In most cases, wry neck is not serious and is usually a temporary mechanical issue. If symptoms are severe or accompanied by neurological signs, seek medical assessment.

How many physio sessions do I need for wry neck treatment?

Many patients improve within 1 to 3 physiotherapy sessions depending on severity and how early treatment begins.

107) Wry Neck (Acute Torticollis): What to Do When You Wake Up Unable to Turn Your Head

Woken up and suddenly can’t turn your head? You’ve likely developed a wry neck (acute torticollis). It’s painful, stiff, and frustrating — but the good news is it’s usually very treatable. In this blog, we’ll explain exactly what causes it, what to do immediately, and how physiotherapy can speed up your recovery.

Woke Up Crooked? You’re Not Alone.

There’s nothing quite like that moment.

You roll over in bed… and realise your neck won’t move. One side feels locked. Turning your head sends a sharp jolt of pain. You’re stuck looking slightly sideways like you’ve permanently spotted something interesting.

This is wry neck, also known as acute torticollis — a common condition we see regularly in clinic.

The good news?
It’s rarely serious.
And with the right wry neck treatment, most people improve quickly.

Let’s break it down.

What Is Wry Neck (Acute Torticollis)?

Wry neck is a sudden onset neck spasm that causes your head to tilt or rotate to one side. The medical term is acute torticollis.

It usually:

Appears suddenly (often overnight)
Causes sharp pain on one side of the neck
Limits rotation (you can’t turn your head properly)
Feels “locked” or stuck

The muscles most commonly involved include:

Upper trapezius
Levator scapulae
Sternocleidomastoid
Deep cervical muscles

When these muscles go into protective spasm, movement becomes painful and restricted.

What Causes Wry Neck?

Most cases happen for simple mechanical reasons. Common triggers include:

1. Sleeping Position

Awkward pillow height or sleeping twisted can irritate joints and soft tissues.

2. Sudden Movement

Quick head turn, sport, gym movement, or even reversing the car.

3. Joint Irritation

Minor facet joint irritation in the cervical spine can trigger reflex muscle spasm.

4. Stress & Tension

High stress can increase muscle tone in the neck and shoulders.

5. Prolonged Posture

Long hours at a desk, laptop, or phone can overload neck structures.

It’s often a combination of factors rather than one clear cause.

What’s Actually Happening in Your Neck?

In simple terms:

A small joint or structure becomes irritated.
The nervous system reacts.
Muscles tighten to protect the area.
Movement becomes restricted and painful.

The muscle spasm isn’t the primary problem — it’s your body’s protective response.

That’s why simply stretching aggressively often makes it worse.

What To Do Immediately (First 24–48 Hours)

If you wake up with a wry neck, here’s what we recommend.

✅ Keep Moving (Gently)

Avoid forcing movement, but don’t completely immobilise it either. Small pain-free movements help calm the nervous system.

✅ Use Heat

A warm pack for 10–15 minutes can relax muscle spasm.

✅ Simple Pain Relief

Paracetamol or anti-inflammatories (if safe for you) may help.

❌ Avoid Aggressive Stretching

Cranking your head into the painful direction can flare it.

❌ Avoid Complete Rest

Staying still all day stiffens it further.

If it’s not improving within 48–72 hours — or if pain is severe — physiotherapy helps significantly.

When Should You See a Physio?

Seek assessment if:

Pain is severe
You can’t rotate your head at all
It’s not improving after 2–3 days
You get pins and needles or arm symptoms
It keeps recurring

Most cases are mechanical and straightforward — but proper assessment ensures nothing more serious is going on.

How Physiotherapy Helps Wry Neck Treatment

This is where we see the biggest improvements.

Effective wry neck treatment isn’t just massage. It’s targeted, specific care.

1. Accurate Diagnosis

We assess:

Cervical joint mobility
Muscle tone
Neural involvement
Postural drivers
Contributing factors

2. Gentle Joint Mobilisation

Specific hands-on techniques reduce joint irritation and reset movement.

3. Muscle Release

Targeted soft tissue work reduces protective spasm.

4. Movement Retraining

We guide safe movement patterns to restore normal range.

5. Education

Understanding what’s happening reduces fear and muscle guarding.

A Recent Case From Our Clinic

Just last month, we saw a 42-year-old patient who drove from Roseville to our clinic in Frenchs Forest NSW after waking up unable to turn her head.

She’d slept awkwardly after a long week at work. By morning, her head was stuck rotated to the right. Pain was sharp and she couldn’t check her blind spot while driving.

Assessment showed:

Acute facet joint irritation
Significant levator scapulae spasm
No nerve involvement

We performed:

Gentle cervical joint mobilisation
Soft tissue release
Guided active movement exercises
Postural advice for her workstation

Within the first session, rotation improved by about 50%.
By her second visit 4 days later, she had near full movement.
One week later, she was back at Pilates pain-free.

This is typical when treatment is early and targeted.

How Long Does Wry Neck Last?

Without treatment:

Mild cases: 3–7 days
Moderate cases: 1–2 weeks

With physiotherapy:

Often significantly reduced
Faster return to full movement
Lower chance of recurrence

The key is calming irritation early and restoring normal movement quickly.

Can Wry Neck Become Chronic?

Occasionally, yes — especially if:

It’s left untreated
Poor posture persists
There’s repeated strain
Underlying cervical stiffness exists

Recurrent episodes usually indicate an underlying mobility or control issue.

That’s where a tailored strengthening program matters.

Exercises for Wry Neck (Once Pain Settles)

These are general examples — individual assessment is best.

1. Gentle Rotation

Turn head slowly toward comfortable range.
10 reps, 3–4 times daily.

2. Chin Tucks

Gently retract chin (like making a double chin).
Hold 5 seconds, repeat 10 times.

3. Scapular Setting

Draw shoulder blades gently back and down.

These help restore control and reduce recurrence risk.

Prevention Tips

To reduce future episodes:

Optimise pillow height (neutral alignment)
Avoid stomach sleeping
Improve desk ergonomics
Take movement breaks every 30–45 mins
Strengthen deep neck flexors
Manage stress load

Small changes make a big difference.

Red Flags (Rare but Important)

Seek urgent medical review if you experience:

Fever
Severe headache
Trauma
Neurological symptoms
Unexplained weight loss
History of cancer

These are uncommon but important to rule out.

Why Early Wry Neck Treatment Matters

The longer muscle spasm persists, the more the nervous system sensitises.

Early physiotherapy:

Reduces pain faster
Restores movement sooner
Prevents compensation patterns
Lowers recurrence risk

Don’t wait it out unnecessarily.

Frequently Asked Questions (FAQs)

What is the fastest way to fix a wry neck?

Gentle movement, heat, and physiotherapy treatment provide the fastest improvement. Hands-on mobilisation combined with guided exercises usually speeds recovery significantly.

Should I massage a wry neck?

Light massage may help, but aggressive pressure can worsen irritation. It’s best combined with joint mobilisation and movement therapy.

Is wry neck serious?

In most cases, no. It’s usually a temporary mechanical issue. However, if symptoms are severe or accompanied by neurological signs, seek assessment.

Can I exercise with a wry neck?

Avoid intense workouts initially. Gentle movement is beneficial, but heavy lifting or high-impact activity should wait until pain settles.

How many physio sessions do I need?

Many patients improve within 1–3 sessions depending on severity.

References

If you’ve woken up stuck and sore — don’t just wait and hope.

Early, targeted wry neck treatment makes a huge difference.

Give us a call today on 9806 3077, or book online, just CLICK HERE:
https://x-physio.au4.cliniko.com/bookings#service