Summary about Disease
Torticollis, also known as wryneck, is a condition characterized by a twisted neck that causes the head to tilt to one side while the chin rotates to the opposite side. It can be congenital (present at birth) or acquired later in life. The condition involves shortening or tightening of the sternocleidomastoid (SCM) muscle, which runs along the side of the neck. This muscle imbalance pulls the head into an abnormal position. Torticollis can range from mild to severe and may cause pain, limited range of motion, and difficulty with daily activities.
Symptoms
Head tilted to one side with the chin rotated to the opposite side.
Limited range of motion in the neck.
Neck pain or stiffness.
Muscle tightness or a knot in the neck.
Headaches.
Shoulder asymmetry (one shoulder higher than the other).
Facial asymmetry (in severe or long-standing cases).
In infants: preference for looking in one direction, difficulty breastfeeding on one side, or a flattened spot on the head (plagiocephaly) due to persistent positioning.
Causes
Congenital Muscular Torticollis: Often caused by positioning in the uterus before birth, birth trauma, or unknown factors leading to SCM muscle injury or shortening.
Acquired Torticollis: Can be caused by:
Muscle spasms or strains.
Injury to the neck muscles or spine.
Infection (e.g., upper respiratory infection, meningitis).
Inflammation of lymph nodes.
Drug-induced (e.g., certain antipsychotics).
Tumors (rare).
Grisel's syndrome (rare; atlantoaxial rotatory subluxation secondary to inflammatory processes in the head and neck).
Medicine Used
Pain relievers: Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help manage pain.
Muscle relaxants: Medications like cyclobenzaprine (Flexeril) may be prescribed to relieve muscle spasms.
Botulinum toxin (Botox) injections: Can be injected into the SCM muscle to relax it and reduce spasms in severe cases.
Antibiotics: If torticollis is caused by an infection.
Other: Treatment of underlying causes if applicable (e.g., anti-inflammatory medications for inflammatory conditions).
Is Communicable
No, torticollis is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
For Infants:
Encourage tummy time to strengthen neck muscles.
Position toys and stimuli to encourage the infant to look in both directions.
Follow the physical therapist's instructions carefully.
For Adults:
Maintain good posture.
Avoid prolonged positions that strain the neck.
Use proper lifting techniques.
Regular stretching and exercise to maintain neck flexibility.
If pain is severe or persistent, seek medical evaluation.
How long does an outbreak last?
Torticollis isn't an outbreak-related disease. The duration of torticollis varies depending on the cause and treatment:
Congenital Torticollis: With early intervention (physical therapy), it can often be resolved within several months. More severe cases might take longer or require more extensive treatment.
Acquired Torticollis: The duration depends on the underlying cause. Acute muscle spasms may resolve within a few days to weeks. Torticollis due to other causes might require longer treatment and rehabilitation.
How is it diagnosed?
Physical Examination: A doctor will examine the neck, assess range of motion, and feel for muscle tightness.
Medical History: The doctor will ask about symptoms, past injuries, and medical conditions.
Imaging Studies:
X-rays: To rule out bone abnormalities.
Ultrasound: Can be used in infants to visualize the SCM muscle.
MRI or CT scan: May be necessary to identify underlying causes such as tumors or spinal problems in acquired torticollis.
Electromyography (EMG): Rarely used, but may be helpful to assess muscle activity.
Timeline of Symptoms
The timeline depends on whether the torticollis is congenital or acquired.
Congenital: Symptoms are usually noticeable within the first few weeks or months of life. The head tilt and limited range of motion are typically gradual in onset.
Acquired: Symptoms can appear suddenly (e.g., after an injury) or gradually (e.g., due to muscle strain or underlying condition). The timeline for symptom progression depends on the specific cause.
Important Considerations
Early Intervention: Early diagnosis and treatment, especially for congenital torticollis, are essential for optimal outcomes.
Physical Therapy: Physical therapy is a cornerstone of treatment for torticollis.
Underlying Causes: Identifying and addressing any underlying causes of acquired torticollis is crucial for effective management.
Compliance with Treatment: Following the prescribed treatment plan, including exercises and stretches, is important for recovery.
Monitoring: Regular follow-up with a healthcare provider or physical therapist is necessary to monitor progress and adjust treatment as needed.