Torticollis – Symptoms, Causes & Physiotherapy Treatment
What is Torticollis?
Torticollis, also known as "wry neck," is a condition in which the neck muscles contract involuntarily, causing the head to twist or tilt to one side. This condition can be congenital (present at birth) or acquired later in life due to injury, inflammation, or neurological disorders.
Types of Torticollis
- Congenital Muscular Torticollis: Most common in newborns, often caused by shortening of the sternocleidomastoid (SCM) muscle.
- Acquired Torticollis: Can occur due to trauma, inflammation, infections, tumors, or neurological disorders.
- Spasmodic Torticollis: A type of dystonia where neck muscles contract intermittently or continuously, often due to nerve-related issues.
Causes of Torticollis
The cause of torticollis depends on the type. Common causes include:
- Birth trauma or positioning in the womb
- Infections like upper respiratory or ear infections
- Cervical spine injuries or abnormalities
- Inflammation of cervical lymph nodes or muscles
- Neurological conditions (e.g., dystonia)
Signs and Symptoms
- Head tilting to one side
- Neck stiffness and pain
- Limited range of motion
- Swelling in neck muscles (especially SCM in infants)
- Headache or shoulder discomfort
- Facial asymmetry (in long-standing cases)
Diagnosis
Diagnosis is based on physical examination, patient history, and sometimes imaging studies like X-ray, MRI, or ultrasound (especially in infants). Identifying the underlying cause is crucial for effective management.
Physiotherapy Management
Physiotherapy plays a vital role in the conservative management of torticollis. It aims to restore neck mobility, correct posture, and strengthen weakened muscles.
Common Physiotherapy Techniques Include:
- Stretching exercises for tight neck muscles
- Strengthening exercises for weak muscles
- Postural correction strategies
- Soft tissue mobilization
- Manual therapy techniques
- Heat or cold therapy to relieve pain and inflammation
- Parent training (in case of infants)
Medical or Surgical Treatment
In severe or unresponsive cases, botulinum toxin (Botox) injections may be used to relax the affected muscles. Surgical release of tight muscles may be considered in rare or congenital cases that don't respond to conservative treatment.
Prognosis and Recovery
With early diagnosis and physiotherapy, most cases of torticollis—especially in infants—improve significantly. Delayed treatment may lead to complications such as facial asymmetry, head deformities, or chronic pain.
FAQs About Torticollis
Torticollis is a condition where the neck muscles contract, causing the head to twist or tilt to one side.
Most cases, especially congenital torticollis, can be successfully treated with physiotherapy if addressed early.
It often results from positioning in the womb or trauma during birth, leading to a shortened neck muscle.
Yes. Adults can develop acquired or spasmodic torticollis due to infections, injuries, or neurological issues.
Symptoms include head tilt, neck stiffness, limited motion, pain, and sometimes swelling in the neck.
Through physical exam, imaging (X-ray, MRI), and understanding the patient’s history.
Mild cases may resolve spontaneously, but physiotherapy accelerates and ensures proper recovery.
No, physiotherapy focuses on gentle stretching and strengthening techniques that are safe and effective.
Recovery varies by age and severity. Infants may recover in a few weeks; adults might need months.
Yes, muscle tension in the neck can refer pain to the head and cause headaches.
Surgery is rarely needed and only recommended when conservative treatments fail.
Neck stretches, strengthening, and range-of-motion exercises guided by a physiotherapist are beneficial.
Yes, maintaining awkward postures for prolonged periods can contribute to acquired torticollis.
Spasmodic torticollis is considered a form of cervical dystonia, which is a neurological disorder.
In some cases, manual therapy including chiropractic adjustments may complement physiotherapy.