It is a surprisingly common condition, but since wry neck can come on unexpectedly (called acute wry neck), it can be both startling and disabling.
All of a sudden, simple neck motions can cause pain or muscle spasms! It is, fortunately, treatable and can be remedied once diagnosed.
Symptoms of Wry Neck
Having wry neck is not the same as having neck pain. As mentioned above, torticollis occurs when the neck is actually twisted. While this can be hard to determine for people without training, there are several distinctive signs.
Patients with wry neck will, naturally, have neck pain and stiffness. The twisted neck may result in their chin tilting to one side and one shoulder may be positioned higher than the other. Additionally, it may be difficult or impossible to move the head normally without pain, and the muscles in the neck may be swollen. The degree to which each symptom presents itself will depend on the form of torticollis experienced (see below: Types of Wry Neck).
Wry neck can be something a person is born with (“congenital”). In this case, wry neck may present itself with additional symptoms. Children with wry neck have faces that may appear “flattened” or otherwise off-balance. Motor skill delays and hearing or vision difficulties are not uncommon as well.
Types of Wry Neck
There are several different possible causes for torticollis and understanding them requires knowing about the two main ways the condition presents itself: facet wry neck and discogenic wry neck.
Facet Wry Neck
If you observe a picture of a spinal column, then you’ll notice how it is arranged into numerous sections, or vertebrae. The points where the vertebrae connect are called facet joints. These joints normally allow smooth movements between the adjacent vertebras and partially limit the movement of your neck. Sometimes, the facet joints can become stiff or stuck. Stiffness is usually the result of injury or arthritis—the sense of joints “getting rusty” as people age—and getting stuck can happen during extreme movement. The pain comes from the large number of nerve endings in the facet joint and the surrounding tissue.
Facet wry neck usually occurs when someone wakes up with a stiff and painful neck. In these instances, it has likely been caused by some form of nighttime movement.
Since the facet joint is fixed in an abnormal position, you physically cannot move your neck much while experiencing facet wry neck. Any movement will aggravate the pain due to the fixed position. Typically, the pain does not extend past the shoulder.
Discogenic Wry Neck
In the spine, the space between vertebrae is filled by intervertebral discs. These ligaments help provide movement and hold the vertebrae together, although one of their more crucial roles is being a shock absorber. If something causes the intervertebral disc to bulge under stress or tear—similar to a sprain—the disc will swell. The swelling disc puts pressure on surrounding nerves, resulting in pain.
The pain of a discogenic wry neck is duller and more slowly-developed than that of its facet equivalent. The pain is felt along the lower neck, shoulder, or upper chest, and in some cases can spread down into the arms. Although the neck in discogenic cases is difficult to move, the causes are more psychological than physical. The limited range of motion associated with a discogenic wry neck occurs when the patient tries to keep their head away from movements that result in pain. Movement is fully possible—it will just hurt a lot.
As with a facet wry neck, muscle spasms can also occur.
Causes of Wry Neck
There are a few general ways to develop torticollis. Some are unique to facet or discogenic forms, but others are shared:
- Fetal positioning: As mentioned previously, facet wry neck can sometimes be congenital. If the fetus’ head is in the wrong position in the womb, the neck bones can be formed incorrectly. This is called Klippel-Feil Syndrome.
- Injury: The intervertebral discs are like ligaments, which means they can sometimes be torn. Discogenic wry neck can be caused by strain from poor posture, heavy lifting, etc. Facet wry neck can also be caused by these, but more likely it is triggered by injuries to the muscles, nervous system, or the neck’s blood supply.
- Sudden movement: Both forms of torticollis can be caused by sudden movement or jerking the head.
- Infection: A cold, ear infection, or swollen lymph node can restrict the movement of the head and cause a temporary state of facet wry neck.
- Cervical dystonia: Sometimes called spasmodic torticollis. It’s a rare disorder that causes the neck muscles to contract and spasm. Patients find their heads twisting or turning painfully to one side or tilting forwards and backwards. Cervical dystonia affects more women than men, but is present in both genders, and commonly occurs in middle-aged individuals.
Treatments for Wry Neck
- First, make sure you actually have wry neck by seeing a doctor. Certain serious illnesses or injuries are associated with symptoms that can be mistaken for torticollis—getting them mixed up is a bad idea.
- Facet wry neck can be unlocked through soft-tissue massage or physical therapy.
- Congenital wry neck can be corrected by stretching the neck muscle without surgery—if caught early enough. If not, surgery will be needed.
- Heat, neck braces, and muscle relaxants can all ease the swelling in cases of discogenic wry neck and help speed recovery.
- Although there is no absolute way to prevent wry neck from occurring, you can reduce your chances by maintaining good posture.
Treatments for wry neck will usually resolve the condition with two days. In the case of facet wry neck, the facet joint can be moved back into place immediately—there will, however, be some amount of lingering pain and muscle issues for around a week or two as your body recuperates. Taking it easy during this period is important in order to reduce the chance of the injury occurring again.
Sources for Today’s Article:
Miller, J., “Wry Neck,” Physio Works web site, last updated August 4, 2015; http://physioworks.com.au/injuries-conditions-1/acute-wry-neck, last accessed August 19, 2015.
Pietrangelo, A., “Wry Neck (Torticollis),” Healthline web site, August 20, 2012; http://www.healthline.com/health/torticollis#Overview1.
“Wry Neck (Discogenic),” Physioadvisor.com; http://www.physioadvisor.com.au/10438450/wry-neck-torticollis-bulging-neck-disc-physi.htm, last accessed August 19, 2015.