Torticollis is a condition in which the neck muscles cause the head to turn or rotate to the side. The condition may also occur without a known cause. With torticollis present at birth, it 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 were injured.
Symptoms of torticollis include:
- Limited movement of the head.
- Headache, neck pain or head tremor.
- Shoulder that is higher than the other.
- Stiffness of the neck muscles.
- Swelling of the neck muscles (possibly present at birth).
Torticollis is usually diagnosed from physical exam. Other tests that may be done include:
- X-ray of the neck.
- CT scan of the head and neck.
- Electromyogram (EMG) to see which muscles are most affected.
- MRI of the head and neck.
- Blood tests to look for medical conditions that are linked to torticollis.
Treating torticollis that is present at birth involves stretching the shortened neck muscle with occupational or physical therapy treatment. Passive stretching and positioning are used in infants and small children. In passive stretching, a device such as strap, a person, or something else is used to hold the body part in a certain position. These treatments are often successful, especially if they are started within 3 months of birth. Applying warmth and massage may help to relieve head and neck pain and allow children to tolerate stretching exercises better.
For refractory cases, a child may be referred to a pediatric physiatrist for botulinum toxin injections, spasticity medications, or trigger point injections. Rarely surgery is needed.
NIH: National Institute of Neurological Disorders and Stroke