Torticollis

What is torticollis?

Torticollis or "wry neck" is a condition where the neck is turned making the head tilt toward one shoulder and the chin point towards the opposite shoulder. Congenital muscular torticollis is the most common form and happens to babies. Another form of torticollis is spasmodic torticollis, also called cervical dystonia. It is most common in middle-aged adults and is more common in women. In spasmodic torticollis, the muscles around the neck may spasm off and on or all the time. There can be other forms of torticollis with varying causes such as an injury.

How does it occur?

Torticollis may have many different causes. Congenital torticollis is caused by a noncancerous mass of tissue in the sternocleidomastoid muscle. The sternocleidomastoid muscle is the strap-like muscle that runs from the collarbone to just beneath the jaw. The mass is often called an olive. One theory is that it is caused by decreased blood flow to the neck muscle during birth. However, the exact cause is not fully known.

The exact cause of spasmodic torticollis in adults is unknown.

Torticollis can sometimes by caused by an injury or inflammation. The inflammation can be due to an upper respiratory infection or sore throat. The swelling causes the tissue that surrounds the upper spine to loosen. This results in the neck muscles going into a spasm and the head tilting to one side. It may be a symptom of another disorder.

What are the symptoms of torticollis?

The main symptom of any kind of torticollis is a crooked head and neck. Often the neck is stiff or sore and cannot be straightened.

People with spasmodic torticollis usually have constant and severe pain. Muscle spasms of the neck muscles usually happen on one side of the neck. Spasmodic torticollis starts slowly and gradually gets worse in 2 to 5 years.

How is torticollis diagnosed?

In newborns, the child's healthcare provider will examine the baby. The neck will be stiff and the head and chin are tilted. A soft lump can be felt in the neck muscle. Neck X-rays are usually ordered to make sure there are no problems with the vertebrae in the neck. In adults it is diagnosed the same way.

How is it treated?

Torticollis can cause permanent facial deformity if it lasts longer than 1 year, so treatment is important. Treatment depends on the cause. It may get better with a simple treatment, such as doing physical therapy exercises and taking over-the-counter medicines. Some other treatments that might be used for torticollis include wearing a soft orthopedic collar, traction, heat therapy, or rarely, surgery. The goal of therapy is to reduce or stop the muscle spasms and pain.

How long will it last?

If you are doing physical therapy, the recovery process usually lasts 8 to 12 weeks until you are able to return to full strenuous activity. You will be able to do many daily activities much sooner than this.

You can return to more strenuous activities when you:

• have full range of motion in your neck
• can move you neck without pain
• have full strength in the muscles of your neck

If you play sports, ask your physical therapist or healthcare provider when you can return to play. When you return may depend on your sport or what position you play.