Torticollis

Torticollis means "twisted neck," and if a child has this condition, her head will be tilted to one side while the chin is turned to the other side. This condition is also sometimes called wryneck and can appear to be painful but usually isn't.

There are two types of Torticollis:

Congenital (Infants and Children)

When a baby is born with the condition, it's called congenital torticollis. About 1 in 250 infants are born with torticollis. (Ten to 20 percent of babies with torticollis also have hip dysplasia, in which the hip joint is malformed.)

Congenital torticollis is most often due to tightness in the sternocleidomastoid muscle (which connects the breastbone and the collarbone to the skull). This tightness might have developed because of the way your baby was positioned in the uterus (with the head tilted to one side) or because the muscles were damaged during delivery.

If your baby has torticollis, you'll probably notice that he holds his head to one side and has limited neck movement. Another telltale sign is a small bump on the side of her neck. The condition is usually diagnosed within the first two months of a baby's life. Even if parents don't spot it, a pediatrician or the family doctor usually will.

In Physiotherapy treatment of Torticollis, the head and neck of the baby is positioned and supported to gain the normal posture. Stretching is done to lengthen the shortened muscles of the neck.

Acquired Torticollis (Adults)

Acquired torticollis is usually a spontaneously occurring form of torticollis with one or more neck muscles being stiff and painful (usually the sternocleidomastoid muscle or the trapezius muscle); this usually passes in 1–4 weeks. The most common causes include: draughts, colds or unusual postures; however in many cases no clear cause is found. Other causes but less common ones, include:

• trauma to the neck, causing the two vertebrae closest to the skull slide with respect to each other, tearing stabilizing ligaments; this condition is treated with traction to reduce the subluxation, followed by bracing or casting until the ligamentous injury heals.
• tumors of the skull base (posterior fossa tumors), compressing the nerve supply to the neck and cause torticollis; these problems must be treated surgically.
• infections in the posterior pharynx, irritating the nerves supplying the neck muscles and causing torticollis; these infections may often be treated with antibiotics if they are not too severe.

Treatment of this type of Torticollis may include the typical physiotherapy treatments used for a strained/sprained neck. This may include hot packs, passive stretching, massage and acupuncture.