poor recovery from neck pain. Previously this section relied too much on similar evidence about other problems: it is now more neck-centric.
  74. Nov 27, 2016 — Science update — Added some useful new indirect evidence about SMT for migraine (Chaibi et al).
  75. Nov 25, 2016 — Edited — Added some important footnotes and clarifications.
  76. Oct 20, 2016 — Edited — Thorough revision and modernization. Although I revised this section a mere five years ago, it needed it again!
  77. Oct 13, 2016 — New section — More than a thousand new words on the topic of neck cracking.
  78. Sep 2, 2016 — Science update — Revised the introduction to treatments for clarity and completeness, added new references, and a new short paragraph about risks and harms.
  79. Aug 9, 2016 — Major update — Broadened scope of section to include all pain killers. Added a summary of opioids, and a guide to experimenting with the over-the-counter meds; added more science; merged and edited previously separate sections on rebound pain and muscle relaxants.
  80. Aug 9, 2016 — Correction — Removed overconfident statements about the clinical significance of the effects of psychoactive drugs, plus related minor updates.
  81. Aug 4, 2016 — Minor update — Some editing and new caveats.
  82. Jun 15, 2016 — Update — Added new intro to section about distorted body image.
  83. May 4, 2016 — Science update — Added citation about the efficacy of ibuprofen for headache.
  84. Mar 21, 2016 — Science update — Added some particularly good science to shore up the personal anecdote added in January.
  85. Feb 28, 2016 — Improved — Added a new key point about how to recognize the pain of a nerve root pinch.
  86. Jan 27, 2016 — Science update — New footnote supporting the use of education (like this tutorial!) to treat chronic pain.
  87. Jan 5, 2016 — Minor update — Added a good personal anecdote … because my spine is degenerating! Also, a footnote about surprisingly painless joint damage.
  88. Dec 9, 2015 — Science update — Added some hard evidence on the minor (non-lethal) risks of SMT from Carlesso 2010.
  89. Dec 9, 2015 — Science update — Added an interesting reference to Carlesso 2013 with some discussion of the implications.
  90. Nov 11, 2015 — Science update — Added a humility citation, conceding the absence of scientific evidence that massage helps neck pain. Also, modernization summary of trigger point therapy.
  91. Nov 2, 2015 — Science update — Added a little more information about the nature of uncovertebral joints.
  92. Oct 29, 2015 — Upgraded — More and clearer red flag details, especially about spinal cord trouble (myelopathy).
  93. Jun 17, 2015 — Major update — Completely rewritten and greatly expanded, with much more science, emphasizing strength as a worthwhile treatment option.
  94. Jun 16, 2015 — Revised — Editing and some new science about changing head posture.
  95. Jun 15, 2015 — Minor update — More data on neck pain recovery rates
  96. Jun 10, 2015 — Minor addition — Added a patient anecdote about a strange muscle spasm experience … which I know all too well.
  97. Jun 10, 2015 — Minor update — Added an expert quote.
  98. Mar 3, 2015 — Science update — Added brief example of nerve pinch by vertebral artery twistiness.
  99. Feb 28, 2015 — Science update — Added three good references and a diagram about how much “wiggle” room nerve roots have.
  100. Feb 24, 2015 — Expanded — Added about 350 words about neck circle safety.
  101. Nov 23, 2014 — Science update — Added a new good-news study about massage for neck pain.
  102. Oct 22, 2014 — Minor update — Upgraded references on neck pain recovery rates.
  103. Jul 11, 2014 — Science update — Added some important acknowledgements that the science of trigger points is a bit half-baked, and linked out to much more information for the curious.
  104. Jul 11, 2014 — More content — Explanation of the difference between a subluxation and an MID.
  105. Jul 1, 2014 — Science update — Added citation to a key 2012 study of the effectiveness of adjustment for neck pain.
  106. Jul 1, 2014 — New — A new section, but also a summary of an existing free article.
  107. Dec 14, 2013 — Minor yoga update — Added a reference and paragraph about the risks of yoga, which are minor but real, especially for neck pain.
  108. Jul 20, 2013 — Minor science update — Added a tiny, flawed study about yoga for neck pain (for what little it’s worth).
