Torticollis, also known as wry neck, is a state of twisted neck, referring to the head being tipped to one side, while the chin is turned to another.

The term torticollis is also used to refer to a broader category of disorders that exhibit flexion, extension or twisting of the muscles of the neck beyond their normal position.

When the disorder occurs in people with a family history, it is referred to as spasmodic torticollis.

Symptoms of Torticollis

In torticollis, the neck twists to one side. Though the symptoms may vary in different individuals, there are certain generic signs and symptoms associated with torticollis. Here we list the main amongst them:

· Enlargement of the neck muscles

· Asymmetry of an infant’s head from sleeping on the affected side

· Elevation of the shoulder on the affected side

· Stiffness of neck muscles

· Limited range of motion

· Headache

· Neck pain

· Head tremor

Certain other symptoms include

· Signs change considerably as the disease progresses

· In later stages of the disease, patients have more difficulty in performing motor activities.

· 1/6th of patients report head trauma that occurred before the onset of main symptoms.

· Neck pain and head shaking occurs in 50% cases and abnormal posture in 25% cases.

Torticollis in Children

Congenital muscular torticollis is the most common form of torticollis known. It is associated with a mass in the sternocleidamastoid muscle, which is the strap that courses from beneath the angle of the jaw to the base of the neck, above the medial end of the collarbone.

It is usually diagnosed in the first couple of months of life. Researchers believe that during vaginal delivery, blood flow to the affected neck muscle is reduced causing damage. This perhaps explains the occurrence of torticollis in kids, though there are other theories debating this finding.

Treatment of Torticollis

A) Torticollis in Adults

This is treated by medication, physical devices, botulinum toxin and surgery. Normally, torticollis resolves itself in a few weeks time. However, some people will develop continuing neck problems for months to years. Continuous muscle spasms may require intervention by a neurologist or surgeon.

In case the condition does not respond successfully to medications, surgical intervention might be required. Selective denervation of the neck muscles is then the most successful surgical approach.

Though rare, psychiatric treatment is recommended if there are any signs of an emotional problem or stress being a causative factor.

B) Congenital Torticollis

Congenital torticollis should be treated within the first few months of life. This initially involves intensive physical therapy, followed by passive stretching of the shortened muscle for infants (less than one year).

If this is unsuccessful, as an alternative, operative division of the contracted muscle and surrounding tissue might be recommended.