Wry Neck (Torticollis)
Wry neck or ‘twisted neck’ is also known as torticollis. It is a common condition where there is a sudden onset of severe pain and muscle stiffness around the neck. As a result, people with wry neck often suffer from restricted neck movements. Symptoms could appear upon waking up in the morning without any signs of pain or injury before heading to bed the previous night.
What Causes Wry Neck?
The cause of sudden-onset wry neck is often unknown. It can happen in people with no previous neck symptoms or trauma and is relatively common in young people. Some of the common causes are:
- Minor sprain or irritation of the neck muscle or ligament
- Carrying heavy loads on the shoulder lopsidedly (E.g.: handbag, laptop bags, etc.)
- Poor ergonomics at the workplace
- Sitting or sleeping in an odd position without proper neck support.
Other causes which are less likely include:
- Muscle spasms derive from infection of the throat or upper airways
- Scarring tissue
Types of Wry Neck:
Apophyseal (Facet Joint) Wry Neck
Apophyseal joint, also known as facet joint, is a small joint which connects the vertebrae on top of one another. Each vertebra segment consists of two apophyseal joints. This facet joint provides structural stability and flexibility to the whole vertebral column.
Apophyseal wry neck refers to the stiffness of the facet joint where the joint gets ‘jammed’ or ‘locked’ in a certain position. It is possible that the nerve endings surrounding the facet joint become irritated and sensitive. This may result in pain even during small movements. Symptoms are usually sudden, effecting at the center or one-sided of the neck with neck muscle spasm.
Discogenic Wry Neck:
As the name suggests, discogenic wry neck implies an injury to the intervertebral disc at the neck. The intervertebral disc acts as a cushion between the vertebrae, absorbing most of the stress and pressure from impact. When stressed, these discs can bulge or tear causing swelling. Similarly, this may cause irritation to the surrounding nerves and soft tissues. Symptoms usually start gradually with dull and diffused pain.
Physiotherapy Management for Wry Neck
Proper physiotherapy management aims to address the pain and restores the full range of motion at the neck. Physiotherapists will incorporate suitable manual technique, including joint mobilizations to promote movements through the restricted range. Nevertheless, exercises to stretch and strengthen the neck muscles will also be given. Doing it several times a day helps to ease pain and will increase range of motion. A comprehensive management reduces the likelihood of a recurrence.