Stiff Neck in Depth AKA: Wry Neck, Acute Torticollis

Common Signs & Symptoms
Pain Swelling Stiffness Weakness Instability Locking

Wry Neck (Neck sprain/ strain, acute torticollis)

This is a muscular spasm which temporarily causes an altered position of the head and neck. The head may be held to one side or in a twisted position. Sometimes the head may be held in a more forward position than usual. There is usually a sudden onset usually on waking. There are a variety of causes. Usually this condition resolves between 24 hours to one week after onset but recurrence is common. The initial management for this condition is pain relief (analgesics), gentle movement and sometimes manual therapy from a physiotherapist.


Pain, reduced neck movement, altered head and neck position


The use of heat, analgesia and gentle movements, session(s) with a physiotherapist who can assess the condition and may decide to administer manual therapy.

Red flags for neck pain.

If you have these symptoms you must seek urgent medical assessment:

Visual disturbances/ Hearing difficulties /Difficulty speaking or swallowing/ Gait disturbances /Progressively worsening weakness or sensation problems /Pins and needles or numbness in the face/ Blackouts / dizziness/ nausea/ Constant headache/ constant pain/ Pain that wakes you up at night and is not due to your position.

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