Acute torticollis (Wryneck)

Sudden neck pain or stiffness may indicate acute torticollis. Torticollis, also known as wryneck, is a common and often harmless condition that occurs, for example, as a result of a rapid neck movement or a strained neck muscle. The symptoms usually go away on their own, but the pain and stiffness can feel very disabling at the time. 

Acute torticollis

About one in two people will experience neck pain at some point in their lives. Neck pain, just like low back pain, is one of the most common causes of disability among the adult population.

Acute torticollis is a common form of neck pain caused by the muscles in the neck spasming, leading to neck pain and limited neck movement. One can say that torticollis in the neck is the equivalent of acute lumbago in the lower spine.

What causes acute torticollis?

You can develop torticollis for several different reasons. Your neck muscles may cramp or spasm if the neck is subjected to a hasty movement or a strain due to poor sleeping or working posture. Carrying something heavy on one side of the body may also strain the neck and lead to a wry neck.

When the neck is suddenly subjected to a strain, warning signals are sent to the brain that the neck needs to be protected to avoid an injury. This causes the neck muscles to spasm in an effort to protect the neck. When the muscles spasm, pain and stiffness occurs and movement of the neck is suddenly limited. 

Sometimes there is no underlying cause of acute torticollis, but in the vast majority of cases one of the following has causedd the condition:

  • Sudden head/neck movement
  • Poor sleeping position
  • Poor working position
  • Overloading of the neck muscles

Common symptoms

The most common symptom of acute torticollis is that it suddenly becomes difficult (or impossible) and painful to turn the head in one direction. The symptoms usually go away on their own, but it can take a few days or a week for the pain and stiffness to subside. 

Typical symptoms of acute torticollis are:

  • Neck pain
  • Difficulty turning the head to one side
  • Intense pain when turning the head to one side
  • Neck stiffness
  • A sensation that the neck is “locked”
  • Mild dizziness
  • Mild headache

Treatment

Even though it may feel scary, it’s important to try to move your neck as much as possible when you have symptoms of torticollis. This will speed up the healing. In the past, health professionals believed that the neck should be held still and recommended the use of a neck brace (cervical collar) to torticollis patients.  However, updated research has shown that neck braces in fact reduce muscle strength in the neck which makes recovery difficult. This is due to the neck being held still for a longer period of time which is unnatural.

The neck should therefore constantly be in motion to speed up the recovery process. A physical therapist can provide specific neck exercises that relieve symptoms. You should also review your working position to avoid straining your neck in a way that worsens your symptoms.

Preventing acute torticollis

Despite there not always being an exact cause behind the development of acute torticollis, there are a few things you can do to help prevent the condition. Being regularly physically active is the best way to avoid a stiff neck. A comfortable bed and a good pillow that supports the neck can also reduce the risk of straining the neck due to a bad sleeping position.

One should try to avoid carrying heavy load on only one side of the body, as this can easily strain the neck muscles. 

A good working position is also important to prevent a wry neck. For example, you can adjust your chair and desk so that your posture is in an upright, correct position. 

When should I see a doctor?

Ordinary torticollis is not dangerous, but if in connection with neck pain and stiffness you develop a fever, severe dizziness, a severe headache, nausea or numbness in the arms, you should seek medical attention immediately. Your neck pain, in combination with these other symptoms, may be a sign of something serious. You should also see a doctor immediately if a major trauma to the back, head or neck has caused the torticollis.

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