What is Acute Wry Neck?
Acute wry neck is a very common condition that often presents with a sudden onset of pain and stiffness in the muscles around your neck commonly accompanied by tightness or spasm in the surrounding neck muscles. This muscle spasm can be a protective response that can cause pain and the inability to move the neck (Cohen, 2017). Around two-thirds of the population will experience neck pain at a given point in their life (Vos, 2007). Anyone can get a wry neck, but it typically occurs in young people between 12 and 49 years of age (Counsell, 2016).
Causes of Acute Wry Neck
The cause may not always be known but there is a strong connection to sleeping in an abnormal position without proper head and neck support, inappropriate seating, poor posture while at a desk, or carrying heavy unbalanced loads. The onset of the pain and stiffness is usually sudden either caused by the locking of a facet joint or irritation to a disc in the neck with the most common cause being a locked facet joint (Groeneweg, 2017). The significant pain from a wry neck is explained by the high density of nerve fibers in the tissues surrounding these joints.
What are the Risk Factors? (Brukner & Khan, 2017)
People aged 12-49 years old
Occupations such as office workers
Sleeping disorders
Depression or anxiety
A previous history of neck pain
Women are more prone to neck pain than men
Sedentary lifestyles
Smoking
Being overweight or obese
Signs and Symptoms of Acute Wry Neck (Brukner & Khan, 2017)
Pain: The onset of pain is sudden and commonly located in the middle or side of the neck that is affected most. The pain is localised to the neck area and does not extend past the shoulder joint.
Location: Usually symptoms are felt on one side of the neck, as this is a protective reaction of the body to safeguard the neck from further injury or damage.
Loss of Range of Movement: The neck is often fixed in an abnormal position (most frequently in a flexed forward and rotated position). The side that the patient’s head is rotated towards will often be away from the side of pain due to this protective reaction.
Muscle Spasms: The surrounding neck muscles often have tightened or spasmed in response to the facet joint irritation. This in turn limits the neck range of motion.
Referring Pain: Generally, there is no referring pain however Discogenic wry necks often present in the same way but are more likely to travel down the arm and may experience pins and needles in their hand as well.
Prognosis
The prognosis for a wry neck is generally very good and with the correct diagnosis and timely treatment, people will often feel relief within 2-3 sessions and return to pre-injury function within a week (Vos, 2007). Discogenic wry neck also has a good prognosis and will often feel a lot better within the first few sessions however, can take 2-6 weeks to return to pre-injury function depending on the severity (Brukner & Khan, 2017; Vos, 2007).
Rehabilitation and Prevention
Early management for both facet and discogenic wry neck with your physiotherapist will often be gentle and involve facet joint mobilisation and soft tissue release of the surrounding neck muscles.
Common early management recommendations include the use of heat packs for pain relief as well as re-introduction of gentle neck movements and avoidance of heavy lifting and rapid head movement. Once the pain has settled significantly and movement is mostly restored, prevention involves exercises targeted at strength and endurance for muscles surrounding the neck (Brukner & Khan, 2017; Vos, 2007).
It’s worth checking your pillow to make sure that your head and neck are well supported while sleeping and avoid sleeping on your belly whilst pain is present. Avoid using a rigid neck brace, you want to keep your head and neck mobile to reduce any further associated stiffness.
Common treatment methods which your physiotherapist may recommend to settle acute wry neck include:
Massage
Dry needling
Gentle passive mobilisations
Heat therapy
Stretches/ light movement
Non-steroidal anti-inflammatory medication
Wry neck which is not treated can result in stiffened neck segments which can lead to an individual being predisposed to recurring episodes of this condition.
Our Physiotherapists at UPG Studio have experience in the assessment, treatment, and management of many conditions including Wry Neck. We ensure a comprehensive assessment is completed not just for the symptoms presented, but also addressing the underlying causes and contributing factors. Our detailed rehabilitation plans and Physfit programs are tailored to each individual to ensure the best possible outcome. Always consult your physiotherapist or medical professional for an assessment of your condition before taking on any new exercises.
References
- Brukner, P., & Khan, K. (2012). Clinical Sports Medicine, 4th Edition
- Cohen, S. P. (2015, February). Epidemiology, diagnosis, and treatment of neck pain. In Mayo Clinic Proceedings (Vol. 90, No. 2, pp. 284-299). Elsevier.
- Cohen, S. P., & Hooten, W. M. (2017). Advances in the diagnosis and management of neck pain. Bmj, 358.
- 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.
- Groeneweg, R., van Assen, L., Kropman, H., Leopold, H., Mulder, J., Smits-Engelsman, B. C., ... & van Tulder, M. W. (2017). Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial. Chiropractic & manual therapies, 25(1), 1-12.
- Vos, C., Verhagen, A., Passchier, J., & Koes, B. (2007). Management of acute neck pain in general practice: a prospective study. British journal of general practice, 57(534), 23-28.