Acute wry neck or ‘torticollis’ can be a really painful form of neck pain. If you’ve ever gone to bed with zero neck pain and then woken up in the morning with a really painful and stiff neck then it’s possible that acute wry neck may have been the cause. When it happens, the neck muscles suddenly spasm, causing a sudden onset of neck pain and very limited movement. Even the smallest of neck movements, such as turning or nodding your neck can elicit pain and it can be a debilitating and sometimes worrying condition to wake up with.
The positive news is that acute wry neck is treatable and normally resolves within a short period of time.
Signs and Symptoms:
- The pain you feel is normally found on one side of the neck and tends to be local to this area rather than affecting the shoulder or arm. The pain will start suddenly and often comes on ‘out of the blue’.
- Reduced neck movement. As soon as the muscles spasm on one side of your neck they will greatly reduce your neck range of movement. With acute wry neck, nearly all neck movements will make the pain feel worse and you’ll often find that you’ll naturally try to turn your head away from the painful side.
- Muscle spasms. The muscles responsible for reducing your neck movement will be in spasm. This can include the sternocleidomastoid, scalene muscles, levator scapula or upper trapezius muscle.
Why Does it Happen?
Acute wry neck is not entirely understood. However, neck muscle spasm can often occur due to a minor injury to the neck or due to sleeping with your head and neck in an awkward position, often exacerbated by pillows which are too high or too low for you.
Physiologically, our spines contain facet joints which enable us to move freely and rotate. Diagnostic scans have indicated that injury or irritation of a facet joint may contribute to wry neck. It’s thought that the facet joint may become locked, leading to a protective neck muscle spasm around the joint and further up the neck. Another causative theory of acute wry neck is that a bulging or tear in an intervertebral spinal disc may cause swelling and inflammation, leading to pain within the neck. However, if a disc is involved, neck pain tends to occur more gradually over time. Additionally, any disc injury can lead to pain radiating into the shoulder and arm and may give rise to pins and needles and numbness.
Treatment and Prognosis:
Whilst acute wry neck can be painful and can stop you from functioning normally, the positive news is that it’s very treatable and normally resolves pretty quickly with physiotherapy treatment and a bit of home management. Aim to seek treatment within a day or two of its onset in order to settle it down quickly. Meanwhile, whilst you’re waiting for your physio appointment, apply heat to your neck muscles in the form of a wheat bag or hot bath to help relax them. Massage, soft tissue and joint mobilisations together with dry needling can all be great clinical treatment options and typically the condition will settle down after a couple of treatments. Any residual symptoms should gradually disappear over the course of a week. Neck pain can return but provided you maintain good neck range of motion the prognosis is pretty good.