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Have you ever woken up with a stiff neck that hurts if you try to move it? If you can’t recall an injury then chances are you may be suffering from a common neck condition – acute wry neck.  

What does this mean? 

An acute wry neck is most commonly a problem with the small (facet) joints on the sides of each vertebrae.  These join the vertebrae together on either side of your spine and control a lot of your movement.  A small injury can cause inflammation of the joints and surrounding soft tissue, causing significant pain especially with movement.  Muscles in the neck will often go into spasm as a protective response. The pain experienced is usually out of proportion to the actual amount of damage, due to the number of small nerve endings in the area.

What causes it?

The cause is often difficult to determine with any certainty.  Common causes are – injury, overworking the structures, postural problems (including sleeping on poor pillows), or a combination of factors.

Symptoms of Acute wry necks

Pain, generally on one side of the neck. Movement is usually restricted, especially when turning your head to look over your shoulder. Headaches can be associated.


Treatment is aimed at fully assessing the problem to determine what structures are causing the problems.  If it is determined to be an acute wry neck, your physio will use a combination of massage for the muscles, gentle mobilisations of the facet joints to try to restore their normal movement, and stretches to relieve your pain and restore movement.  Your physio will also assist with postural training and advice to help avoid problems in the long term.

Acute wry necks can last from a couple of days up to about 14 days.  With appropriate physio treatment, and perhaps pain relieving medications, this time frame will be shorter.

What can I do to prevent it occurring?

In the long term, using good ergonomic pillows, ensuring you have good postural habits, and doing regular stretching and strengthening exercises can help to prevent this sort of condition.