Acute Wry Neck

What is it?

Rotator cuff Injury of the shoulder is a very common condition involving the tendons of the rotator cuff. The rotator cuff is made up of 4 muscles that function to hold the arm into the shoulder socket. When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus.

In most rotator cuff tears, the tendon is torn away from the bone. Most tears occur in the supraspinatus tendon, but other parts of the rotator cuff may also be involved. In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object. There are different types of tears.

An acute wry neck is the sudden onset of neck pain accompanied by spasm of the neck muscles.

The main symptom is pain localised to one side of the neck. The pain can be referred to the head or shoulder region. The neck feels “stuck” in one position and attempted movements to free it usually results in sharp spasms of pain. Think of these joints becoming jammed or locked, rather like a door jamming on its hinge. The result is a painful, protective muscle spasm.

Anyone can get a wry neck but it occurs typically in young people between 12 and 30 years of age.

Mechanism of Injury

The precise cause of a Wry Neck is unknown. It may be the result of a minor injury or simply sleeping with the neck in an unusual position.

For many years the theory was that a “slipped disc” caused a wry neck, but with the help of modern diagnostic imaging the cause seems to be an injury to the facet joints. Contrary to popular belief, a wry neck is not caused by a cold draught on the neck.

Common Management Techniques

Physiotherapy uses a combination of massage, joint mobilisations, stretches and strengthening exercises.

You can do the following things at home:

  • Heat and massage. Applying a heat in the form of a hot face washer or heat pack to the painful area may help. Massage using an analgesic balm can also relieve symptoms.

  • Sleeping and pillows. Avoid sleeping on too many pillows. Pillows should support the head without bending the neck to an angle.

  • Tailored Exercise. Keep neck mobile within your comfort zone. We can design gentle exercise that aids a more rapid recovery.

  • Posture. Keep a good posture during all tasks. As part of a patient’s treatment, our physiotherapist will demonstrate how to achieve this.

  • Driving. Driving during the initial period of a wry neck should be avoided; the inability to get full rotation of the head to view oncoming traffic is hazardous.


Fortunately an acute Wry Neck is a transient and self-limiting condition that can recover in a matter of days. The Physiotherapists at Palms Physiotherapy are skilled in treating neck ailments and can effectively assist with pain relief and rapid recovery.