Wry Neck (Acute Torticollis)

Brighton Beach Physio - Tuesday, August 02, 2016

Acute wry neck is a very common neck condition causing pain and stiffness in the neck. A common presentation is waking up with slight stiffness in the neck, then on turning your head later in the day you get a sudden onset of pain with restricted neck movements. Following this it is very difficult to move the neck due to severe pain.


Acute wry neck is usually caused by the facet joints in the spine locking. Facet joints are located in the in the back of the vertebrae and are responsible for the movement of one vertebrae over another which is the key to correct movement in the neck. Locking of these facet joints is thought to be caused by inflammation; muscle spasm follows this which creates further difficulty with moving the neck. Although it is usually a sudden injury there are several causative factors which may predispose you to wry neck which include:

  • Poor posture
  • Poor sleep posture
  • Poor work station set-up
  • Poor strength and endurance of the deep neck muscles
  • Poor strength and endurance of the muscles around the shoulder blade


Patients with wry neck usually report the following symptoms:

  • Pain which is usually on one side of the neck but can also be in the middle, pain can also radiate between the shoulder blades but does not usually go below the shoulders
  • Restricted movement with associated pain
  • Deformity which can present as rotation and/or tilting of the head away from the side that is painful
  • Muscle spasm


Physiotherapy management is the most effective treatment of wry neck and pain usually resolves within 2 or 3 sessions. However, depending on the cause of your wry neck further appointments may be beneficial to address the underlying cause of the concern.
Your physiotherapist may use a selection of treatments including

  • Joint mobilisations to improve joint function
  • Soft tissue treatment including massage to relieve the muscle spasm.
  • Dry Needling
  • Taping to offload the neck or shoulder blades
  • Home exercises including stretching and strengthening targeting the neck, shoulder blades and whole body posture

It is important to address the underlying issues which may have contributed to your wry neck. Wry neck which is left to resolve on its own may result in a stiffened segment or increase in muscle tension which can result in recurrent episodes.
If you feel you, or someone you know, may be suffering from wry neck or any other neck or postural condition call Brighton Beach Physiotherapy Centre on 9304 4100 for an assessment and treatment plan. No GP referral is required and private health rebates can be claimed immediately.