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Torticollis

Wry neck; Loxia
Torticollis is a twisted neck in which the head is tipped to one side, while the chin is turned to the other.
 

Causes, incidence, and risk factors

Torticollis may be:

Inherited -- due to changes in your genes

Acquired -- develops as a result of damage to the nervous system, upper spine, or muscles

If the condition occurs without a known cause, it is called idiopathic torticollis.

Torticollis may develop in childhood or adulthood. Congenital torticollis (present at birth) may occur if the baby's head was in the wrong position while growing in the womb, or if the muscles or blood supply to the neck are injured.

Symptoms

Limited range of motion of the head

Headache

Head tremor

Neck pain

Shoulder that is higher on one side of the body

Stiffness of the neck muscles

Swelling of the neck muscles (possibly present at birth)

Signs and tests

Tests or procedures may be done to rule out possible causes of head and neck pain. A physical examination will show:

Head tilts toward the affected side while the chin points to the opposite side

Shortening of the neck muscles

The entire head pulls and turns to one side (in more severe cases)

Tests that may be done include:

CT scan of the neck

Electromyogram (EMG) to see which muscles are most affected

MRI of the brain

Treatment

The Alternative Perspective

Treating torticollis that is present at birth involves stretching the shortened neck muscle. Working with a Holistic Chiropractor is the best method for doing this and offers you the best chance of a full recovery.  Passive stretching and positioning are used in infants and small children. These are applied between visits to your Holistic Chiropractor.  This form of care is often successful, especially if they are started within 3 months of birth.

The Medical Perspective

Surgery to correct the neck muscle may be done in the preschool years, if other treatment methods fail.

Torticollis that is caused by damage to the nervous system, spine, or muscles is treated by identifying the cause of the disorder.

Applying heat, traction to the cervical spine, and massage may help relieve head and neck pain. This is best done by working with a Holistic Chiropractor.

Stretching exercises and neck braces may help with muscle spasms between visits to your Holistic Chiropractor.\

Medications may be used, including the anticholinergic drug baclofen.  As with any medication, understanding the risks and side-effects of the medication should be considered before starting any medication regime.

Injecting botulinum toxin can temporarily relieve torticollis, but repeat injections are usually needed every 3 months.  As with any medication, understanding the risks and side-effects of the medication should be considered before starting any medication regime.

Surgery of the spine might be needed when the torticollis is due to dislocated vertebrae. In some cases, surgery involves destroying some of the nerves in the neck muscles, or brain stimulation.

Expectations (prognosis)

The condition may be easier to treat in infants and children. If torticollis becomes chronic, numbness and tingling may develop due to pressure on the nerve roots in the neck.  Working with a Holistic Chiropractor can prevent this outcome from occurring.  

The muscle itself may become large (hypertrophic) due to constant stimulation and exercise.

Complications

Complications if not treated may include:

Muscle swelling due to constant tension

Nervous system symptoms due to pressure on nerve roots

Calling your health care provider

Call for an appointment with your health care provider if symptoms do not improve with treatment, or if new symptoms develop.

Torticollis that occurs after an injury would require a visit to your Holistic Chiropractor.  Torticollis that occurs with illness may be serious. Seek immediate medical help if this occurs.

Medicines Two Choices for You

Your Solution

Prevention

While there is no known way to prevent this condition, early treatment may prevent it from getting worse.  Working with your Holistic Chiropractor is the best way to treat this condition and is the best way for full recovery and a normal life.

References

  1. Spiegel DA, Hosalkar HS, Dormans JP, Drommond DS. The neck. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap. 679.
  2. Persing J. Prevention and management of positional skull deformities in infants. American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Plastic Surgery and Section on Neurological Surgery. Pediatrics. 2003;112:199-202.
  3. Patel M, Shah K. Orthopedics. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 42.

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