Overview

Torticollis, also known as “wry neck” or “twisted neck,” is a condition characterized by an abnormal, asymmetrical head or neck position. It can be congenital (present at birth) or acquired (developing later in life). The condition often involves the sternocleidomastoid muscle, which causes the head to tilt to one side while the chin rotates to the opposite side. Torticollis can lead to discomfort, limited range of motion, and a noticeable head tilt. Early diagnosis and treatment are crucial for preventing long-term complications.

Torticollis has been recognized and described in medical texts since antiquity. The earliest references can be traced back to the works of Hippocrates, who noted the twisted neck posture in his medical treatises. The condition has been depicted in art and literature throughout history, highlighting its long-standing presence in human health. Over the centuries, the understanding and management of torticollis have evolved significantly, particularly with advances in neurology and musculoskeletal medicine.

Causes

The causes of torticollis vary depending on whether it is congenital or acquired:

Congenital Torticollis

Muscular torticollis: Caused by the tightening or shortening of the sternocleidomastoid muscle, often due to the baby’s position in the womb or birth trauma.

Bone abnormalities: Malformations of the cervical spine can lead to a tilted head position.

Acquired Torticollis

Injury: Trauma or injury to the neck muscles or spine.

Inflammation: Infections or inflammatory conditions affecting the neck muscles or cervical spine.

Spinal abnormalities: Conditions such as herniated discs or cervical dystonia (a neurological disorder causing involuntary muscle contractions).

Tumors: Masses or growths that affect the muscles or bones of the neck.

Risk Factors

Several factors may increase the likelihood of developing torticollis:

  • Family history: A history of torticollis or other musculoskeletal disorders.
  • Trauma: Previous neck injuries or trauma.
  • Infections: Upper respiratory or ear infections that spread to the neck muscles.
  • Neurological conditions: Disorders that affect muscle control and coordination.

Complications

If untreated, torticollis can lead to several complications:

Chronic pain: Persistent neck pain and discomfort.

Muscle imbalances: Uneven muscle development and strength.

Postural issues: Poor posture and asymmetry of the head, neck, and shoulders.

Developmental delays: In infants, untreated torticollis can affect motor skills and development.

Neurological symptoms: Nerve compression leading to numbness, tingling, or weakness.

Prevention

While congenital torticollis cannot be prevented, the risk of acquired torticollis can be minimized by:

  • Avoiding neck injuries: Using seat belts and protective gear during physical activities.
  • Maintaining good posture: Ensuring ergonomic workspaces and practicing good posture.
  • Treating infections promptly: Seeking medical care for upper respiratory or ear infections.
  • Stretching and strengthening exercises: Regularly performing neck exercises to maintain flexibility and strength.

Symptoms

When to see a doctor