Torticollis: A-to-Z Guide from Diagnosis to Treatment to Prevention

Introduction to torticollis:

“What is that lump in my baby’s neck?” “Why does my baby only turn his head to one side?” Could it be torticollis?

What is it?

The Latin word tortus means ‘twisted.’ Collum (collar) means ‘neck.’Torticollis simply means twisted neck. It can have many different causes. By far the most common cause in young children is muscular torticollis. Here, the neck-strap muscle is injured, either before birth, during birth, or afterward. Bleeding into the muscle may cause a hematoma to form. The muscle may contract over time as the hematoma heals, pulling the head to one side.

The list of other possible causes is quite long, including GE reflux, arthritis, scoliosis, and congenital malformations.

Who gets it?

Muscular torticollis is most common in large babies and following difficult first time deliveries. It is also more common in breech deliveries and in conjunction with congenital hip dislocation. Children with first time torticollis later in childhood should be carefully evaluated. Most of these turn out to have torticollis from minor neck muscle trauma or from upper respiratory viruses. Nevertheless, some have it as a result of a serious problem such as a tumor.

What are the symptoms?

The head is usually tipped to one side, with the chin pointing to the other. The neck may feel tight or stiff. A lump may be felt in the sternocleidomastoid muscle (the muscle that attaches to the breastbone, collarbone, and behind the ear).

Is torticollis contagious?

No. Although some underlying causes of it are contagious.

How long does torticollis last?

How long it lasts depends on the underlying cause. If it comes from a congenital malformation (fused vertebrae or absent muscle) then it will last until successfully treated. If it comes from a brief muscle spasm, it may occur only briefly.

How is torticollis diagnosed?

Initial diagnosis may be made on physical exam. Imaging studies and lab work may be necessary to determine the underlying cause.

How is torticollis treated?

Different types of torticollis require different types of treatment. For congenital muscular torticollis, gentle stretching exercises may be prescribed. There may also be specific instructions for positioning during sleep. If the condition has another cause, or if the exercises are not working, other treatment may be necessary – possibly including medicines or surgery. Note: Stretching may be harmful for some types.

How can it be prevented?

Usually, torticollis cannot be prevented.

Related concepts:

Wryneck, Congenital muscular torticollis