Acute Wry Neck

Acute wry neck usually effects pre-teens to young adults, with a greater ratio of females to males.  It usually has a sudden onset, with the nature of injury being fairly trivial and ends with the person waking with a “locked”, stiff or “kinked” neck.

What are the Causes of Acute Wry Neck?

It is thought that acute wry neck is caused by structures that are closely related to the facet joints (the small joints either side of your neck, that allow turning and gliding movements of the spine).  These structures may be an entrapped fat pad or meniscus, or a pinching of the synovial capsule surrounding the joint.  This can occur after a sudden movement, but usually occurs from staying with your neck in one sustained position too long, resulting in pain from the affected facet joints.

What are the Symptoms of Acute Wry Neck?

Symptoms are mostly localised to the neck, on the same side as the restricted movement.  Normally you will be able to find a pain-free position at rest, but with active movement the pain will be sudden and sharp.

Your head will be positioned most comfortably just off centre, being side flexed and rotated away from the side of pain.  You will have difficulty turning your head past this midline.

What is the prognosis?

There is usually an excellent prognosis, with acute wry neck completely resolving over a couple of weeks in the worst case scenario.  You should ideally see a physio within the first 12 hours of the problem occurring, as they can usually get immediate improvements in pain and movement, after the first session.  You may still have some restrictions and a dull pain when you move your neck, due to overlying muscle spasm, but this should settle.

There is however a high rate of reoccurrence with this type of injury, so talk to your physiotherapist about ways to prevent it from happening again, such as changing your sleep position,  treating any muscle imbalances or stiffness around the neck and shoulders, or ongoing exercises that may be of benefit.