Acute wry neck explained – the bible to managing acute neck pain

Are you suffering from recent and sudden neck pain?

Is the pain very severe?

Does your neck feel stiff and the surrounding muscles feel tight?

Do you have a reduced ability to confidently move your neck through its normal ranges of motion?

Are you unable to move your neck pain-free?

Are you having trouble turning to safely perform a head check whilst driving your car?

Is your sleeping disrupted due to pain?

If you have answered yes to the above questions, there is a high possibility that you are suffering from what is called an “acute wry neck”, otherwise referred to as “torticollis”.

The term “acute” is explained as a sudden onset of severe pain, whilst “wry neck” refers to the presence of stiffness and associated muscle spasm (tightness) from the base of the skull down to the shoulder blade.

What causes this sudden painful neck pain?

There are multiple causes of an acute wry neck, however the most common include:

• A sudden awkward neck movement
• Poor sleeping posture – specifically a poor sleeping neck posture.
• Change in weather – mainly exposure to cold breezes
• Viral infection or head cold
• Idiopathic (unknown cause)

What can you do to alleviate your sudden neck pain?

Medication – Non-steroidal anti-inflammatory drugs (NSAIDs) and pain management

Pain analgesia (medication) and non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen or Voltaren may help reduce neck inflammation and subsequent pain within the first 48-72 hours.

These products can be purchased over the counter at your local pharmacy.

Please be sure to consult the pharmacist or your local GP prior to ensure appropriate and safe use.

Application of heat – Keep your neck warm!

Whether it be in the home or outdoors, keep your neck warm!

In your home, apply a hot water bottle/heat pack wrapped in a towel for soothing and pain relief.

Feel free to use the heat pack for as long of a time duration as you wish – there is no time minimum or maximum guidelines.

Heat application may also be in the form of a hot shower and the application of topical massage creams such as Fisiocrem (all natural) and Deep Heat.

Gently rub in and apply the creams to the area of pain, tightness and discomfort.

Additionally, if going outdoors, specifically in the winter, make sure to wear any item of clothing that will protect your neck such as a scarf, fleece or turtle neck jumper.  

Keep your neck moving – “I like to move it move it”

Gentle neck movements such as looking up, down, and over your shoulders are recommended.

Do not push yourself, and only perform these exercises within your pain-free range.

I understand you may be hesitant to move your neck in fear of creating further injury or enhancing your pain, but I promise that you will actually be doing more damage if you don’t move your neck.

Avoiding neck movements will only create further joint stiffness, and that is something to rather be fearful of. Therefore, gentle neck movements will minimise this risk.

Stop activities that will aggravate your pain

Before you have seen your Physiotherapist, stop high neck loading activities such as running, bike riding, gardening and the use of upper limb weights at the gym to name a few.

Stay hydrated

Drink lots of water to keep the muscles hydrated and prevent further muscle spasm and cramps.

Sleeping habits

For those of you who are “tummy” sleepers, or like to sleep on your side, I can pre-empt you won’t be happy to read this next sentence.

Try and sleep on your back!

I know it is hard to change your sleeping pattern but sleeping on your back with the base of your pillow touching the edge of your shoulders allows for your neck to be supported and kept in neutral position.

This assists in reducing further neck muscle strain and pain.

Visit a Physiotherapist ASAP!

Acute wry necks respond remarkably to Physiotherapy treatment within the first 1-4 days.

Your Physiotherapist will first thoroughly assess you to better understand your neck pain and reduced function.

Following this assessment, a range of treatment methods may be used such as:

• Soft tissue massage
• Ultrasound machine – The application of heat and stimulation to promote cell healing.
• Gentle mobilisations
• Education – Surrounding the “do’s and don’ts” as listed above under “What can you do to alleviate your sudden neck pain?”.
• Specific individualised home exercise program including both stretches and strengthening exercises. These exercises aim to increase the necks range of motion, improve muscle endurance, improve muscle stabilisation and improve muscle strength to prevent a recurrence or further injury.  

As you progress through your Physiotherapy sessions (quantity as recommended by your Physiotherapist) and your neck pain begins to reduce and subside, other appropriate interventions may be utilised such as:

• Deep tissue massage
• Dry needling – An intervention that aims to reduce pain by releasing deep tissue and muscle tightness. Instead of leaving the needle stationary (as done in acupuncture), the qualified Physiotherapist will “flick” and “twitch” the needle as to stimulate muscle contraction release.
• Postural taping
• Increased mobilisation strength and pressure
• Specific individualised home exercise program progression including both stretches and strengthening exercises

Clinical group Physiotherapy exercise/pilates classes

Once your acute wry neck has been successfully managed and you are no longer experiencing debilitating neck pain, joining clinical pilates classes conducted by a Physiotherapist is highly recommended.

Pilates is an amazing clinically proven means of exercise that will allow for the strengthening of your deep neck muscles and cervical spine stabilisers. It will ensure the ongoing maintenance of your pain free neck and reduce your risk of a future relapse!

If you are suffering from neck pain and wanting to give your neck some attention, book an appointment with one of our qualified physiotherapists at Physio AUS at our Highett clinic on 1300 392 552 or book online here.  

Please do not hesitate to call us if you have any questions!

Written by Jaime Bild – Physiotherapist.