What is Acute Wry Neck?
Acute wry neck is a musculoskeletal condition where patients exhibit pain and significantly reduced neck range of motion in a particular direction. It is often accompanied by spasm of the neck musculature.
What causes Wry Neck?
The most common cause of wry neck is thought to be restricted/blocked motion through the facet joints. These joints connect the vertebrae forming the spinal column, they allow our neck to rotate, flex and extend. When one of these joints becomes blocked, it restricts neck motion and causes muscles to spasm due to the increased neural sensitivity, further reducing range of motion.
How do Wry Necks Present?
Wry necks can occur suddenly, with or without a traumatic incident. It is commonly reported that people awake with a stiff and painful neck which worsens throughout the day. Alternatively, people may report hearing a noise or feeling a clicking/pulling sensation in their neck, again followed by pain and increasing stiffness. Acute wry neck is typically seen in the younger population, it less commonly occurs in those above the age of 40.
Signs and Symptoms
Pain will typically be located to one side of the neck and not extend further than the shoulder.
The most significant loss of range will occur when flexing or rotating your head towards the side of pain. People may find at rest they are holding their head off centred, away from the side of pain, to alleviate stress through the irritated facet joint.
Muscle spasm often occurs, commonly on the side of pain. Active trigger points may also develop through the neck muscles.
Treatment
Your Physiotherapist will be able to accurately diagnose wry neck and alleviate the symptoms. The aim of treatment is to regain movement and alleviate pain by normalising joint range of motion, calming sensitive neural structures and reliving muscle spasm. This can be done through techniques such as:
- Soft tissue massage
- Trigger point release
- Dry needling
- Joint mobilisation
With Physiotherapy input, wry neck can typically be resolved within one week.
References
Shanmugam, S., & Mathias, L. (2017). Immediate Effects of Paraspinal Dry Needling in Patients with Acute Facet Joint Lock Induced Wry Neck. Journal of clinical and diagnostic research: JCDR, 11(6),. doi:10.7860/JCDR/2017/26407.10079
Teichtahl, Andrew J and McColl, Geoffrey. (2013). An approach to neck pain for the family physician [online]. Australian Family Physician, Vol. 42, No. 11, pp. 774-778.