Stiff Neck

Stiff Neck and Torticollis

What is a Stiff Neck?

A stiff neck (torticollis) is an acute blockage of the cervical spine characterised by sharp pain and significant limitation of neck movement. It most commonly occurs suddenly, upon waking or following a sudden movement, and results in an antalgic posture with the head tilted and rotated.

Common torticollis is mechanical in origin. It generally results from a reflex muscular spasm, associated with a joint blockage of one or more cervical vertebrae. It is a frequent reason for consulting an osteopath.

Symptoms

• Sharp cervical pain, usually on one side
• Inability or difficulty turning the head to one side
• Palpable muscular spasm in the neck (upper trapezius, sternocleidomastoid, scalenes)
• Antalgic posture: head tilted and turned away from the painful side
• Pain that may radiate to the shoulder, shoulder blade or base of the skull
• Associated headaches in some cases

Common Causes

• Poor sleeping position — the most common cause; the neck remains in an awkward position for several hours
• Sudden or awkward movement — rapid rotation, forced extension of the neck
• Stress and accumulated tension — cervical muscles are particularly sensitive to emotional stress
• Prolonged screen posture — forward head position, excessive strain on cervical muscles
• Draught or cold exposure — a well-recognised contributing factor
• Pre-existing cervical vulnerability — history of neck pain, cervical osteoarthritis, sedentary work

Osteopathic Approach

Osteopathy is particularly well suited for treating common torticollis. Treatment aims to:

• Release cervical muscular spasm through gentle, progressive techniques
• Restore joint mobility of the blocked cervical vertebrae
• Work on associated regions: cervico-thoracic junction, first rib, shoulder
• Rebalance jaw tension if a link is identified

Techniques are adapted to the acute phase: priority is given to gentle, functional and muscle energy techniques.

How Many Sessions?

1 to 2 sessions are generally sufficient for an acute stiff neck. Significant improvement is often felt after the first consultation. If the torticollis is recurrent, deeper work may be proposed to identify and treat the underlying contributing factors.

References

• Gross A, Langevin P, Burnie SJ et al. (2015). Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database of Systematic Reviews, 9:CD004249. PMID 26397370
• Dunning JR, Cleland JA, Waldrop MA et al. (2012). Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain. Journal of Orthopaedic & Sports Physical Therapy, 42(1):5-18. PMID 21979312