Table of ContentsView AllTable of ContentsCauseSymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Cause
Symptoms
Diagnosis
Treatment
Torticollis(wryneck) occurs when the neck turns or twists into an involuntary position. It affects both children and adults. There are two main types: congenital (present at birth, often in first pregnancies) and acquired due to causes likeinfectionor spinal changes.
Congenital torticollis in infants is generally painless, while acquired torticollis often causesneck painand restricted neck movements. Torticollis is typically not a medical emergency, though it can be.
This article discusses torticollis symptoms, possible causes, and diagnosis. It explains how torticollis treatment (includingphysical therapy) can offer benefits.
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What Is the Cause of Torticollis?
The potential causes of torticollis depend on the type.
Congenital Torticollis
Congenital torticollis occurs due to the shortening of one of thesternocleidomastoidmuscles (SCMs). The SCMs are two large muscles in the neck that connect the back of your skull to your breastbone (sternum) and clavicle (on either side)
After hip dysplasia (often seen with torticollis) andequinovarusfoot disorders, it is the third-most common congenital condition in newborns and infants.The exact cause is unknown but may be due to:
Gastroesophageal reflux disease (GERD) can occur in babies.It can lead to an acquired torticollis.
Acid Reflux in Children
Acquired Torticollis
Torticollis can develop as a consequence of a chronically strained neck position or damage to the muscles that move the neck. Possible causes include:
Injury to thesternocleidomastoidor thetrapezius(a muscle involved in shoulder and neck movements) can lead to acquired torticollis. Rarely, there are other culprits behind torticollis, like a tumor or bleeding in the cervical spine.
Vision problems are a common cause of torticollis. This type is called ocular torticollis.
Torticollis Symptoms
Like the underlying causes, the symptoms of torticollis vary based on the type.
In addition to a head and chin tilt, babies with congenital torticollis may have a lump on the side of the neck that the head is tilted toward. Babies with congenital torticollis may also have an asymmetrical appearance of the face.
Children and adults with acquired torticollis usually experience neck pain with certain neck movements, as well as a “locked” sensation after quickly rotating their neck.Headaches, headtremors, and stiff or swollen neck muscles can accompany these symptoms. One shoulder may also appear higher than the other.
Other symptoms of torticollis in children and adults often correlate with the underlying cause.
When to See Immediate Medical AttentionTorticollis is typically not life-threatening, and episodes tend to be temporary. They may go away in a day or two. If not, see a healthcare provider.Some symptoms indicate injury or irritation to the structures of the brain and/or spinal cord, including:Difficulty breathing, speaking, orswallowingDifficulty walkingWeakness, numbness, orpins and needlesin your arms and legsIncontinence (urinary orfecal)Neck-muscle spasms and a feverSwollen glandsNeck stiffnessor swellingHeadacheIf you or your child are experiencing any of these symptoms, it’s important to seek medical attention right away:
When to See Immediate Medical Attention
Torticollis is typically not life-threatening, and episodes tend to be temporary. They may go away in a day or two. If not, see a healthcare provider.Some symptoms indicate injury or irritation to the structures of the brain and/or spinal cord, including:Difficulty breathing, speaking, orswallowingDifficulty walkingWeakness, numbness, orpins and needlesin your arms and legsIncontinence (urinary orfecal)Neck-muscle spasms and a feverSwollen glandsNeck stiffnessor swellingHeadacheIf you or your child are experiencing any of these symptoms, it’s important to seek medical attention right away:
Torticollis is typically not life-threatening, and episodes tend to be temporary. They may go away in a day or two. If not, see a healthcare provider.Some symptoms indicate injury or irritation to the structures of the brain and/or spinal cord, including:
If you or your child are experiencing any of these symptoms, it’s important to seek medical attention right away:
Torticollis Diagnosis
The diagnosis of torticollis begins with a thorough medical history.
Your healthcare provider may ask you questions about when your symptoms started and whether you have associated symptoms, such as pain, fever, headache, or neurological problems. and whether there was an inciting injury or trauma. They will also ask about your medication exposures.
Your healthcare provider will then do a physical exam that is focused on your head and neck muscles and nervous system.
Sometimesimaging tests—like an X-ray,computed tomography (CT) scan, ormagnetic resonance imaging (MRI)—may be warranted, especially if there is a history of trauma.
Is Torticollis Curable?
The treatment of congenital torticollis usually involvesphysical therapyto help stretch and straighten out the neck. Surgery to lengthen or release the muscle may be needed.
To relieve neck pain and help relax the neck muscles, the following therapies may be recommended:
Botulinum toxin (Botox)injections can also be helpful, especially for spasmodic torticollis.
The treatment of acquired torticollis is focused on treating the underlying cause (such as antibiotics for an infection) and easing symptoms.
Summary
Torticollis can be treated effectively, especially with an early diagnosis. Physical therapy can be a key component of your treatment plan. It’s possible that torticollis can become severe, or be a part of an underlying health condition that requires treatment.
