Have you ever woken up with a kinked neck that is painful? Or moved your head a certain way and suddenly your neck is painful and stiff? Acute wry neck (also known as spasmodic torticollis) is a common musculoskeletal condition resulting in increased neck pain and stiffness.
Signs and Symptoms
May include the following:
- Pain with certain neck movements, commonly finding it difficult to turn your head in a certain direction
- Feeling of stiffness when moving your head towards the end of its range
- Feeling of muscle tightness around the neck, top of shoulders and upper back
Causes
The mechanism of injury is generally reported as sudden unguarded movements or sustained atypical postures (E.g., sleeping in an abnormal way and then waking up with a stiff and painful neck). The body then triggers a protective response; muscles will spasm, the neck won’t want to move through normal range and there may be an associated pain response.
The exact pathophysiology is not well understood however it is theorised that there are two structures that contribute to the presentation. The facet joint (sometimes referred to as zygapophyseal or Z – joint) connect adjacent spinal segments and may become blocked causing symptoms of stiffness and pain.
Alternatively, the cervical disc may become irritated. Between spinal segments there is a disc which acts as a shock absorber and can be a potential source of neck pain. Disc irritation, can present with pain, decreased range of movement as well as referral into shoulder. Commonly pain will be the limiting factor for a discogenic source rather than a mechanical blockage at the facet joint.
Treatment
Importantly with the presentation of acute wry neck, the condition is often self-resolving over several days or weeks. Physiotherapy is an effective intervention in reducing pain and regaining function of the neck.
Physiotherapy will focus on educating the client on the diagnosis and specific treatments that will be effective for management. Manual therapy will be utilised to restore joint movement, provide pain relief and address muscle spasms. This can be achieved through techniques such as soft tissue massage, mobilisations, and dry needling.
In addition to hands on treatment, your physiotherapist will provide you with a home exercise program and self-management strategies based on your needs to improve capacity and function in your neck. This will involve targeted strengthening, mobility and stretching exercises that correlate with your goals!
Our aim is to empower you with the tools to effectively manage your condition whilst not at the clinic, with the aim to improve function, range and decrease pain!
References:
- Brukner, & Khan, K. (2017). Brukner & Khan’s clinical sports medicine. Volume 1 : injuries (5th edition.). McGraw-Hill Education Australia.
- Cunha B, Tadi P, Bragg BN. (2021) Torticollis.In: StatPearls. Treasure Island (FL): StatPearls Publishing.