physio can help with neck pain

Acute Wry Neck

Have you ever woken up in the morning feeling like your neck has been locked into a certain position? Or moved your head and neck without thinking and felt a sudden, sharp pain after? This sudden onset of pain and stiffness in the neck is commonly referred to as an acute wry neck, otherwise known as an acute torticollis.

What is an Acute Wry Neck exactly?

An acute wry neck usually presents as neck pain and restriction of movement that is focused on one side. Most people have an acute wry neck may have no problem turning to one side but find that turning the head and neck in the opposite direction can bring on sharp, unpleasant pain.

This painful condition tends to occur most frequently in teen to adult populations, and the research shows that women are more likely than men to experience it. It is usually of sudden onset and patients often find that they are pain-free as long as they keep the head and neck still.

How does it occur?

We’re not entirely sure what causes a wry neck, but the research suggests that there may be sudden compression of structures in the neck that lead to pain. Other reasons may be sudden muscle spasms that result in difficulty with moving and pain.

What do we see usually in our assessments?

As mentioned above, one of the most common findings is the loss of movement in one direction, especially with tilting the head or twisting to look over the shoulder. This is usually very painful, but some patients also report just feeling extremely stiff when trying to perform those movements.

When feeling around the neck and shoulder, it is also common to be very tender through the muscles in the area. This just indicates that these muscles are in “protective” mode and are spasming to limit your movement.

How does physio help?

Physiotherapy can be very helpful when dealing with an acute wry neck as various treatment techniques can help reduce pain during movement and restore your normal range of motion. Treatment for an acute wry neck will usually involve the following:

  • Massage and soft tissue mobilization to the protective or tense muscles around the neck and/or shoulder
  • Mobilisation of the vertebrae of the neck
  • Dry needlingto the muscles of the neck
  • Gentle exercises to help decrease tension in protective muscles
  • Stretching

Depending on how your assessment goes, your physiotherapist may choose one or a combination of different treatment methods to help with your pain. It is important to have guidance in this process to ensure you receive the right treatment for your condition!
The good news about an acute wry neck is that it generally clears up pretty quickly – most people report being back to normal within a few days to a week. However, it can sometimes take up to four weeks for all symptoms to completely resolve, but you can expect continual improvement in this time. Patients usually report that the initial sharp pain eases and that stiffness becomes the primary complaint. Physiotherapy can help speed up the recovery.

If you think you might have an acute wry neck, give us a call! With the right treatment, we can get you moving well again and back to your usual self!

– Asha SE, Kerr A, Jones K, et al. Benztropine for the relief of acute non-traumatic neck pain (wry neck): a randomised trial. Emergency Medicine Journal. 2015 Aug;32(8):616–9. doi: 10.1136/emermed-2014-204317. PMID: 25414475. [PubMed] [CrossRef]
– Brukner, P. and Khan, K. (2007). Clinical Sports Medicine (3rd ed.) McGraw-Hill, Sydney.
– Counsell, C., Sinclair, H., Fowlie, J., Tyrrell, E., Derry, N., Meager, P., … Grosset, D. (2016). A randomized trial of specialized versus standard neck physiotherapy in cervical dystonia. Parkinsonism & related disorders., 23, 72–9. Retrieved from

BAppSc(Ex&SpSc), Mphty APAM

High-Performance Physiotherapist

Ehsam Popal is a physiotherapist with a special interest on post-surgical hand injuries and ACL tears. He has a wide knowledge in relation to sporting injuries with his favourite sports being soccer, tennis and MMA.

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