What is an Acute Wry Neck? The Symptoms & Treatment Options

Written by Leon Mao
Physiotherapist, University of Melbourne
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on April 4, 2022
Contributed by Jamie Page
Physiotherapist, Salford University

Woman sitting on edge of pain with acute wry neck

According to the Australian Institute of Health and Welfare, neck pain is categorised as the second leading burden of disease in Australia.[1] The Australian Family Physician states that neck conditions, such as acute wry neck, affects up to 21.3% of the population within any given year and more commonly affects women.[2]

How an acute wry neck develops is still not fully understood, and it can be very concerning as symptoms develop very quickly, often overnight after waking up. However, the term ‘acute’ suggests that symptoms are usually short-lived and often resolve within weeks.

Read on to understand what you should know about an acute wry neck; the risk factors, treatment options and expected recovery time.

What is an Acute Wry Neck (Torticollis)?

An acute wry neck (torticollis) occurs when the muscles around the neck suddenly contract. People experiencing a wry neck often report pain, locking and limited ability to move their neck. The tight muscles can also cause the neck to be tilted and twisted in awkward positions.

What are the symptoms of an acute wry neck?

An acute wry neck is characterised by a combination of symptoms, including a sudden onset of neck stiffness, pain on one side of the neck, muscle spasms and a tilted head position. This may be accompanied by a headache and stiffness of the upper back and shoulders.

Common symptoms of an acute wry neck

What causes an acute wry neck?

The exact cause of an acute wry neck is relatively unknown. Poor sleeping positions or rapid movements of the head are some of the potential causes. Other factors that may increase the risk are stress, increased computer work or any new/unusual activity putting more tension on the neck.

Common causes of an acute wry neck

  • Sleeping with your neck in an awkward position

  • Waking up suddenly in the middle of the night and twisting your neck

  • Uncomfortable pillows

  • Disc bulge causing nerve irritation

Sports that increase your risk of an acute wry neck

Sports that may cause a direct blow to the head and neck causing overstretching of the tendons and ligaments around the cervical spine may increase the risk of an acute wry neck.

  • Football

  • MMA

  • Boxing

  • Wrestling

  • Weightlifting

How is an acute wry neck diagnosed?

There are several options available when it comes to diagnosing your neck pain as an acute wry neck. One of the more common and most recommended by Australian GPs is an assessment from a physiotherapist.

Physiotherapists are highly qualified experts in the field of rehabilitation. They can effectively identify the root causes of your pain and injury in the neck region and provide you with appropriate treatment.

Physiotherapy assessment is similar to visiting a GP. Your consultation will start with a mini-interview about your health status to provide the background of your condition and help formulate an accurate diagnosis and treatment goals.

After establishing the background of your condition, your physiotherapist will perform a physical assessment and movement screens to determine the best possible cause of your pain and rule out other conditions.

The initial evaluation typically lasts for about 30 to 60 minutes. Your physiotherapist will then create a specific treatment plan based on your assessment to help you recover from injury.

From here, your physiotherapist will give you the details of your treatment program; this will include:

  • Number of treatment sessions

  • List of exercises you need to do at home

  • Strategies to manage the pain and to prevent worsening of the condition

  • Timeline of your total recovery

  • Recommendations.

How is an acute wry neck treated?

An acute wry neck can be painful and affect your head mobility. Immobility of your neck for a prolonged period may cause secondary complications that can affect the quality of your life.

There are several options when it comes to treating the conditions that cause an acute wry neck. One of the more common and the treatment option referred to by Australian GPs the most frequently is physiotherapy.

An acute wry neck is an injury that physiotherapists come across regularly and the process of treating it is straightforward. Following an initial consultation, the physiotherapist will be in the best position to determine your treatment plan.

A combination of treatment protocols such as manual therapy, pain modalities, and specific movement exercises will be given to you by your physiotherapist.

Your treatment will focus on improving your neck mobility, increasing your range of motion and decreasing your pain.

Depending on the severity of your acute wry neck, a physiotherapist may provide you with a combination of the following types of treatments:

  • Soft Tissue Massage - Soft tissue mobilisation techniques improve blood circulation and decrease muscle spasms in your upper back and neck region.

  • Dry Needling - Specialised needling techniques to reduce pain and muscle spasms.

  • Therapeutic Exercises - Given to correct impairments and improve the function of your muscles and tendons around your neck.

