Wry Neck

What is it?

A wry neck is a condition that causes pain and stiffness on one side of the neck. The onset is generally quick and people often report waking up and being unable to turn their head. 

What Causes it?  

Wry necks often occur after a sharp movement of the neck or sleeping with your neck twisted or in an awkward position. 

Clinically wry necks can be categorised into either facet joint or discogenic:

Facet joint wry neck

This is the most common type of wry neck and is due to the stiffening or locking of the joints that attach to either side of the spine known as the facet joints. These joints open, close and rotate to enable you to turn and tip your head from side to side. When they become stiff or ‘locked’ they cause pain that is localised to one side of the neck and does not travel beyond the tip of the shoulder. Sleeping with your neck twisted or in an awkward position and/or tummy sleeping are common causes of a wry neck. 

Discogenic wry neck

This is less common and can be longer lasting. This impacts the intervertebral disc that lies in between the central joints in your spine which are important for neck movement and shock absorption. With this type of wry neck the onset is often more gradual, can cause pain that radiates below the tip of the shoulder and pins and needles/ numbness into the hands. 

Other factors that can contribute to a wry neck

• Prolonged period of sitting in a poor posture e.g. long flight, desk based work etc.
• Poor ergonomic set up.
• Heavy lifting and/ or poor lifting technique.
• Different or poor sleeping position e.g. too many/ few pillows, unsupportive pillow, tummy sleeping.
• Repetitive or sustained awkward neck position e.g. looking at a screen on an angle.

Physiotherapy Treatment 

In the majority of cases physiotherapy treatment is effective in relieving symptoms and regaining normal range of movement within a week or two. Discogenic wry neck presentations may take longer depending on the severity. Ideally the earlier you see a physiotherapist the better as this will generally reduce the time it takes to get the joints moving again.  

Treatment may involve a range of modalities including:

• Joint mobilisation
• Soft tissue release
• Dry needling
• Gentle traction
• Exercises to promote movement of your neck
• Advice regarding: appropriate pillow, sleeping positions, ergonomic set up.
• Self management strategies: application of heat or ice as appropriate, keeping active within pain limits, avoiding the use of neck braces and pain relief if required.
• Longer term strategies: postural strengthening, core strengthening.

Keeping moving is best! 

Written by Caitlin Collenette, Physiotherapist