“Wry neck”, or “torticollis“, is a very common neck condition which can be quite debilitating as it causes severe pain with just the smallest neck movements.
It is estimated that approximately 70% of the population experience an episode of neck pain at some point in their lives with it typically occuring in young people between 12 and 30 years of age.
It can be very difficult to carry out daily activities with a lack of range of motion within the neck and this can cause some concern but the good news is that acute wry neck can be successfully treated in a short period of time.
The pain from acute wry neck typically happens very suddenly. It is associated with neck pain and stiffness, which is often accompanied by muscle spasms of the surrounding neck muscles. This causes restriction of the neck to turn through its full range of motion.
Signs and Symptoms of “wry neck”
- Pain: Onset of pain is sudden. Pain is commonly located in the middle or side of the neck that is affected. 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.
- 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.
- Muscle Spasms: The surrounding neck muscles, for example sternocleidomastoid, scalenes and levator scapula, have tightened or spasmed in response to the facet joint irritation. This in turn limits the patient’s neck range of motion.
What causes a “wry neck”
We do not know the exact mechanism of injury for wry necks but it is thought to be the result of a minor injury to the neck or simply caused by sleeping with the neck in an awkward position, uncomfortable pillows or waking up suddenly in the middle of the night. The neck is made up of several vertebras, intervertebral discs and joints. The small swivel joints that allow for smooth gliding movements and turning are called facet joints.
One theory on the cause of wry neck is from an injury or irritation to one or more of the facet joints. The theory is that the facet joints become ‘locked’ or jammed, causing pain and protective muscle spasms throughout the neck.
The second theory of wry neck is due to the irritation to our discs. The spinal discs are between the vertebrae and they help absorb shock and stress to the spine. These intervertebral discs can sometimes bulge or tear under stress similar to a small sprain, this would cause inflammation and swelling, putting pressure on the surrounding structures and nerves within the neck.
There are many nerve endings around the spine and this can explain why movement can be very painful. In this theory, movement is more limited by pain, not mechanically blocked as in the facet theory. This type of wry neck usually comes on over a period of time (more gradual onset) and is not as sudden. Symptoms of discogenic wry neck can radiate into the arm and occasionally people may experience pins and needles or numbness.
How do we treat wry neck?
Most cases of acute wry neck resolve quickly and treatment options that would help settle the symptoms faster are massage, dry needling, joint mobilisations, heat, and exercises.
If you think that you have a wry neck, book an appointment to see one of our physiotherapists today to help settle your symptoms down quickly and talk to them about how to limit the risk of a repeat injury.