Wry Neck

Does this sound like you?

Most people have several of these, not all of them.

• Waking with sharp one-sided neck pain, the head held tilted or turned away
• Movement sharply blocked one way, relatively free the other
• Strong muscle spasm you can feel as a hard band
• Pain referring into the shoulder blade or upper back
• Distress and alarm out of proportion to how serious it actually is

Why it happens

• Sleeping in an awkward position, by far the most common trigger
• A sudden unguarded movement, such as turning quickly to look behind
• A facet joint catching, with the surrounding muscles then locking it down
• Cold draughts on a neck already tired or tense
• In children, occasionally a response to a throat or ear infection

What we would do about it

Roughly in this order — each step waits for the one before it.

1. Gentle joint mobilisation to free the segment, within what the neck will tolerate
2. Soft tissue release and dry needling for the protective spasm
3. Heat and positions of ease to use at home between sessions
4. Rotation restored gradually as the guarding settles
5. Pillow height and sleep position advice, to reduce the chance of it recurring
6. Most cases improve markedly within three to five days of starting treatment