Have you ever woken up with a stiff, sore neck, or experienced ongoing neck pain after a sudden
November 15, 2022
Have you ever woken up with a stiff, sore neck, or experienced ongoing neck pain after a sudden quick movement? These are classic triggers for an injury known as Acute Wry Neck or Torticollis. Physiotherapists and Chiropractors are well-placed to provide treatment for this presentation. Keep reading to find out more..
Acute Wry Neck is characterised by a sudden onset of sharp neck pain, with a protective deformity and limitation of movement. It may be difficult to drive or ride a bike, as turning the head may aggravate the neck pain. There may also have been unusual movements or prolonged abnormal postures prior to the onset of pain.
There are two common types which are:
This occurs more frequently in children and young adults, and is commonly associated with a sudden movement resulting in sharp pain. The individual may typically adopt a posture to guard the pain, which is usually a bent neck away from the irritated joint, or a neck bent forward. It may be hard for the individual to correct the abnormal posture themselves due to pain and the severity of the muscle spasm.
This type of wry neck usually has a more gradual onset, and classically occurs when waking after a long sleep in an abnormal posture. It tends to occur in an older age group, such as in middle-aged adults. The pain is often felt in the lower region of the neck or the upper mid-back, and sometimes near the shoulder blade. The pain also often feels deep, and the individual may have a history of degenerative joint disease in the lower cervical spine.
Zygapophyseal wry neck occurs at the zygapophyseal joints (facet joints - the red part in the image above) of the cervical spine, most commonly at the C2-3 level. The upper cervical joints (C0-1 & C1-2) may also be involved with some trauma, which requires testing to ensure the integrity of the craniovertebral ligaments involved.
On the other hand, the discogenic wry neck (the blue in the image above) involves the discs between the vertebral levels which act as shock absorbers. It is important to differentiate this type of neck from the zygapophyseal presentation as certain treatment techniques may further aggravate this condition.
Physiotherapy and Chiropractic treatment for acute wry neck often involves reducing the muscle spasm through manual therapy techniques such as trigger point therapy, myofascial release, gentle traction, craniosacral techniques and adjustments as required. Depending on the severity of the presentation, taping may also be required. More often than not, an improvement in range of motion and a reduction in pain should be expected after the initial treatment. Self-management includes gentle range of motion and motor control exercises, sleep hygiene to support the cervical spine, and ice to reduce the inflammation and swelling.