Cervical Facet Strain (Wry Neck/Locked Syndrome)
Anatomy
The cervical spine (neck) is comprised of 7 vertebrae (bones) which all glide on each other to produce movement. Fundamentally, each segment bar one is comprised of vertebral foramen which is a central hole which the spinal cord runs through. Either side of this lies transverse foramen through which blood and fight or flight nerve supply runs. Above each cervical spine segment, a nerve root (bundle of fibres sending movement and sensation messages to and from the spinal cord) exits through a neural foramen (hole).There are three key neck joints; one big joint at the front, and two smaller joints at the back/sidesBiomechanics & planes of movement
Breaking it down, the spine is responsible for moving in four key directions:
Flexion (looking down), Extension (looking up), Lateral flexion (tilting sideways), Rotation (looking to the side)
However, movement in these planes does not occur equally throughout all the joints. Flexion and extension are initiated by the lower neck segments and are then joined by the upper neck. The lower neck is then again responsible for the very end range of movement.
This is the opposite for rotation; 50% of this movement occurs in the upper neck joints.
Segments 3-7 allow anatomical movement in flexion, extension, lateral flexion, rotation
Segments O to 3 provide flexion/extension and rotationConsiderations 
The orientation of the facet joints begins relatively horizontal at the upper neck, but slopes down to more of a 45 degree angle moving further downCommon pathologiesCommon conditions which physiotherapists regularly treat patients for include:
The cervical spine (neck) is comprised of 7 vertebrae (bones) which all glide on each other to produce movement. Fundamentally, each segment bar one is comprised of vertebral foramen which is a central hole which the spinal cord runs through. Either side of this lies transverse foramen through which blood and fight or flight nerve supply runs. Above each cervical spine segment, a nerve root (bundle of fibres sending movement and sensation messages to and from the spinal cord) exits through a neural foramen (hole).There are three key neck joints; one big joint at the front, and two smaller joints at the back/sidesBiomechanics & planes of movement
Breaking it down, the spine is responsible for moving in four key directions:
Flexion (looking down), Extension (looking up), Lateral flexion (tilting sideways), Rotation (looking to the side)
However, movement in these planes does not occur equally throughout all the joints. Flexion and extension are initiated by the lower neck segments and are then joined by the upper neck. The lower neck is then again responsible for the very end range of movement.
This is the opposite for rotation; 50% of this movement occurs in the upper neck joints.
Segments 3-7 allow anatomical movement in flexion, extension, lateral flexion, rotation
Segments O to 3 provide flexion/extension and rotationConsiderations The orientation of the facet joints begins relatively horizontal at the upper neck, but slopes down to more of a 45 degree angle moving further downCommon pathologiesCommon conditions which physiotherapists regularly treat patients for include:- Cervical facet syndrome (acute wry neck/locked neck)
- Whiplash
- Disc bulge +/- pain radiating into the arm
- Postural pain
- Spinal stenosis (narrowing)
- Joint mobilisation (loosening up the joint)
- Neural stretches (loosening up the nervous system)
- Soft tissue massage,
- Dry needling,
- Home exercises/strength work.
