Acute Torticollis
Patient usually awakes with acute neck pain with neck flexed and rotated.
- If possible straighten neck with gentle traction. Ethyl chloride spray may reduce muscle spasm.
- Soft collar for maximum of 48 hours, analgesia.
- Many benefit from physiotherapy.
Acute neck pain with or without root symptoms/signs
These patients should have a full neurological examination of the upper limbs.
- Discuss patients who have hard neurological signs with ED Senior re MRI. If out of hours bring patient back to early Review Clinic
- Analgesia; NSAIDs and/or paracetamol with codeine (eg co-codamol 500/30) are the mainstay of treatment
- May benefit from Physiotherapy
- Many of these patients have long standing symptoms and in the absence of new hard neurological findings should be referred back to their GP