Acute torticollis, sometimes called wry neck, is a sudden painful neck spasm that makes the head tilt or turn to one side. It often appears after sleeping in an awkward position or a minor muscle strain and usually improves within several days.
Symptoms
Typical features include pain on one side of the neck, restricted movement, muscle tightness and a tilted or rotated head position. Pain may spread toward the shoulder or upper back.
Simple acute torticollis does not usually cause fever, severe headache, limb weakness, difficulty swallowing or altered consciousness. Those symptoms need medical assessment.
Possible causes
In adults and older children, common triggers include awkward sleep posture, sudden movement, prolonged poor posture and minor muscle or ligament strain. Torticollis can also occur after an injury, as a reaction to certain medications, with infection or because of a problem affecting the spine, nerves or muscles.
Babies with a persistent head tilt may have congenital muscular torticollis and should be assessed. This is different from a sudden stiff neck in an adult.
Self-care
- Keep the neck gently moving within a comfortable range rather than holding it completely still.
- Use a wrapped warm pack or cold pack for short periods, whichever feels more helpful.
- Choose a low, supportive pillow and avoid sleeping on your stomach.
- Ask a pharmacist about suitable pain relief.
- Avoid driving, cycling or hazardous work while neck movement is restricted.
Do not force the neck, use aggressive manipulation or wear a collar unless a healthcare professional recommends it. Prolonged immobilization can increase stiffness.
When to arrange medical advice
Seek assessment if pain is severe, symptoms are worsening, the problem followed an injury, episodes keep returning, or movement is not improving after several days. Persistent neck pain, tingling, numbness, weakness or pain traveling into an arm also needs review.
Children should be assessed promptly if torticollis occurs with fever, sore throat, drooling, difficulty swallowing, unusual behavior, poor balance, headache, vomiting or recent trauma.
Emergency warning signs
Contact local emergency services for neck stiffness with severe headache, fever, confusion, marked drowsiness, seizures or a non-fading rash because these may be signs of meningitis.
Emergency assessment is also needed after significant neck trauma, or if there is new weakness, loss of sensation, difficulty walking, loss of bladder or bowel control, breathing difficulty or rapidly worsening severe pain.
Sources and further reading
Last reviewed: 28 September 2026.
This information is general and does not replace examination or treatment by a qualified healthcare professional.