Acute wry neck or torticollis is relatively rare and precipitated typically by the sudden onset of significant neck pain which leads to reflex neck muscle contractions and the maintenance of an abnormal neck position. Patients often report pain clinics that they woke with severe neck pain and torticollis, with the process often assumed to be secondary to sleeping in an inappropriate position during the night.
A few days or up to a fortnight is enough to resolve most of these pains and the chronic pain treatment is analgesia, collar if needed, physiotherapy such as neck massage, neck stretching and neck exercises. When examined a patient exhibiting torticollis will keep their head flexed to the painful side to some degree and also rotated away from the painful side.
The first thing a person is aware of is the sudden pain on one side of the neck, often severe and lower in the neck. Nerve root problems are usually somewhat slower in onset but if the symptoms presented on waking this could be the diagnosis. The outcome is very likely to be just as good as the muscle or joint strain which is more common, but recovery typically takes longer over a period of weeks.
The posture of the head will be recorded by the physio with ranges of motion achievable and the resulting symptoms. The physiotherapist will take the history including previous episodes of pain medication and how this one came on, either suddenly or during the night.
The physiotherapist is less likely to choose to test the muscle power in the shoulders and arms as this would cause an increase in pain and not reflect the patient's true muscle strength. The usual questioning to exclude potentially serious underlying causes or complicating medical conditions will be undertaken.
Pain management of an acute wry neck is based on the same principles for all injuries of soft tissues. Firstly the physio attempts to reduce the inflammation and pain of the injury and thereby the muscle spasms which exacerbate the pain.
Analgesics and anti-inflammatory drugs can be very useful as the pain is the primary problem and not some anatomical abnormality of the neck. Typical physiotherapy management includes ice, use of a collar if indicated and gentle tractioning of the neck relax the neck muscles and settle pain.
A few days or up to a fortnight is enough to resolve most of these pains and the chronic pain treatment is analgesia, collar if needed, physiotherapy such as neck massage, neck stretching and neck exercises. When examined a patient exhibiting torticollis will keep their head flexed to the painful side to some degree and also rotated away from the painful side.
The first thing a person is aware of is the sudden pain on one side of the neck, often severe and lower in the neck. Nerve root problems are usually somewhat slower in onset but if the symptoms presented on waking this could be the diagnosis. The outcome is very likely to be just as good as the muscle or joint strain which is more common, but recovery typically takes longer over a period of weeks.
The posture of the head will be recorded by the physio with ranges of motion achievable and the resulting symptoms. The physiotherapist will take the history including previous episodes of pain medication and how this one came on, either suddenly or during the night.
The physiotherapist is less likely to choose to test the muscle power in the shoulders and arms as this would cause an increase in pain and not reflect the patient's true muscle strength. The usual questioning to exclude potentially serious underlying causes or complicating medical conditions will be undertaken.
Pain management of an acute wry neck is based on the same principles for all injuries of soft tissues. Firstly the physio attempts to reduce the inflammation and pain of the injury and thereby the muscle spasms which exacerbate the pain.
Analgesics and anti-inflammatory drugs can be very useful as the pain is the primary problem and not some anatomical abnormality of the neck. Typical physiotherapy management includes ice, use of a collar if indicated and gentle tractioning of the neck relax the neck muscles and settle pain.
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