Blog Post

Understanding Acute Neck Lock-up (Wry Neck)

Have you ever experienced a sudden, sharp pain in your neck that seems to lock it in place, making it extremely difficult, if not impossible, to move? If you have, you may have experienced what we call a “wry neck.” This condition, although painful and alarming, is quite common and generally resolves on its own.

However, despite its usual benign nature, it’s essential to understand the signs, causes, and, most importantly, the right steps to take for treatment.

What is Wry Neck?

Acute wry neck in children and adults is a common condition characterised by a sudden onset of pain and spasm that locks the neck up temporarily. It is usually worse on one side of the neck but can involve both.

It can be triggered by many things, including sleeping in certain positions, trivial head movements such as flicking your hair, and even by a reach, push, pull, or lift with the arms when the neck is not even moving.

A wry neck can be associated with disc issues such as protrusions, whiplash, facet joint inflammation, postural strain, headache and migraine, vertigo, and nerve impingement that can also produce pain and tingling in the scapula region, shoulder, and arm.

What Causes Wry Neck?

The most common cause of a wry neck is an inflamed cervical disc, facet joint, and/or nerve root getting aggravated enough to trigger a strong muscle-guarding lockdown of the cervical spine. The lockdown can be dramatic enough that even shoulder and arm movements become limited too.

It’s similar to bumping your pinkie toe against a hard surface—the sharp pain and quick jerky withdrawal is quite dramatic. Likewise, in wry neck, a sensitive joint structure in your neck can be unexpectedly tweaked, causing a strong guarding reaction in surrounding neck muscles. The only way the body can stop you from putting more strain on that area is to keep it locked up until inflammation, sensitivity, and swelling can die down over a few days. Not pleasant, yet a useful protective mechanism to stiffen the neck and allow for some healing to occur.

Remember, the spine is tough, and it’s rare that any significant damage has occurred, so despite the unnerving experience of a painful lock-up, try to stay calm. With that said, having experienced a wry neck many times myself, I will admit it’s hard not to stress out a bit the first time it happens. As always, though, it’s important not to self-diagnose and seek professional advice to rule out more concerning injuries and get a treatment plan in place.

How Do You Treat Wry Neck?

A common mistake my clients have made is to assume the problem is ‘just muscular’ or a ‘stuck joint’ that needs to be popped back into alignment and proceed to prematurely unlock or release all the tightness and stiffness.

Invariably this approach results in irritating things further. Some stretching, rubbing, and poking may feel good at that moment, but, like the satisfaction gained from firmly scratching an itchy rash, it’s not helping the real source of the issue and can leave you in more pain afterward.

It’s recommended to reduce head, neck and arms movements and general physical activity levels until symptoms settle over a few days to a week. If you are concerned, then seek professional advice immediately.

When it comes to professional assistance, physiotherapy plays a vital role in treating wry neck.

Our approach at Adam Physiotherapy Cairns includes the following:

  • A thorough diagnostic assessment.
  • Activity modification advice to offload the neck for a short period while it heals.
  • Neck, thoracic, and shoulder range of motion and upper body strength progressions.
  • Taping to restrict the range of motion and support when in the acute phase.
  • Progressive hands-on therapy for pain relief and to facilitate better movement of the neck joints as inflammation settles over time.
  • Teach simple self-massage, joint mobilisation, and range of motion techniques to empower patients to take control of their condition and get to know their bodies better.
  • Prevention of future wry neck episodes includes early detection of more subtle warning signs and symptoms, ongoing adjustments to physical activity, gym techniques, postural strain, and increasing general strength and conditioning beyond previous levels. Sometimes people are doing way too much and need to scale things back.

Ultimately, a wry neck, although inconvenient and painful, is usually not a cause for alarm. That being said, it is also not a condition to ignore, especially if there are other symptoms such as referred pain down the arms. It’s crucial to avoid attempting to force your neck back into alignment or resorting to vigorous massaging techniques. These well-intended yet premature actions could lead to further discomfort and even exacerbate the issue. Instead, take a step back, reduce your physical activity levels, and seek professional advice for a proper diagnosis and treatment plan.

If you’re experiencing a wry neck or have concerns about any neck discomfort, don’t hesitate to reach out to Adam Physiotherapy Cairns.

We’re here to get you back on track.


Let’s Talk About the Role of the Neck in HEADACHE and MIGRAINES.

When it comes to understanding the trials of living with constant headaches or migraines, it goes beyond just appreciating the toll of the physical discomfort. It’s about recognising how these conditions can cast a shadow over life’s simplest joys, robbing you of the...

Real Patient Stories – “I was holding alot of tension”

Julie has a busy working life as an optometrist and family life, with 3 children. Julie works long days, and after one especially long day, the following morning she was driving to golf and found she couldn’t move her neck, it had “locked up”. She also had pain...

Stretching and Sciatica: Is it Helping or Hindering?

Sciatica and even post-workout discomfort can lead to a range of painful symptoms, including tension and pain in the buttock, thigh, and leg. If you’re experiencing these symptoms, you might feel an immediate urge to stretch it out, but is this helping or hindering...

Brace For It!… Do We Actually Need Core Stability Exercises For Back Pain?

After decades of research and vigorous debate on the topic (in the physio world, at least), the answer to that question appears to be NO. Now, it’s key to remember that this doesn’t mean training core muscles is not important. The devil is in the details, and I will...