Due to the complexity of this condition and the fact that treatment is often warranted, if you think that your child (or yourself) might have torticollis, be sure to talk to your healthcare provider.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Torticollis.Płomiński J, Olesińska J, Kamelska-Sadowska AM, Nowakowski JJ, Zaborowska-Sapeta K.Congenital Muscular Torticollis-Current Understanding and Perinatal Risk Factors: A Retrospective Analysis.Healthcare (Basel). 2023 Dec 20;12(1):13. doi:10.3390/healthcare12010013.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms and causes of GER and GERD in infants.Tan ETC, Rostamzad P, Esser YS, Pleumeekers MM, Loudon SE.Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related.J Clin Med. 2023 Sep 19;12(18):6059. doi:10.3390/jcm12186059.Temple University Health System.What Is Torticollis?Greene KA, Lu V, Luciano MS, Qubty W, Irwin SL, Grimes B,et al.Benign paroxysmal torticollis: phenotype, natural history, and quality of life.Pediatr Res. 2021 Nov;90(5):1044-1051. doi: 10.1038/s41390-020-01309-1.El Bouhmadi K, Oukessou Y, Saout Arrih B, Rouadi S, Abada R, Mahtar M.The outcomes of congenital torticollis delayed surgery in older children: A case series.Int J Surg Case Rep. 2023 May;106:108144. doi:10.1016/j.ijscr.2023.108144.Castelão M, Marques RE, Duarte GS, et al.Botulinum toxin type A therapy for cervical dystonia.Cochrane Database Syst Rev. 2017;12(12):CD003633. Published 2017 Dec 12. doi:10.1002/14651858.CD003633.pub3
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Torticollis.Płomiński J, Olesińska J, Kamelska-Sadowska AM, Nowakowski JJ, Zaborowska-Sapeta K.Congenital Muscular Torticollis-Current Understanding and Perinatal Risk Factors: A Retrospective Analysis.Healthcare (Basel). 2023 Dec 20;12(1):13. doi:10.3390/healthcare12010013.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms and causes of GER and GERD in infants.Tan ETC, Rostamzad P, Esser YS, Pleumeekers MM, Loudon SE.Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related.J Clin Med. 2023 Sep 19;12(18):6059. doi:10.3390/jcm12186059.Temple University Health System.What Is Torticollis?Greene KA, Lu V, Luciano MS, Qubty W, Irwin SL, Grimes B,et al.Benign paroxysmal torticollis: phenotype, natural history, and quality of life.Pediatr Res. 2021 Nov;90(5):1044-1051. doi: 10.1038/s41390-020-01309-1.El Bouhmadi K, Oukessou Y, Saout Arrih B, Rouadi S, Abada R, Mahtar M.The outcomes of congenital torticollis delayed surgery in older children: A case series.Int J Surg Case Rep. 2023 May;106:108144. doi:10.1016/j.ijscr.2023.108144.Castelão M, Marques RE, Duarte GS, et al.Botulinum toxin type A therapy for cervical dystonia.Cochrane Database Syst Rev. 2017;12(12):CD003633. Published 2017 Dec 12. doi:10.1002/14651858.CD003633.pub3
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Johns Hopkins Medicine.Torticollis.Płomiński J, Olesińska J, Kamelska-Sadowska AM, Nowakowski JJ, Zaborowska-Sapeta K.Congenital Muscular Torticollis-Current Understanding and Perinatal Risk Factors: A Retrospective Analysis.Healthcare (Basel). 2023 Dec 20;12(1):13. doi:10.3390/healthcare12010013.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms and causes of GER and GERD in infants.Tan ETC, Rostamzad P, Esser YS, Pleumeekers MM, Loudon SE.Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related.J Clin Med. 2023 Sep 19;12(18):6059. doi:10.3390/jcm12186059.Temple University Health System.What Is Torticollis?Greene KA, Lu V, Luciano MS, Qubty W, Irwin SL, Grimes B,et al.Benign paroxysmal torticollis: phenotype, natural history, and quality of life.Pediatr Res. 2021 Nov;90(5):1044-1051. doi: 10.1038/s41390-020-01309-1.El Bouhmadi K, Oukessou Y, Saout Arrih B, Rouadi S, Abada R, Mahtar M.The outcomes of congenital torticollis delayed surgery in older children: A case series.Int J Surg Case Rep. 2023 May;106:108144. doi:10.1016/j.ijscr.2023.108144.Castelão M, Marques RE, Duarte GS, et al.Botulinum toxin type A therapy for cervical dystonia.Cochrane Database Syst Rev. 2017;12(12):CD003633. Published 2017 Dec 12. doi:10.1002/14651858.CD003633.pub3
Johns Hopkins Medicine.Torticollis.
Płomiński J, Olesińska J, Kamelska-Sadowska AM, Nowakowski JJ, Zaborowska-Sapeta K.Congenital Muscular Torticollis-Current Understanding and Perinatal Risk Factors: A Retrospective Analysis.Healthcare (Basel). 2023 Dec 20;12(1):13. doi:10.3390/healthcare12010013.
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms and causes of GER and GERD in infants.
Tan ETC, Rostamzad P, Esser YS, Pleumeekers MM, Loudon SE.Torticollis in Non-Syndromic Unicoronal Craniosynostosis Is Predominantly Ocular Related.J Clin Med. 2023 Sep 19;12(18):6059. doi:10.3390/jcm12186059.
Temple University Health System.What Is Torticollis?
Greene KA, Lu V, Luciano MS, Qubty W, Irwin SL, Grimes B,et al.Benign paroxysmal torticollis: phenotype, natural history, and quality of life.Pediatr Res. 2021 Nov;90(5):1044-1051. doi: 10.1038/s41390-020-01309-1.
El Bouhmadi K, Oukessou Y, Saout Arrih B, Rouadi S, Abada R, Mahtar M.The outcomes of congenital torticollis delayed surgery in older children: A case series.Int J Surg Case Rep. 2023 May;106:108144. doi:10.1016/j.ijscr.2023.108144.
Castelão M, Marques RE, Duarte GS, et al.Botulinum toxin type A therapy for cervical dystonia.Cochrane Database Syst Rev. 2017;12(12):CD003633. Published 2017 Dec 12. doi:10.1002/14651858.CD003633.pub3
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