Have you ever woken up and been unable to move your neck, or felt like it was ‘locked’ in a certain position? Perhaps you slept or moved awkwardly, and felt intense pain in your neck upon waking and couldn’t look over your shoulder? In these cases, you may be given the diagnosis of acute wry neck.

Acute wry neck is a complaint that involves neck pain and stiffness, often resulting in the inability to turn the head into a particular direction. It is also accompanied by muscle spasm of the surrounding neck muscles. It usually comes on very quickly, but a likely cause can usually be determined. It is a very common condition, but can be very painful – even with small movements. The good thing is, this type of injury can be easily and quickly fixed by your physiotherapist.

There are 2 main causes of an acute wry neck – a locked facet joint, or a disc issue (“discogenic wry neck”).

Locked Facet Joint

A locked facet joint is considered the most common mechanism of cause for an acute wry neck. Facet joints are the small joints on either side of the vertebra, that allow movement between one vertebra and the others above and below. The cervical (neck) facet joints allow us to move our neck in all directions, by sliding and gliding over their opposing joint surfaces.

Occasionally, these joints can become stiff, which may be a result of traumatic injury or arthritis, and sometimes they may just get stuck in an extreme of movement. In this situation, there will be pain in the side of the neck, usually able to be pin-pointed by the sufferer. There will also be a loss of movement of the neck, sometimes the neck will be ‘fixed’ in an abnormal position, and usually a degree of muscle spasm.

After an assessment, your physiotherapist may use a range of techniques, including gentle joint techniques, soft tissue massage and dry needling, to unlock the involved facet joint. Your physiotherapist will also provide you with gentle exercises to relieve pain and improve neck movement.

If acted upon quickly, a joint can usually be unlocked within 1-2 sessions however there may still likely be residual swelling and muscle spasm due to the trauma, and this may require further treatment.

Discogenic Wry Neck

Discogenic wry neck is caused by an injury to the disc in between two adjacent vertebrae. Usually, an injury occurs and causes the disc to bulge and press against surrounding structures, including nerves.

The onset of discogenic wry neck is usually different to the locked facet joint. Instead of coming on suddenly, discogenic pain tends to come on gradually, and is usually described as dull and diffuse. Pain often can’t be pin-pointed, and may radiate to the shoulder, upper chest or down the arms. There will often be associated stiffness and pain in the neck, muscle spasm, and possibly pins and needles or numbness into the arms/hands (if nerves are involved).

Treatment will include de-loading techniques for the intervertebral disc, soft tissue massage or dry needling for the surrounding muscle spasm, and gentle joint techniques to return proper function to the cervical spine. Gentle exercises will also be provided.

This type of injury may take longer to settle, as there will be more swelling and possible neural interference than with an acutely locked facet joint.

In summary, there are 2 main types of wry neck, which are best to be assessed by a physiotherapist to ensure the correct and most helpful treatment. Both injuries will respond well to treatment. Proper treatment will ensure no loss of neck function further down the track.

If you feel that you have developed an acute wry neck, or if you would like to ask further questions, please don’t hesitate to call us at Therapia Physiotherapy and Pilates on (08) 8221 5011.