cervical spine – Hinteractive Physio

Have you ever woken up with an inexplicably stiff and painful neck that will only turn to one side? You might have been suffering from acute wry neck, a painful condition following a typical pattern of symptoms. In the clinic, wry neck is classified as one of two different types – Facet or Discogenic wry neck.

Facet Wry Neck:

Facet joints are found on either side of the spine and allow controlled rotation and side bending of the neck. An awkward or sudden movement of the neck can cause a part of the joint capsule to tear or get caught in the joint, making it feel locked. The muscles around the area can also become tight and spasm, which amplifies the pain. The pain is usually sharp and can be pinpointed quite accurately to the part of the neck causing the problem, and the pain rarely travels down into the arm. It is usually possible to find a resting position where the pain goes away completely, only having pain when turning in specific directions. The good news about Facet Wry Neck is that your physiotherapist is usually able to help you ‘unlock’ the neck quite quickly with gentle mobilisations. Most of the time, a full recovery can be expected within a week.

Discogenic Wry Neck:

The vertebrae of the neck are separated from each other by fibrous discs, filled with a gelatinous centre. These discs provide support, flexibility and shock absorption. When placed under pressure, these discs may bulge or tear, and the resulting swelling can cause pain and muscle spasm in the surrounding area. It is important to note that in an area as sensitive as the neck, a small amount of damage can result in a large amount of pain.

The development of discogenic wry neck is usually due to a combination of factors, including neck stiffness, poor posture and biomechanics than can contribute to the disc being vulnerable prior to the injury. In this case, it can be challenging to find a comfortable position, and it is more likely for the pain to travel into the arm and include pins and needles.

Treatment of discogenic wry neck is focused on reducing pain and muscle spasm with massage, taping, heat and postural education. Further treatment aims to reduce any stress that is being placed on the disc, mobilise any stiff spinal segments and correct any muscle imbalances. While the initial symptoms may settle down quite quickly, it can take up to six weeks to fully recover from discogenic wry neck. In this condition, it is also essential to address all the factors that may cause a recurrence of the issue.

Headaches where the pain originates in the cervical spine (upper spine), neck and upper shoulders are often referred to as a “cervicogenic” headache. Many times, these headaches can be a byproduct of injuries such as whiplash, joint or muscle trauma and more commonly due to poor prolonged posture or even cases of severe stress.

Headaches are one of the most common ailments in modern society, approximately 12-15% of the population suffers from headaches each year. Usually these are minor stress or tension related headaches, and in some people are more severe migraine headaches. Unfortunately, one type of headache that is often overlooked and misdiagnosed is the cervicogenic headache.

Cervicogenic headaches are one of the most common types of headache, and are clinically defined as pain that is present in the head, but which originates in the cervical spine. The pain associated with this condition is an example of referred pain. This occurs because the nerves that supply the sensation in the upper neck also supply the skin overlying the head, forehead, jawline, back of the ear and behind the eye. Pain that begins in the base of your neck in the cervical spine and then progressively spreads upwards into the head is a typical symptom of cervicogenic headache.

There are two symptoms that are classic to those with cervicogenic headaches.

The first is that the headache can be made worse or actually onset by head or neck movement.
The second is that there is marked tenderness in the suboccipital (base of head) region.

A thorough examination by your physiotherapist or doctor is usually sufficient to diagnose cervicogenic headache. Occasionally further investigations may be required, such as Xray or CT scan / MRI if there are some complicating symptoms and circumstances. These headaches arising from the neck generally respond quite quickly to treatment and a complete resolution of symptoms can be expected if there are no underlying causes still present. In some cases where the headaches are quite long-term (chronic) your physiotherapist may have to address your posture (study, work and sleep), spinal stiffness, muscle weakness / tightness and imbalances, along with advice on exercises, pillows for sleep and other lifestyle factors. Immediate treatment is the best management for all headaches caused by the neck that do not resolve within a few days of rest and analgesia.

Local physiotherapist, Craig Steele, has had extensive experience in treating headaches and neck / jaw problems related to cervicogenic headaches. He can be contacted at Hinteractive Physio on 5442 5556 for consultations and further advice regarding your treatment.

Acute Wry Neck

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