The medical term for a stiff and painful neck is called, an Acute Wry Neck. This is often accompanied by spasm of the surrounding neck muscles, neck pain and an inability to turn your neck through its full range of motion.
Acute wry neck is an extremely common condition, which can be quite disabling as the sufferer experiences constant severe pain with simple neck movements.
The most common cause of acute wry neck, is due to a locked facet joint. Facet joints are located at the back of your spinal column. These facet joints allow, guide and limit the movements of your neck. Your facet joints are intended to allow smooth gliding movements between the adjacent vertebra. Occasionally your facet joints can become either stiff through traumatic injury or arthritis or simply get stuck at at extreme of movement.
A common reported history for the wry neck patient is to wake with a stiff and painful neck. Onset of the wry neck is usually sudden. The cause may have included a restless night sleep, uncomfortable pillow, waking suddenly in the night (eg a noise) or simply unknown. Professional cricketers, travel a great deal, that is, sleeping on long flights to various countries around the world and most importantly, they sleep in different beds and on different pillows. A pillow is extremely important for a comfortable sleep and a "healthy" neck. The comfort and moulding of a pillow to a cricketers neck, changes from their own pillow at home, to a pillow in a hotel in Brisbane, London and Colombo. Apart from this, I feel that batsman are more prone to wry necks because of long periods of batting, in the same side-on position. They need to keep their head in a side-on position for a repeated time to face a bowler. Hence, this becomes a repeated movement and an overuse movement.
Wry neck pain is due to the numerous nerve endings that are located in the facet joint itself and in the tissues adjacent to the facet joint. Facet wry neck is most common in younger populations, ranging from young children to people in their thirties. Older facet wry neck sufferers tend to have a more gradual onset with the facet joints becoming "rusty" over time.
Signs and Symptoms of Facet Wry Neck
Pain – generally located in the middle or side of the neck that is affected. The onset of pain is sudden. The pain experienced does not extend beyond the shoulder joint.
Loss of Movement – your neck is generally fixed in an abnormal position – most commonly flexed forward and rotated away from the side of pain. All movements aggravate the pain, as the joint is fixed and movement triggers irritation to the joint and thus pain.
Muscle Spasm – this is a tightening of the associated neck muscles that further limit movement.
Treatment:
Physiotherapists assess your neck and confirms which joint or joints are locked, they will utilise a range of low risk joint treatment techniques and soft tissue massage to normalise your facet joint function.
While the joint can almost always be immediately unlocked, you will have some residual muscle spasm and swelling in the region due to the trauma. Think how a sprained ankle swells! Neck joints will also swell, but it won't be as visible.
How Long is Recovery?
Most acute wry necks can be unlocked immediately. However the residual effects may last for up to one week. It is also important to normalise your neck muscle and joint function (eg strength and motion) to prevent a regular recurrence, which unfortunately commonly occurs if your neck injury is poorly rehabilitated.
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Craig Govender Physiotherapy @ The Bullring
