Torticollis

Torticollis, also known as wry neck, is a painful twisted, and slanted neck. The upper part of the head tends to lean to one side, whereas the chin leans to the other. It is possible that this disorder is congenital (existing at birth) or acquired. Blood flow or neck muscles impairment might also cause this.

Torticollis might sometimes go away on its own. There is, nevertheless, a possibility of relapse. The chronic twisted neck can result in agonizing pain and make it difficult to carry out regular tasks. The good news is that pain and stiffness can be alleviated with the use of drugs and other therapies. In other cases, surgery can help to fix the problem.

When the treatment begins early, it has the best chance of being successful, particularly in the case of children.

Types of Torticollis

The following are the types of torticollis that can develop in both children and adults;

Temporary torticollis

Temporary torticollis is a condition that normally persists for one to two days before vanishing. Temporary torticollis patients should try to relax as much as possible while maintaining their necks still. On the other hand, they might not need any medical treatment.

At times, the lymph nodes get inflamed due to a cold or an infection, or when one sustains a neck injury, causing the joints in the neck bones to enlarge. When this happens, temporary torticollis can result.

Fixed torticollis

This happens when there is an underlying issue or damage to the muscles or bone structure. It can also occur if a tumor in the spinal cord grows and exerts pressure on the surrounding nerves.

Fixed torticollis in children can make their features appear imbalanced or their face to appear flattened. Children's ability to use their face muscles appropriately may be delayed as well.

Muscular torticollis

This is the most prevalent type of fixed torticollis. Musculoskeletal torticollis occurs if the neck muscles on one side are unusually stiff or if scar tissue impairs motion. Muscular torticollis in the baby can occur during pregnancy. This happens if it shifts into an unusual location inside the uterus or if the fetus has insufficient space.

Klippel-Feil syndrome

Klippel-Feil syndrome is a genetic disorder. It occurs if the bones around the neck fail to develop properly, causing the neck to twist. When the bones in the ears are damaged, people who have Klippel-Feil syndrome might have trouble hearing.

Cervical dystonia

Cervical dystonia, sometimes called spasmodic torticollis, is a type of torticollis that is less common than the others. The neck muscles tend to spasm as a result of cervical dystonia. It also causes contraction of the neck muscles while the head bends to one side, backward, or forward, causing pain.

Signs and Symptoms of Torticollis

Torticollis symptoms differ from one person to the other. The tilting or twisting of the neck to one side is the most noticeable sign of this illness. In addition, people with torticollis can also experience the following symptoms;

Tense and painful neck muscles
Neck aches and pains, as well as burning feeling around the neck
A reluctance to turn or twist the head or neck to the other side
Uncontrollable upward gaze
Head and neck motions, as well as jerky muscular spasms
Backache and headaches

Symptoms of torticollis in babies can include the following;

Slanting their head on one side
Flattening at the back the ear on one side of the head
Head and neck movements are restricted.
Facial features that look asymmetrical
A tiny and soft hump on the neck
Breastfeeding infants preferring one breast to the other
Hip dysplasia and other musculoskeletal issues

During the periods of head tilting, the child with acquired torticollis may appear fatigued, irritated, and can even vomit.

Causes of Torticollis

Torticollis in adults can occur due to various reasons. However, the doctors are generally unable to pinpoint the cause.

The following are some of the most common causes of torticollis;

An injury on the neck or the spine, which causes muscles spasms
Head or neck infection, in which the muscles tense due to inflammation
Throat abscesses or upper airway abscesses
Infections of other regions of the body, including the sinuses, ears, teeth, jaw, or scalp

Some of the less prevalent yet possible causes of torticollis are;

Tissue scars
Cervical spine arthritis
Irregularities in the blood vessels
Use of certain drugs
Misuse of drugs, leading to a loss of muscular control.
Tumors

Torticollis commonly develops in children, infants, and newborns as a result of congenital muscular torticollis (CMT). This generally means they are born with the disorder. CMT occurs when the sternocleidomastoid muscle on one side of the neck is overly short.

