Wry neck is neck pain with restriction of movement. Patients often have trouble with all neck movements, in particular rotating their head and laterally flexing (when trying to place your ear towards your shoulder). They will also tend to hold their neck more to the side without pain.
Wry neck often occurs suddenly (acute), it is very common for people to present with wry neck upon waking from sleeping. Factors including sleeping in an uncomfortable position for an extended period or an uncomfortable pillow can both be factors.
The most common causes of wry neck are:
- Locked Facet Joint (Facet wry neck) - most common cause
- Cervical Disc Injury (Discogenic wry neck)
Facet Wry Neck
Facet wry neck is common in young children and adults (under 30 years). Facet wry neck is caused from the facet joints becoming stiff or stuck, this can occur through trauma (uncomfortable sleeping position or pillow), or arthritis. Facet joints allow movements to take place in your neck, they also restrict movement when required. The pain is due to the numerous nerve endings located within the facet joint and adjacent tissues.
- Pain - generally around the middle and side of neck
- Restricted movement
- Muscle spasms in the surrounding muscles
- Pain doe not normally occur below the shoulder
TREATMENT AND RECOVERY
Facet wry neck responds well to treatment which is focused on unlocking the facet joint and relieving the muscle spasms in the surrounding muscles. Facet wry neck can still take a week or two to fully recover from.
DISCOGENIC WRY NECK
Discogenic wry neck is caused from an injury to the cervical intervertebral discs. Pain is the result of the disc protruding and pressing against surrounding nerves and tissues. Movement is restricted due to the pain rather than being blocked as in facet wry neck. Discogenic wry neck is more common in 35-60 year olds
- Gradual onset of pain which is often dull
- Pain can be situated in the lower neck, shoulder or chest region
- Pain can radiate down the arm, pins and needles may be present and numbness and weakness may occur
- Muscle spasms
TREATMENT AND RECOVERY
Treatment for discogenic wry neck focuses on reducing pain and increasing range of movement through mobilisations and soft tissue massage. Gentle movement exercises will also be given. Recovery time for discogenic wry neck can be up to 6 weeks, although the initial symptoms can settle quite quickly. To avoid reoccurrence strength and flexibility exercises along with postural education is important.