Starting the day with a pain in the neck

Woman with neck pain

Picture this scenario. A cheerful alarm clock pips and fractures the sweet repose of the night's sleep. You lie there unmoving, in your mind arguing with yourself that this notion of waking up could actually be truth, yes, it is time to re-engage the world. The brain runs a swift check of all systems, and finally the courage button is pressed and you sit up, flinging feet to the floor. Escaping the warm cocoon your brain signals a need to top up on oxygen, YAWN, and throwing in a stretch of the neck for good measure...AAARGHH! My neck, my neck!
If you know where I'm going with this, you have probably experienced an acute wry neck. You participate in a distinctively trivial manoeuvre of the neck, usually combining rotation, extension and a touch of side bend, and suddenly the cares of the world are as a popping bubble, replaced by the steel beach ball of musculoskeletal suffering.
Nowhere else in the world of human experience can such a minuscule investment bring such a bountiful yield, cueing the arrival of the injury induced time share holiday plan, pain in quality and quantity, and embarrassing Ultimate Warrior grimacing neck musculature.
To be wry is to be displeased, vexed or cheesed off. It is also a synonym describing ironic, derisive or sarcastic humour. None of these terms really satisfy Acute Torticollis (twisted neck) as it is known in medical circles. A more archaic search uncovers a defining of "distortion or turning the neck to one side". This is appropriate, as the distinct inability to turn your head is hugely unsettling, and hard to conceal. Tip your head to one side a few degrees, now turn the head back the opposite way a few degrees. Look in the mirror and you can see how wry you can actually look.
Thankfully, J S R Russell MD in 1897 concluded, to the relief of all sufferers today, that "surgical measures such as division of muscles and stretching of the spinal sensory nerve, are useless, and there must be few cases in which excision of a portion of the nerve can be expected to lead to permanently good results". We have moved on a long way indeed. In my experience, wry neck being a transient experience of a mere few days is not one of those to be reaching for scalpel and theatre schedule.
Wry neck presents as an unwelcome house guest that drops in unannounced with brazened fanfare, and outstays their welcome by several days. Physically, rotation of the neck becomes significantly reduced and painful, and turning to speak to someone resembles the less than supple machinations of Thunderbird Two's Virgil Tracey, but thankfully, unlike our puppet friend, you won't walk like you have your buttocks super glued together. Usually muscle spasm affect the sore side and so you adopt a side bent, rotated head, which can be used for little else than to express or mock sympathy.
The structures involved are both highly supplied with nerve, so injury or dysfunction don't go unnoticed.
In the younger person, a neck vertebral joint is a probable cause whereas for the majority of readers in the "middle age and beyond" demographic, the cause more often is the disc, which sits between adjacent vertebral bones.
The joint variety is described as locking of the joint, but it may be better described as a seizing up of the joint, as locking may give the idea of the joint in a state of dislocation, which it is not. Usually it comes on with a sudden movement, or awkward postures of the neck.
It is thought this seizing is a muscular spasm protection, where movement is prohibited by brain and muscle. The sensitive ligaments of the joints when subjected to sudden forced movement in directions not recommended by the manufacturer become injured mildly. They seem to then access some pain amplifier, giving the impression of severity. Symptoms are usually localised to a particular side, and transient, although still, the facet joint wry neck may trouble you for a week or so.
The disc problem often involves a prolonged poor posture, such as sleeping on a mountain of pillows, or simply unconscious sleep contortionism, or in one recent case, prolonged sitting on the "throne" with eventual sudden neck rotation to view specialist soft stationery. Such distortion of sensitive structures in poor postures is enough to trigger protective spasm and a miserable disposition. Disc pain often has sensory wanderlust. In other words, it's more likely to travel, and some report pain down the arms or into the area between the shoulder blade and spine. Accurate assessment will separate the facets from the discs, enabling a prognosis of days or weeks to recovery. If there is inherent weakness in the neck, it can then be addressed to stop a repeat episode.
Thankfully the quest for relief is satisfied in the hands of a skilful physio who can apply appropriate gentle mobilisation to the grumpy joint, soothing joint and disc, and offering effective self care solutions to get through the ensuing several days.
For me, having experienced two or three episodes, I found gentle range of motion exercises and neck traction (a stretching of the neck induced by the therapist pulling the head) offered relief and gradual freedom from symptoms alongside the staples of treatment, heat and massage. The message to take home is that, as long as your symptoms match those mentioned above, the path back to function is reasonable. If however, there are troubling symptoms, such as numbness of lips and tongue, dizziness, nausea, double vision or drop attacks, the expertise of a doctor is essential.