Acute Wry Neck

Wry neck refers to a disabling condition affecting the cervical spine where the individual experiences intense pain, spasm and restriction.

Definition

Wry neck, or ‘locked’ neck as it is sometimes known, refers to a disabling condition affecting the cervical spine where the individual experiences intense pain, spasm and restriction.

Signs & Symptoms

Moderate to severe neck pain that is usually localized to one side of the neck (may refer into the upper back and shoulder region); other symptoms include muscle spasm and restriction
Symptom onset may be associated with a sudden neck movement or pain present on waking from an awkward sleep position
Symptoms will be aggravated by neck movements, especially towards the painful side
The neck may appear to be flexed or rotated away from the side of pain, and it may be difficult or extremely painful to try and correct this

Causes

It is not known exactly what causes a wry neck to occur. There are two proposed mechanisms:

Facet / Apophyseal Joint Dysfunction
Commonly occurring in the younger population, acute wry neck involving ‘locking’ of the facet joints is more likely to affect the upper cervical spine. It is thought that the tiny menisci, or articular cartilage, between the facet joints become entrapped or awkwardly positioned following a sudden neck movement, causing the facet joint to lock.

Intervertebral Disc Dysfunction
Discogenic wry neck is more prevalent in the middle aged or elderly population as it linked to degenerative disc disease. The cervical intervertebral disc may be bulging or protruding into the spinal canal and sensitizing or mechanically compressing the surrounding tissues.

Treatment

We recommend that you attempt to rest from those activities at home, work or during sport which make your symptoms worse. You may apply heat to the neck in the form of a microwaveable wheat bag or hot water bottle and take analgesic or anti-inflammatory medications to help with your pain.

Wry neck will respond rapidly to physiotherapy, and you should notice a significant improvement after your first session. This condition usually resolves with between one and three treatment sessions and is not likely to cause you ongoing problems. Your physiotherapist will use techniques to reduce your pain, correct your neck posture, restore normal and functional movement to the neck region and address any muscle spasm. Part of your treatment will include the prescription of home exercises to improve your neck movement. The mobility exercises given to you are an important part of your treatment, and it is always those who are most compliant with their exercises that will get the best results.