Torticollis is both a diagnosis and a description of a medical problem where the muscles in the side of the neck are in a prolonged state of contraction or spasm, causing the head to tilt and twist to the side. The term comes from the Latin words for wry neck. It can be painful or nonpainful and is considered a self-limiting problem, meaning that it usually goes away on its own. One treatment approach commonly used is stretching.
Medical Care of Torticollis
Generally, torticollis has no known cause. For a small percentage of people, it may be hereditary. It is a type of dystonia, or muscle dysfunction, and is frequently seen in cases where there are other dystonias present. It is an involuntary spasm that holds the head twisted to the side and can last for as long as five years. It is often treated with botulinum toxin injections that block the ability of the muscle to contract. Conservative care approaches center around stretching and physical therapy.
There are several forms of torticollis, and each one involves a different muscle or set of muscles. In laterocollis, there is simply a tilting of the head to the side. Other forms cause the head to be pulled forward or backward. The most common is both a twisting and tilting and the primary muscle involved is the SCM, or sternocleidomastoid. This muscle starts on the bony bump on the side of the skull behind the ear and runs down to the top of the collar bone. When it is in spasm, it tilts the head to that side and the chin points up and out to the other side.
Stretching for Torticollis
Any treatment of this condition should involve your family doctor or specialist. The spasm of torticollis tends to go away while the person is sleeping, so relaxation is an important component of reducing the spasm. Start by warming up the area with a hot towel or heating pad for 10 minutes to increase blood flow to the area and begin by moving your chin back toward neutral. You can do this with the heating pad in place. If you are able to move to neutral, begin to tilt your head away from the spasm side. Expect slow progress and be patient.
Other Treatment Considerations
Because the condition usually resolves on its own, surgery is needed in only a small percentage of cases. The important factor in treating this condition is to have an accurate diagnosis to rule out other more serious conditions. Have any prolonged muscle spasm evaluated by a physician to ensure that you are not dealing with something of greater concern.