  109. May 29, 2013 — New evidence — Rare good news: the first good quality scientific test showing that reducing fear is actually good medicine. The section got a decent editing as well.
  110. May 29, 2013 — New section —
  111. Oct 26, 2012 — Science update — Added evidence that the stakes are high with chronic pain: it may even shorten lives.
  112. Oct 24, 2012 — Science update — Added a key reference about the effectiveness of massage for back pain, with the (safe) assumption that it probably applies to neck pain as well.
  113. Jul 4, 2012 — Science update — A new study shows that massage therapists cannot reliably find the side of pain by feel — good evidence that no gross spasm (or other structural factor) is usually involved.
  114. Mar 8, 2012 — Minor update — Added some creative problem-solving for hot climates.
  115. Dec 14, 2011 — Minor update — Added a minor but odd note about “sensory annoyances” like hats and collars.
  116. Dec 1, 2011 — Minor update — Added some unusual research about the risks heavy metal “head-banging” — a fun example, for perspective.
  117. Dec 1, 2011 — More content — Added scientific cases studies, examples, pictures and video of true dislocation and abnormal anatomy to help drive home the point that even significant spinal joint dysfunction can be surprisingly harmless … never mind subtle joint problems.
  118. Nov 4, 2011 — Minor science update — Cited a study about yoga and stretching for back pain.
  119. Aug 26, 2011 — New section — This section is a summary of an important concept that’s been available in a free article since late 2008, but also needed to be emphasized here. Now it is.
  120. Jul 29, 2011 — Minor update — Added a reference about the poor overall quality of online information about common injuries. See Starman et al.
  121. Jul 15, 2011 — Added a fun thing — I can’t believe I didn’t know about inflatable neck extenders until now!
  122. Jul 13, 2011 — New section — More information about an important characteristic of muscle-dominated neck pain.
  123. Jul 12, 2011 — Major update — Totally renovated section: re-written, reformatted, expanded, upgraded. A few new checklist items were added, most were expanded, and all were clarified. A separate and handier “quick” checklist was added to the existing “slow” checklist.
  124. Jun 21, 2011 — Major update — Major improvements to the table of contents, and the display of information about updates like this one. Sections now have numbers for easier reference and bookmarking. The structure of the document has really been cleaned up in general, making it significantly easier for me to update the tutorial — which will translate into more good content for readers. Care for more detail? Really? Here’s the full announcement.
  125. Feb 17, 2011 — Upgraded — New artwork from artist Gary Lyons, plus some important new references.
  126. Oct 6, 2010 — Updated — Updated with an important story about a disastrous example of neck stretching that backfired. Not just for customers: this particular section is a short version of a new free article.
  127. Oct 5, 2010 — Minor update — Some good new science cited in the introduction, about the overall effectiveness of manual therapies. See D’Sylva et al.
  128. Oct 1, 2010 — Major Update — Rewriting and expansion of the Special Supplement on spinal manipulative therapy.
  129. Sep 29, 2010 — Update — New science confirms that helmets do not cause neck injuries — they just keep your head safe. However, minor injury remains likely and problematic.
  130. Aug 6, 2010 — New cover — At last! E-book finally has a “cover.”
  131. May 24, 2010 — Minor update — Update with another recent study showing that strength training doesn’t work.
  132. Apr 20, 2010 — Major update — Completely overhauled and substantially expanded, and polished several relevant bibliographic records.
  133. Apr 20, 2010 — Rewritten — Completely overhauled and substantially expanded, and polished several relevant bibliographic records.
  134. Dec 31, 2009 — Minor update — Shored up substantiation of the relationship between migraines and trigger points.
  135. Dec 16, 2009 — New section — First new section since the huge update in the fall, a short-but-useful section.
  136. Sep 23, 2009 — Huge upgrade — Over the past several months, the neck pain tutorial has more than quadrupled the amount of information it offers, and it is now book-length at more than 40,000 words. Almost every single section was overhauled, and many new sections were added. Dozens of references to more recent scientific research were integrated and their significance explained, including several good new studies less than six months old.