Torticollis is one of a broader category of disorders that exhibit flexion, extension, or twisting of muscles of the neck beyond their normal position. In torticollis your neck tends to twist to one side. The condition can either develop slowly if you have a family history of the disorder,acutely from trauma, or as an adverse reaction to medications.
Torticollis may be:
- Inherited: Due to specific changes in your genes
- Acquired: Develops as a result of damage to the nervous system 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 fetus’ head is in the wrong position while growing in the womb, or if the muscles or blood supply to the fetus’ neck are injured.
- Limited range of motion of the head
- Head tremor
- Neck pain
- Shoulder is higher on one side of the body
- Stiffness of neck muscles
- Swelling of the neck muscles (possibly present at birth)
Exams and Tests
Various tests or procedures may be done to rule out possible causes of head and neck pain. A physical examination will show a visible shortening of the neck muscles and the head will tilt toward the affected side while the chin points to the opposite side. In more severe cases, the entire head pulls and turns to one side
A electromyogram (EMG) may be done in mild cases to see which muscles are most affected.
Treatment of congenital torticollis involves stretching the shortened neck muscle. Passive stretching and positioning are treatments used in infants and small children. Such treatments are often successful, especially if started within 3 months of birth.
Surgery to correct the neck muscle may be done in the preschool years, if other treatment methods fail.
Acquired torticollis is treated by identifying the underlying cause of the disorder. Application of heat, traction to the cervical spine, and massage may help relieve head and neck pain. Stretching exercises and neck braces may help with muscle spasms.
Medications used to treat this condition include an anticholinergic drug called baclofen. Injection of botulinum toxin can temporarily relieve the torticollis, but repeat injections every 3 months are usually needed. Surgery is rarely used.
The condition may be easier to correct in infants and children. If the condition becomes chronic, numbness and tingling may develop as nerve roots become compressed in the neck.
The muscle itself may become large (hypertrophic) due to constant stimulation and exercise.
Botulinum toxin injections often provide substantial relief.
Complications may include:
- Muscle swelling due to constant tension
- Neurological symptoms due to compressed nerve roots
While there is no known prevention, early treatment may prevent a worsening of the condition.