What is Acute Wry Neck?
Acute wry neck is a complaint where you develop neck pain and stiffness, which is often accompanied by spasm of the surrounding neck muscles. This causes neck pain and an inability to turn your neck through its full range of motion.
Acute wry neck is an extremely common condition, which can be quite disabling as the sufferer experiences constant severe pain with simple neck movements. Luckily the solution is normally very quick!
What Causes Acute Wry Neck?
Acute wry neck can have several causes.
However, it is the thought that the pain and reduction in range of motion results mainly from two mechanisms. Either Facet Wry Neck caused by a locked facet joint or Discogenic Wry Neck caused by a cervical disc injury.
What is Facet Wry Neck?
The most common cause of acute wry neck is a locked facet joint.
Facet joints are located at the back of your spinal column. These facet joints allow, guide and limit the movements of your neck. Your facet joints are intended to allow smooth gliding movements between the adjacent vertebra. Occasionally your facet joints can become either stiff through traumatic injury or arthritis or simply get stuck at at extreme of movement.
A common reported history for the wry neck patient is to wake with a stiff and painful neck. Onset of the wry neck is usually sudden. The cause may have included a restless night sleep, uncomfortable pillow, waking suddenly in the night (eg a noise) or simply unknown. Let's face it, who knows what we exactly get up to in our sleep!
Wry neck pain is due to the numerous nerve endings that are located in the facet joint itself and in the tissues adjacent to the facet joint. Facet wry neck is most common in younger populations, ranging from young children to people in their thirties. Older facet wry neck sufferers tend to have a more gradual onset with the facet joints becoming "rusty" over time.
Signs and Symptoms of Facet Wry Neck
- Pain – generally located in the middle or side of the neck that is affected. The onset of pain is sudden. The pain experienced does not extend beyond the shoulder joint.
- Loss of movement – your neck is generally fixed in an abnormal position – most commonly flexed forward and rotated away from the side of pain. All movements aggravate the pain, as the joint is fixed and movement triggers irritation to the joint and thus pain.
- Muscle Spasm – this is a tightening of the associated neck muscles that further limit movement.
Acute Wry Neck Treatment
After your physiotherapist assessed your neck and confirms which joint or joints are locked, they will utilise a range of low risk joint treatment techniques and soft tissue massage to normalise your facet joint function.
While the joint can almost always be immediately unlocked, you will have some residual muscle spasm and swelling in the region due to the trauma. Think how a sprained ankle swells! Neck joints will also swell, but it won't be as visible.
How Long is Recovery?
Most acute wry necks can be unlocked immediately. However the residual effects may last for up to one week. It is also important to normalise your neck muscle and joint function (eg strength and motion) to prevent a regular recurrence, which unfortunately commonly occurs if your neck injury is poorly rehabilitated.
Facet Wry Neck Treatment Aims
- Confirm your diagnosis
- Unlock your locked facet joint: facet joint techniques
- Normalise joint range of motion: joint techniques
- Relax muscle spasm: massage, gentle stretches, acupuncture or dry needling
- Normalise your muscle length-tension ratio: massage, stretches and home exercises
- Check and normalise your deep neck and superficial muscle strength
- Ensure normal cervical posture and function.
If need more specific advice, please consult your physiotherapist who has a special interest in acute wry neck rehabilitation.
What is Discogenic Wry Neck?
Acute wry neck may also caused by a injury to your intervertebral disc. This is known as Discogenic Wry Neck. Usually the injured disc protrudes posteriorly and presses against surrounding structures and nerves.
Signs and Symptoms of Discogenic Wry Neck
- Sufferers generally experience a gradual onset of dull, diffuse pain.
- Pain is usually felt in the lower neck, shoulder or upper chest.
- Pain may radiate down into the arms.
- Your neck is fixed and difficult to move. You will usually be holding your head and neck away from the painful side because of pain. However, this movement is only limited by pain, not mechanically blocked as in the facet wry neck.
- Muscle Spasm
- Occasionally, you'll experience pins and needles, numbness or weakness in your arms or legs. If this is the cases, seek prompt medical assessment.
Physiotherapy Treatment for Discogenic Wry Neck?
In most cases, Discogenic Wry Neck is successfully managed with a steadily progressed physiotherapy intervention. Discogenic wry neck does not normally respond as quickly as facet wry neck treatment. This is due to the more severe injury that involves the intervertebral disc.
While the time period does vary, it is not uncommon for a discogenic wry neck to take up to six weeks to rehabilitate successfully. In severe cases, spinal surgery is required.
Physiotherapy is important for the short and long-term management of your neck pain and restoration of its full function. This includes, full neck range of movement and the stabilisation and strengthening of your neck to protect your injured disc for the remainder of your life.
You'll find that a physiotherapist's assessment and treatment will reduce your likelihood of a recurrence.
Discogenic Wry Neck Treatment Aims
- Confirm your diagnosis
- Reduce intradiscal pressure and pain: disc deloading techniques
- Normalise joint range of motion: joint techniques
- Relax muscle spasm: massage, gentle stretches, acupuncture or dry needling
- Normalise your muscle length-tension ratio: massage, stretches and home exercises
- Normalise your deep neck and superficial muscle strength
- Ensure normal scapular stabilisation control to reduce neck intradiscal pressure
- Ensure normal cervical posture and function.
If need more specific advice, please consult your physiotherapist who has a special interest in acute wry neck rehabilitation.
What Can You Do Until You See a Physiotherapist?
At PhysioWorks, we understand that acute wry neck can be particularly disabling. Ideally, we recommend immediate treatment for the best and quickest result.
If you suspect acute wry neck, please call one of our clinics and inform them that you suspect you have acute wry neck. They’ll do their best to fast track your appointment. Until your appointment, you may find relief from the application of ice or heat to the neck and surrounding muscles.
If you are able to consult with your doctor, they may prescribe muscle relaxants or other medication to assist your symptoms. A neck brace or soft collar may also assist until you can seek professional advice and treatment.
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