One of the most common neck complaints we have presented to the clinic is when a patient wakes up and they feel a locked out and painful sensation at the side of the neck which affects their ability to move their head particularly when turning the head. This sudden onset of pain and stiffness at the neck is commonly what we refer to as an acute wry neck or 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 with unilateral or asymmetrical symptoms. There are many different types of wry necks that present and we here to determine if it’s an acute wry neck or not.
Types of Wry Neck
- Acute Wry Neck
- Discogenic Wry Neck
- Atlanto Axial Subluxation (C0-C1)
- Spasmodic Torticollis Wry Neck (Cervical Dystonia)
- Hysterical Wry Neck
We often find that an Acute Wry neck tends to occur in teens to adult populations, and the research shows us that females are more likely than males to suffer from this. It is usually of sudden onset, incident related or sometimes viral-induced. Patients usually find that if they are not moving their neck, they are pain free or when resting without movement.
The two most common wry necks are usually disc or joint driven.
Facet Joint Wry Necks
A Facet joint is on each side of the neck between two vertebrae and these joints allow controlled rotation and side bending of the neck. Sometimes something simple such as sleeping in an awkward position or a quick, jerky movement of the neck can cause the tissues of this joint to tear or become stuck. In response, surrounding muscles tend to spasm which then increases the pain at the neck and causes restriction of neck movements.
Discogenic Wry Neck
A spinal disc is a structure which sits between the vertebrae of the neck and its role is to absorb force. The disc can sometimes bulge under stress or tear, like a small sprain and the resulting swelling puts pressure on the nearby nerves. Movement is not actually blocked but because there are so many nerve endings around the spine a small amount of damage can feel extremely painful. This is caused by a combination of factors such as neck stiffness, biomechanics. It can also take a much longer time to heal. The pain is often described as a dull ache which can radiate into the arm and can be associated with pins and needles.
How does it occur?
In short, we simply do not exactly the cause of why acute wry necks do occur but there are some possible reasons floating around in the literature which identify a potential fat pad compression at the site of the dysfunction, a trapped menisci, or changes at the synovial fringe of the capsule at the site of dysfunction.
What do we see usually in our assessments?
Usually, with an acute wry neck as a therapist, we can find movements in the assessment in which the patient can perform with or without pain, the neck movements that tend to be most difficult usually are twisting or tilting movements to the opposite side of their painful side.
How does physio help?
Here at P360, we have a number of ways in which we can help you reduce the pain and improve the range of motion of the neck when suffering from a bout of acute wry neck, this can carry from person to person in response to treatment, but the most common treatments are the following
- Massage to the protective or hypertonic muscles around the neck
- Mobilisations treatment at the cervical spine (neck)
- Dry Needling at the muscles of the neck
- Exercises to help offload the protective neck muscles such as stretching or activation exercises of under active muscles
How can P360 help you?
An assessment of the neck would be a great start by one of our physiotherapists here so that we can differentiate what type of wry neck it is that you are dealing with, we then give you a diagnosis based on the type of wry neck you are suffering from and choose a treatment that is based on being more successful for that presentation and patient in front of us. Often, we find that an acute wry neck can ease within for 1-3 days but in the literature, it can range from 1-4 weeks for pain to abolish and movement of the neck to restore. For an initial consultation, you can book an appointment with one of our physiotherapists by calling 1800 777 360 or make a booking online.
- 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 https://www.ncbi.nlm.nih.gov/pubmed/26723272