Suffering from a pain in the neck is no laughing matter. Acute wry neck is a very common injury that can present with sudden onset of pain and stiffness in the muscles around your neck.

Acute Wry Neck

What is Acute Wry Neck?

Acute wry neck is a very common condition which can present with a sudden onset of neck pain and stiffness which is commonly accompanied by tightness or spasm in the neck muscles. This muscle spasm is most often a protective response which can cause pain and inability to move the neck. Wry neck can be quite disabling as the pain is often significant with very simple neck movements.


Causes of Acute Wry Neck

Wry neck is either caused by locking of a facet joint or irritation to a disc in the neck.

The most common cause is a locked facet joint. Normally these joints both allow and restrict gliding movements between the vertebrae above and below the joint in the neck. Occasionally, these joints become stiff due to injury, arthritis or simply getting stuck at extreme ranges of movement. The significant pain from the wry neck is explained by the high density of nerve fibers in the tissues surrounding these joints.

Discogenic wry neck is caused by excessive strain on one or more of the discs in the neck. Discs sit between vertebrae or bones in the neck and are a jelly-like substance enclosed by a strong ligament. When these discs are put under stress/repetitive strain they can bulge which results in swelling, pain and muscle spasm in the neck.


Symptoms of Acute Wry Neck

People experiencing facet wry neck will often wake up in the morning with a very stiff and painful neck. The onset of the pain and stiffness is usually sudden and causes can include sleeping on an uncomfortable pillow, having a restless night or waking suddenly with no known cause. The pain is often sharp and localised to the affected area. People will often experience loss of neck movement towards the painful side. Pain rarely travels down the arm and people don’t often experience pins and needles with facet wry neck.

Discogenic wry necks often present in the same way however, pain is more likely to travel down the arm and people often experience pins and needles in their hand as well.



Prognosis for facet wry neck is generally very good and with the correct diagnosis and timely treatment, people will often feel relief within 2-3 sessions and return to pre-injury function within a week.

Discogenic wry neck also has a good prognosis and will often feel a lot better within the first few sessions, however can take 2-6 weeks to return to pre-injury function depending on the severity.


Rehabilitation and Prevention

Early management for both facet and discogenic wry neck with your physiotherapist will often be gentle and involve facet joint mobilisation and soft tissue release of the surrounding neck muscles. Common early management advice includes use of heat packs for pain relief as well as re-introduction of gentle neck movements and avoidance of heavy lifting and rapid head movement. Once pain has settled significantly and movement is mostly restored, prevention involves exercises targeted at strength and endurance for muscles surrounding the neck.


Other points/further management

Wry neck which is not treated can result in stiffened neck segments which can lead to an individual being predisposed to recurring episodes of this condition.

Learn how to do these super effective gentle exercises when you have pain. Progressing to strength exercises when the pain has reduced. Always consult your physio or medical professional for an assessment of your condition prior to taking on any exercises.


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Libby Gracias
Symmetry Physiotherapy