David Roche MSc Pg Dip BSc HNC CSCS
Acute Stiff Neck
Have you ever woken up with an inexplicably stiff and painful neck that will only turn to one side? You might have been suffering from acute wry neck, a painful condition following a typical pattern of symptoms. In the clinic, wry neck is classified as one of two different types – Facet or Discogenic wry neck. These have similar presentations, yet are caused by slightly different things and require different treatment.
Facet Wry Neck:
Facet joints are found on either side of each vertebrae of the spine and allow for controlled rotation and side bending. An awkward movement of the neck can cause a part of the joint capsule to tear or get caught in the joint, making it feel locked. The muscles around the area can also be come tight and spasm, which contributes to the problem. The pain is usually sharp and can be pin pointed quite accurately to the part of the neck causing the problem and the pain rarely travels down into the arm. It is usually possible to find a resting position where the pain goes away completely, only having pain when turning in certain directions.
The good news about Facet Wry Neck is that your physiotherapist is usually able to help you ‘unlock’ the neck quite quickly with gentle mobilisations and get you back into action. Most of the time a full recovery can be expected within a week.
Discogenic Wry Neck:
Each of the vertebrae of the neck are separated by fibrous disc that are filled with a gelatinous center. These discs provide support, flexibility and shock absorption. Under pressure, these discs may bulge or tear and the resulting swelling can cause pain and muscle spasm in the surrounding area. It is important to note that in an area as sensitive as the neck, a small amount of damage can result in a large amount of pain.
The development of discogenic wry neck is usually due to a combination of factors, including neck stiffness, poor posture and biomechanics than can contribute to the disc being vulnerable prior to injury. In this case it can be difficult to find a comfortable position and it is more likely for the pain to travel into the arm and may even be associated with pins and needles.
Treatment of discogenic wry neck will be focused on reducing pain and muscle spasm with massage, taping, heat and postural education. Further treatment aims to reduce any stress that is being placed on the disc, mobilise any stiff spinal segments and correct any muscle imbalances. While the initial symptoms may settle down quite quickly, it can take up to six weeks to fully recover from discogenic wry neck. In this condition it is also important to address all the factors that may cause a recurrence of the issue