Torticollis is a chronic condition in which a person is unable to control neck muscles from contracting. This causes the head to turn and tilt to one side, and the chin to point to the opposite side. Sometimes one shoulder is lifted. The muscle contraction may be constant (fixed) or may come and go (intermittent). The abnormal posture caused by tilting the head may lead to neck pain.
Torticollis may be present at birth (congenital) or develop later in life (acquired).
The causes are not well understood. Researchers are investigating genetic, environmental, or other causes that may play a role.
Causes may include: Genetic defectInfant's position during pregnancy or deliveryHead or neck injuryInfection in neck muscles or bonesDamage or malfunction of the nervous system, specifically the basal ganglia, which is a deep brain structureInner ear or eye problemsDeformities of the bones or muscles in the neckTumors of the head
of the neck
(passage of acid from the stomach into the throat)
Use of certain medications
Factors that may increase your chance of developing this condition include: Sex: femaleAge: newborn and children under age 10Age: adults aged 30 to 60 yearsFamily member with torticollis or similar disorders
Muscles of the Neck
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Symptoms may include: Rotation and tilting of the head to the affected sideEnlargement of neck muscles, possibly present at birthStiffness of neck musclesPainful spasms of neck and upper back musclesLimited range of motion of the head and neckHeadache
Torticollis ranges from mild to severe. It usually progresses slowly for 1-5 years, and then stays the same. However, torticollis may last for life and can result in limited movement and deformed posture.
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Your doctor may need pictures of structures inside your body. This can be done with: X-raysCT scanMRI scan
The treatment for torticollis depends on whether it is congenital or acquired. Treatment generally centers on physical therapy, oral medication, botulinum toxin injections, and surgery. Possible treatments may include:
Positioning of the infant to avoid sleeping on one sidePositioning of toys to encourage turning of the headStretching exercises several times each dayIn some situations, surgery to lengthen the tendon
Identifying the causePhysical therapy, especially when used with botulinum toxin, to help relax the muscle and reduce painIn some situations, surgery to cut the nerve to the muscle that is in spasmDeep brain stimulation surgeryCertain oral medications, such as pain medication and muscle relaxants
to weaken or partially paralyze the muscle—This may help improve neck posture, but only if begun soon after torticollis begins. The drug's effect wears off after several months and treatment must be repeated.
Injection of alcohol or phenol to deaden the nerve that causes the muscle contraction
Each of these options has risks and benefits. Work with your doctor to find the right treatment for you.
There are no guidelines to prevent torticollis. Early treatment may help keep the symptoms from worsening.
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Last reviewed November 2012 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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