wry neck pain

What is wry neck. How do we treat acute neck pain.

Neck pain as a whole is a major contributor to disability worldwide, with about 70% of the population experiencing an episode of neck pain at some point in their lives. Wry neck is a recognised syndromes causing pain in the neck it occurs as involuntary contractions of the neck muscles, leading to abnormal postures and movements of the head. Fortunately wry neck is a transient and self limiting condition that can usually recover in a few days to a week. There are usually no risks or complicating however neck pain can return. Statistics show that around 10-15% if the population has neck pain at any given time.

What causes wry neck?
The exact cause of wry neck is not know but usually results from unusual movements or prolonged abnormal postures. It is thought that one of the joints in the neck become jammed or locked, resulting in a painful, protective muscle spasm. Any one can get wry neck but is typically occurs in young people between 12– 30 years of ages

Characteristics of Wry Neck
• A sudden onset of sharp neck pain
• Pain can be anywhere in the neck extending the head, shoulder and upper back, usually worse on one side.
• Difficultly turning head in one direction
• Patient is unable to correct posture due to pain and muscle spasm.
• Palpable neck spasms on affected side.

Differential Diagnosis
It may not be Acute torticollis
• Non Specific neck pain
• Cervical postural syndromes
• Cervical spine degeneration
• Acceleration / deceleration injuries
• Cervical spine fracture
• Acute never root pain


Explaining the Symptom
As Wry neck an abnormal contraction of the muscle in one side of the neck, people may appear with their head turned to one side. Their head is rotated due to the attachments of the spasming muscle and the pull of the muscle on the neck whilst contracting. The loss of movement in the neck may be due to pain and tightness of spasming muscle.

Evidence based Treatment

What work and what doesn’t
Multi-modal treatments – stretching/strengthening exercises and mobilisation/manipulation
Proprioceptive and therapeutic exercise—Muscle energy exercise
Massage - release tight affected muscle and reduce pain
Thermotherapy - heat pack applied to painful muscle
Acupuncture—short term pain relief. Can help with muscle tightness.
Temporary use of a soft collar – collar can provide support and comfort for a short period for acutely painful necks. Not generally recommended as the neck is best kept mobile and exercised naturally

Thank you