Torticollis, Wry Neck, Crick in the Neck

 

We have covered this subject before but it is worth another look as it does crop up at The Physiotherapy Centre on a weekly basis, and all crew members are vulnerable to this problem no matter what your position. This is because acute wry neck can occur from physical activity such as lugging sails and fenders to making beds, lifting mattresses, lifting heavy engineering and even spending too much time using a computer mouse. In fact the list of causes for wry neck is pretty much endless.

 

Torticollis, Wry Neck and a Crick in the Neck all cause symptoms of pain and loss of range of movement depending on the cause..

The fixed awkward position of the neck are described as,

Laterocollis – head is stuck in the direction of a shoulder.

Rotational Torticollis – head is rotated right or left.

Anterocollis – head is fixed in a forward nodding position.

Retrocollis – a rarer form where the head is hyperextended backwards.

 

What Causes These Painful Fixed Positions Of The Neck ?

 

Wry fixed necks can be held in position by

 

1) Locking of the transverse intervertebral joints. This is most commonly seen in kiddies who are are very bendy and involved in sport such as rhythmic gymnastics and trampoline. Spasm of the sternocleidomastoid muscle can bring about locking of an intervertebral transverse joint. These are the small synovial joints which are on the right and left of each vertebra connecting to the vertebrae above and below.

 

2) Muscle spasm of overstrained muscles. Caused by heavy lifting or overhead activity such as hanging curtains, painting ceilings, repeated overhead stretching.

3) Trauma to the neck such as a whiplash from a car injury or a direct blow to the head or neck. An uncontrolled outside force can both disturb the placement of the intervertebral joints and cause injury to the muscle tissue.

 

 

 

 

While Torticollis is traditionally understood to be an overstrain of the Sternocleidomastoid muscle, overstraining of the Scaleni and Trapezius muscles can also cause a locked neck conditions with pain both at rest and when turning the head towards the affected side.

Other more serious causes include severe throat infection or lymph node pathology.

Treatment (adults)

The first priority is of course addressing the pain. Your Doctor may well prescribe anti inflammatory medication with a muscle relaxant. A soft neck collar may also be required to rest the neck.

Physiotherapy treatment will include heat (ice packs can also be used though I prefer heat in this case) which can be applied in the form of heat packs, infra red or short wave diathermy. TNS (transcutaneous electrical nerve stimulation) may also be used to control pain. Continuous Ultrasound can also produce a deep heating effect to help reduce muscle spasm.

Manual mobilisations, massage and passive stretching techniques will be used by your physio to regain flexibility and range of movement.

 

 

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