Acute Wry Neck is characterised by the sudden onset of pain and stiffness in the neck. It presents as the inability to rotate or laterally flex the neck, either to one side or both. Interestingly, it can be brought on by a sudden movement OR a long sleep in a seemingly awkward posture.

Signs and Symptoms of Acute Wry Neck

Patients who experience Acute Wry Neck will commonly present with neck pain and restriction of movement. It can present to one side or both. It can be pain-free at rest with sharp pain on active movements. Flexion and extension of the neck are not normally affected. Rotation and/or lateral flexion will be painful in one or both directions.

What causes Acute Wry Neck?

The exact cause of an acute wry neck is still unknown. It comes about differently for everyone. It is more common in younger people with females more likely to experience it than males.

Some of the main noted causes are;

prolonged abnormal postures
sudden or unusual movements
long sleep in awkward position
neck exposed to cold draught

Acute Wry Neck presents most frequently in two different categories; Apophyseal or Facet Wry Neck (most common) and Discogenic Wry Neck. Differentiating between the two is important for establishing the most effective treatment plan.

Apophyseal (Facet) Wry Neck

Facet joints are located on the back of the spine and allow each vertebrae to move freely on each other. In apophyseal wry neck, these joints become locked and movement becomes restricted. It occurs more frequently in children and younger adults. A comfortable posture post injury usually involves having the head tilted away from the injured side with slight flexion. Localised muscle spasm and pain prevents correction of this posture.

Discogenic Wry Neck

This condition presents more frequently in the older person. The pain is felt around the lower cervical region, spreading down to the upper thoracic with some referral pain into the medial shoulder blade region. The pain is associated with damage or deterioration of the disc or surrounding structures in the neck. The restrictive nature of discogenic wry neck is more often associated with pain as opposed to mechanical (joint) causes. Discogenic pain tends to have a more gradual onset and can even present with neural symptoms such as pins and needles or numbness down the arms. If you do experience any of these neural symptoms, seek treatment as soon as possible.

Treatment of Acute Wry Neck

The good news is that Acute Wry Neck is self limiting. This means that most cases will normally self resolve within a week's time. However, without treatment, an acute wry neck has a tendency to recur. The sooner you can be treated, the better!

A Myotherapist's treatment will involve gently mobilising the affected cervical joints to improve movement while also applying manual therapy to the muscles around the area to reduce muscle guarding. These techniques work effectively and almost immediately with a return to almost full movement of the neck and a reduction in sharp pain on active movements following a successful treatment. Some tenderness around the areas that have been worked on is to be expected but this normally pales in comparison to the pain and restriction experienced by the acute wry neck.

Before your treatment...

While you are waiting for your appointment, some effective techniques for assisting in lessening your discomfort include:

Heat/Ice - the age old debate. Ice is good for settling inflammation while heat is good for relaxing muscles. Try both and see what works best for you.
Keep moving - if possible, keep the neck moving. If you only get pain rotating and lateral flexing to one side, then move the neck to the opposite direction of your pain.
Stretching - while heat or ice is applied, try stretching the neck away from the pain. For example, if your neck is hurting on the right side, rotate your head to the left and then pull your chin down towards your armpit. To increase this stretch, try sitting on your right hand to keep your shoulder fixed down. If this aggravates your pain, discontinue.
Self massage - with a spiky ball up against a wall, try getting into the top angle of your shoulder blade on the side of your body that has the neck pain. This site has many layers of muscles, most of which are affected during an incident of acute wry neck. Slowly apply pressure into the ball with your back. Move the ball around until you find a site of diffuse, dull pain (it may even radiate out from the site). Hold the ball on this site while slowly rotating your head to the opposite side as pain and comfort allows. Hold until pain reduces.

Pain Profile: Acute Wry Neck