  • Stretching Exercises - Techniques used to lengthen your muscles, decrease tension and improve your range of motion.

  • Heat Therapy - Used to increase blood circulation in the area and reduce muscle spasms.

  • Range of Motion Exercises - Techniques used to maintain and improve the range of motion of your neck and prevent stiffness due to inactivity.

  • Postural Exercises - Exercise techniques to improve your posture and promote proper muscle and joint mechanics to help reduce tension in the neck area.

  • Manual Therapy - Hands-on treatment technique applied by your physiotherapist to achieve greater mobility of the cervical spine and allow pain-free movements

  • Traction - Specific to neck pain, traction can relieve tension at the base of the skull.

  • Advice and Education - Professional expert advice to help you manage the pain and improve your recovery.

Physiotherapy treatment can last for about 30 to 60 minutes. Most patients can feel the difference in just a single session.

Next step - Creating a treatment plan made for you

Your physiotherapist will create a detailed treatment plan that will guide you step-by-step based on your treatment goals to maximise your recovery.

Self-care for an acute wry neck

If you are experiencing an acute wry neck, here are the best things you can do and avoid.

Things to do:

  1. Stay active within your pain limit

Staying active is beneficial to help prevent secondary complications of inactivity.

  1. Use Hot Compress

A hot compress helps relieve muscle stiffness. Apply a hot compress for at least 15 to 20 minutes to improve blood circulation in the area and relax your muscles.

  1. Gentle Stretching

Gentle stretching of your neck can reduce muscle stiffness and improve your range of motion.

Things to avoid:

  1. Avoid complete rest

Resting is good if you are suffering from direct trauma or injury. However, prolonged rest and inactivity of your neck muscles can further limit your range of motion and cause more pain.

Do I need a specialist or surgery?

Tests are not usually needed to diagnose acute wrynecks. However, several imaging exams such as X-rays, MRI, and CT scans can further assess the cervical spine structures.

Severe cases may need medications and Botulinum Toxin injections to resolve hypertonicity and painful muscle spasms.

Your physician may refer you for physiotherapy for further assessment and help you recover faster.

What is the recovery time / prognosis for an acute wry neck?

Ultimately, recovery time is dependent on your proactiveness to seek professional treatment and the severity of your neck pain and injury.

As fast as you may develop an acute wry neck is as fast as you may recover with the right treatment. Research suggests that recovery time for an acute wry neck can be as quick as 1-2 days, sometimes 2 to 3 weeks depending on the severity.

Physiotherapy improves the overall outcome and promotes a faster recovery for patients who have an acute wry neck.

Can an acute wry neck be prevented?

Guaranteeing prevention can be impossible, however there are some things you can do to reduce the likelihood. These tips for prevention are also useful treatment options if you are already in pain.

  • Strengthening your neck muscles – exercising your neck muscles regularly can help you build strong muscles that are more resilient to injuries.

  • Stretch your neck muscles – stretch your neck muscles regularly to help relieve tension in the area.

  • Be mindful of your posture – slouching posture and excessive rounding of your shoulders can place extra stress on your neck muscles. Always be mindful of your posture and incorporate proper body mechanics.

Outlook and the main takeaways

An acute wry neck is a painful neck condition that can last for several weeks if left untreated. Pain and limitation of your neck motion can be a real worry and make it more difficult for you to go about your daily life. Don’t hesitate, book a visit today with your nearest physio and start your recovery immediately.

Anatomy of the neck

Your neck is a mobile region of your body that allows a variety of movements for the head. However, injuries around the cervical spine can irritate the nerves and cause severe muscle spasms limiting your neck movements.

Facet Joints

Facet joints are small joints in the side of your vertebrae that facilitate movements of the spine to a certain degree and limit excessive motions of the neck.

These facet joints can sometimes become stiff or “locked”, preventing movements resulting in loss of motion and pain in the neck. Nerves around these facets can also be irritated, causing more pain and spasm.

Spinal Discs

There are specialised discs in between your spine called spinal discs, which serve as a cushion for various stress forces around your spine.

Spinal discs can become injured and bulge out of position, causing swelling and irritation of the nerves around the area.

Written by Leon Mao
Physiotherapist, University of Melbourne
Published on April 4, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on April 4, 2022
Contributed by Jamie Page
Physiotherapist, Salford University
Medical reviewers
Last medically reviewed on April 4, 2022
BookPhysio.com has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
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