Stiff Neck (Torticollis)
Acute torticollis, is a painful neck stiffness that decreases
range of motion and can be secondary to several problems,
such as a disc prolapse, a facet joint problem, an undiagnosed
cervical fracture, although the underlying cause may also
be unknown. Most of the time it is caused by spasm of the
neck muscles which causes a temporary rotation and tilting
of the head
In most cases the person wakes up with the painful stiff neck
for no apparent reason. Occasionally the neck may become stuck
following a sudden movement. The head will be held to one
side and the neck is too painful to move. Attempting to move
the neck will usually make the pain worse. In some cases the
pain will radiate up the neck or down to the shoulder area.
It may be accompanied by severe muscle spasm, tenderness over
the trapezii (upper back), headache, and rarely temporary
paraesthesia (altered sensation). Symptoms usually resolve
spontaneously within 2-3 weeks. Stress and emotional events
may exacerbate the symptoms.
Because the cause of this condition is not known for sure,
it is important to rule out injury to the discs in the neck
, degenerative conditions (eg. Arthritis) of the neck and
fractures. To do this is it best to see a GP and, if necessary,
a referral will be made to a specialist.
Treatment of torticollis (stiff neck)
Once it has been
established that there is no serious underlying problem, the
wry neck is usually best treated with mobilisations (by a
physiotherapist in order to loosen the vertebrae and allow
a greater range of movement) and massage. Another helpful
treatment is the heat provided by an infra-red lamp. This
has the effect of relaxing the muscles that had previously
been in spasm, increasing circulation to the area and relieving
some of the pain. Another way of treating the torticollis
is by interferential therapy, cryotherapy and spinal mobilizations.
One must not forget the importance of muscle relaxants and
analgesic medication.
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