Rehabilitating a Stiff Neck

Acute torticollis, also known among some physicians as wry neck, is essentially a stiffness of the neck due to a muscular spasm.

In fact, an approximate translation from the Latin-based “acute torticollis” is twisted collar or twisted neck. This name sounds severe, but the condition itself is not as bad as it sounds.

Changes that occur with age can cause a stiff neck, but it is usually the result of a sudden or unusual movement of the neck. Although the problem is more frequent in older people, it can happen to people of any age.

A stiff neck can be frightening if it occurs suddenly, so it's important to reassure patients. They may be tempted to rush off to have expensive imaging scans, but these scans are rarely helpful. Lying in an MRI machine might actually make the problem worse. I rarely even order x-rays for a patient with acute torticollis—I usually just start them on exercises. A muscle spasm won't show up on an x-ray, anyway. The image will only show a straightening of the neck's natural curve due to the tightening of the muscles.

The trapezius muscle in the upper shoulder can contribute to a stiff neck, and neck exercises will engage this muscle.

The most effective immediate treatment for a stiff neck is to put ice on the area for 15 minutes, and then do neck exercises slowly and carefully to loosen the tight muscles. The ice helps to relieve the pain of an acute spasm. Wrap the ice pack in a towel to prevent skin irritation. I also recommend that people use a bag of small frozen vegetables, such as peas or corn, which conforms well to the neck's curves. (Just be sure to mark the bag so no one eats the vegetables by mistake!)

After a few days, patients can use a heating pad if the neck muscles still feel tight and painful, but it's better to use ice first to ease the immediate pain. Patients can also take aspirin, acetaminophen, or ibuprofen during the first few days after the injury.

It is important to do neck exercises slowly and carefully. The idea is to ease the muscles out of their spasm, not force them. Remind patients to breathe normally during the movements. If pain and stiffness of the neck do not subside after 3 days, patients should see a physiatrist or orthopedic surgeon.

In next month's column, I will discuss exercises to improve abdominal strength.

Limbering Maneuvers

Shoulder shrug. Sit in a straight-backed chair with your feet flat on the floor and your hands resting on your thighs. Slowly raise your shoulders toward your ears as far as you can without excessive straining, although the upward movement might hurt slightly. Relax for a count of 3. Keep the shoulders as loose as possible while relaxing. Repeat five times.

Trapezius muscle stretch. While sitting in a straight-backed chair, place your fingertips on your shoulders, raising your elbows to shoulder height, and spread your elbows back as far as you can, then bring them together in front of your chest and breathe out at the same time. Hold for 5 seconds. You should feel a gentle pull in the upper back and neck. Repeat five times.

Posterior neck stretch. Sit or stand in a relaxed position. Slowly turn your head to the right as far as possible without straining, then slowly bring it back to the middle. Rest for 2 seconds and breathe, then turn your head slowly to the left as far as possible and bring it back to the middle. The turning action should be slow, and should take 5 seconds. Repeat five times.

Neck stretch. Stand against a wall with your head in a level position just touching the wall. Slowly tuck your chin back into your neck as far as possible without excessive straining. Do not bring the chin down toward the chest or let the head fall forward. The movement should be horizontal only, and you should feel a slight pull in the back of the neck. Hold for 5 seconds, then relax for 2 seconds. Repeat five times.

Acute torticollis, also known among some physicians as wry neck, is essentially a stiffness of the neck due to a muscular spasm.

In fact, an approximate translation from the Latin-based “acute torticollis” is twisted collar or twisted neck. This name sounds severe, but the condition itself is not as bad as it sounds.

Changes that occur with age can cause a stiff neck, but it is usually the result of a sudden or unusual movement of the neck. Although the problem is more frequent in older people, it can happen to people of any age.

A stiff neck can be frightening if it occurs suddenly, so it's important to reassure patients. They may be tempted to rush off to have expensive imaging scans, but these scans are rarely helpful. Lying in an MRI machine might actually make the problem worse. I rarely even order x-rays for a patient with acute torticollis—I usually just start them on exercises. A muscle spasm won't show up on an x-ray, anyway. The image will only show a straightening of the neck's natural curve due to the tightening of the muscles.

The trapezius muscle in the upper shoulder can contribute to a stiff neck, and neck exercises will engage this muscle.

The most effective immediate treatment for a stiff neck is to put ice on the area for 15 minutes, and then do neck exercises slowly and carefully to loosen the tight muscles. The ice helps to relieve the pain of an acute spasm. Wrap the ice pack in a towel to prevent skin irritation. I also recommend that people use a bag of small frozen vegetables, such as peas or corn, which conforms well to the neck's curves. (Just be sure to mark the bag so no one eats the vegetables by mistake!)

After a few days, patients can use a heating pad if the neck muscles still feel tight and painful, but it's better to use ice first to ease the immediate pain. Patients can also take aspirin, acetaminophen, or ibuprofen during the first few days after the injury.