Congenital torticollis in children can also be caused by;

A traumatic birth
Flathead syndrome; this is when the child sleeps with their head in one position every night.
Muscular and nervous system disorders caused by hereditary illnesses.

Torticollis Diagnosis

The doctor will conduct a physical examination and inquire about the family and medical history to diagnose torticollis. He or she might as well ask about the current drugs you or your child is using.

In addition, they can order neck x-rays to see if the condition is because of a bone fracture or displacement. To detect torticollis caused by more difficult-to-spot anomalies or disorders, a CT scan can be used. An example of such a condition is degenerative spinal arthritis.

In certain cases, what appears to be torticollis could be a sign of a more serious condition. Therefore, if you have any of the following symptoms, then you need to seek medical attention right away;

Breathing problems
Difficulty when passing urine
Enlargement of the tongue or mouth
Fecal or urinary incontinence
Fever
Headache
Neck muscular spasms following an injury
Numbness or weakness around the arms and legs
Speech impairment
Swallowing problems
Swollen glands
Walking difficulties

Torticollis Treatment

Torticollis treatment typically depends on the type, the underlying cause, and the patient’s age. If you relax and avoid rotating your neck, some cases of torticollis can go away in a few days.

Some of the treatment options doctors can recommend for torticollis include;

Medication
Ice packs
The physical equipment to help maintain the neck in a stable position.
Massage therapy
Physical therapy
Exercises for stretching
Surgical procedure

For spasmodic torticollis that occurs due to an injury or a consequence of certain medications, the doctor can recommend anti-inflammatory drugs and muscle relaxants. On the other hand, botulinum A toxin (Botox) is used to treat cervical dystonia and chronic neck muscle spasms. Botox can give relief by keeping muscles from constricting and might also help avoid the issue from getting worse.

If conventional treatments fail, the provider can recommend surgery to prevent additional problems. To stop the muscles and nerves from contracting, a neurosurgeon may suggest cutting them off.

About 10% of children born with torticollis will need surgery to stretch the sternocleidomastoid muscle around their neck. As soon as the child approaches the age of preschool, the procedure would most likely be performed.

Brain stimulation is another treatment choice that is rarely used. This can be accomplished by putting a wire into the portion of the brain regulating movement and disrupting brain impulses. Patients with cervical dystonia may benefit from brain stimulation.

Alternatively, individuals with torticollis can also opt for home treatments to alleviate pain and discomfort. Some of these home remedies are;

Getting plenty of rest and sleeping: Torticollis symptoms might go away as you sleep. Therefore, getting lots of rest and lying down could help you feel better.
Heat or ice packs use: This equipment can help to reduce pain and relax the tense muscles.
Touching the chin, face, or neck on the other side: This can deceive the body and assist in temporarily stopping spasms.
Stress reduction: Stress could make muscles stiffen, which can exacerbate torticollis symptoms. Understanding the actual causes of stress and employing stress-reduction methods can aid in the management of symptoms.
Exercising your muscles: These can involve gently moving the head in the other direction while increasing the distance each time can aid in the improvement of mobility and alleviating discomfort.

Stretching can also benefit infants with torticollis. Allowing the child to turn his or her head in each direction might help reduce tension and strengthen neck muscles. Babies can be encouraged to move their heads with the use of stimuli, including light and noise.

A physical therapist can treat infants with torticollis more intensively and recommend stretches to attempt at home.

Conclusion

Torticollis occurs when the neck muscles involuntarily contract, especially the sternocleidomastoid muscle, making the head turn. Torticollis can be idiopathic (without a known cause), genetic (inherited), or acquired as a result of muscle or nervous system damage.

Although torticollis is not often preventable, immediate treatment can help cure it or prevent it from worsening. There are several treatment choices for controlling symptoms and lowering their frequency. With this, patients with the condition usually have a positive outcome.