It is important to do neck exercises slowly and carefully. The idea is to ease the muscles out of their spasm, not force them. Remind patients to breathe normally during the movements. If pain and stiffness of the neck do not subside after 3 days, patients should see a physiatrist or orthopedic surgeon.

In next month's column, I will discuss exercises to improve abdominal strength.

Limbering Maneuvers

Shoulder shrug. Sit in a straight-backed chair with your feet flat on the floor and your hands resting on your thighs. Slowly raise your shoulders toward your ears as far as you can without excessive straining, although the upward movement might hurt slightly. Relax for a count of 3. Keep the shoulders as loose as possible while relaxing. Repeat five times.

Trapezius muscle stretch. While sitting in a straight-backed chair, place your fingertips on your shoulders, raising your elbows to shoulder height, and spread your elbows back as far as you can, then bring them together in front of your chest and breathe out at the same time. Hold for 5 seconds. You should feel a gentle pull in the upper back and neck. Repeat five times.

Posterior neck stretch. Sit or stand in a relaxed position. Slowly turn your head to the right as far as possible without straining, then slowly bring it back to the middle. Rest for 2 seconds and breathe, then turn your head slowly to the left as far as possible and bring it back to the middle. The turning action should be slow, and should take 5 seconds. Repeat five times.

Neck stretch. Stand against a wall with your head in a level position just touching the wall. Slowly tuck your chin back into your neck as far as possible without excessive straining. Do not bring the chin down toward the chest or let the head fall forward. The movement should be horizontal only, and you should feel a slight pull in the back of the neck. Hold for 5 seconds, then relax for 2 seconds. Repeat five times.

Acute torticollis, also known among some physicians as wry neck, is essentially a stiffness of the neck due to a muscular spasm.

In fact, an approximate translation from the Latin-based “acute torticollis” is twisted collar or twisted neck. This name sounds severe, but the condition itself is not as bad as it sounds.

Changes that occur with age can cause a stiff neck, but it is usually the result of a sudden or unusual movement of the neck. Although the problem is more frequent in older people, it can happen to people of any age.

A stiff neck can be frightening if it occurs suddenly, so it's important to reassure patients. They may be tempted to rush off to have expensive imaging scans, but these scans are rarely helpful. Lying in an MRI machine might actually make the problem worse. I rarely even order x-rays for a patient with acute torticollis—I usually just start them on exercises. A muscle spasm won't show up on an x-ray, anyway. The image will only show a straightening of the neck's natural curve due to the tightening of the muscles.

The trapezius muscle in the upper shoulder can contribute to a stiff neck, and neck exercises will engage this muscle.

The most effective immediate treatment for a stiff neck is to put ice on the area for 15 minutes, and then do neck exercises slowly and carefully to loosen the tight muscles. The ice helps to relieve the pain of an acute spasm. Wrap the ice pack in a towel to prevent skin irritation. I also recommend that people use a bag of small frozen vegetables, such as peas or corn, which conforms well to the neck's curves. (Just be sure to mark the bag so no one eats the vegetables by mistake!)

After a few days, patients can use a heating pad if the neck muscles still feel tight and painful, but it's better to use ice first to ease the immediate pain. Patients can also take aspirin, acetaminophen, or ibuprofen during the first few days after the injury.

It is important to do neck exercises slowly and carefully. The idea is to ease the muscles out of their spasm, not force them. Remind patients to breathe normally during the movements. If pain and stiffness of the neck do not subside after 3 days, patients should see a physiatrist or orthopedic surgeon.

In next month's column, I will discuss exercises to improve abdominal strength.

Limbering Maneuvers

Shoulder shrug. Sit in a straight-backed chair with your feet flat on the floor and your hands resting on your thighs. Slowly raise your shoulders toward your ears as far as you can without excessive straining, although the upward movement might hurt slightly. Relax for a count of 3. Keep the shoulders as loose as possible while relaxing. Repeat five times.

Trapezius muscle stretch. While sitting in a straight-backed chair, place your fingertips on your shoulders, raising your elbows to shoulder height, and spread your elbows back as far as you can, then bring them together in front of your chest and breathe out at the same time. Hold for 5 seconds. You should feel a gentle pull in the upper back and neck. Repeat five times.

Posterior neck stretch. Sit or stand in a relaxed position. Slowly turn your head to the right as far as possible without straining, then slowly bring it back to the middle. Rest for 2 seconds and breathe, then turn your head slowly to the left as far as possible and bring it back to the middle. The turning action should be slow, and should take 5 seconds. Repeat five times.

Neck stretch. Stand against a wall with your head in a level position just touching the wall. Slowly tuck your chin back into your neck as far as possible without excessive straining. Do not bring the chin down toward the chest or let the head fall forward. The movement should be horizontal only, and you should feel a slight pull in the back of the neck. Hold for 5 seconds, then relax for 2 seconds. Repeat five times.