Torticollis is a painfully twisted and tilted neck. The head is generally tilted to one side and the chin to the other. It is also known as wry neck.
This condition can be congenital (present at birth). It can also be caused by damage to the neck muscles or blood supply. Wry neck sometimes goes away on its own. However, there is a chance of relapse.
Chronic wry neck can cause debilitating pain and difficulty performing daily tasks. Fortunately, medications and therapies can help to relieve pain and stiffness. Surgery can also sometimes correct the condition. Treatment is most successful when begun early, especially for children.
Wry neck can be inherited. It can also develop in the womb. This may happen if the fetus’ head is in the wrong position. It can also be caused by damage to the muscles or blood supply to the neck.
Anyone can develop wry neck after a muscle or nervous system injury. However, most of the time, the cause of wry neck is not known. This is called idiopathic torticollis.
This type of wry neck usually disappears after one or two days. It can be caused by:
- swollen lymph nodes
- an ear infection
- a cold
- an injury to the head and neck that causes swelling
Fixed torticollis is also called acute torticollis or permanent torticollis. It is usually due to a problem with muscle or bone structure.
This is the most common type of fixed torticollis. It is caused by scarring or tight muscles on one side of the neck
This is a congenital form of wry neck. It occurs when the bones in an infant’s neck have formed incorrectly. Children born with this condition may have difficulty with hearing and vision.
This rare disorder is sometimes referred to as spasmodic torticollis. It causes neck muscles to contract in spasms. If you have cervical dystonia, your head twists or turns painfully to one side. It may also tilt forward or backward. Cervical dystonia sometimes goes away without treatment. However, there is a risk of recurrence.
This type of wry neck can happen to anyone. However, it is most commonly diagnosed in middle age. It affects more women than men.
Symptoms of wry neck can begin slowly. They may worsen over time. The most common symptoms include:
- inability to move the head in a normal fashion
- neck pain or stiffness
- one shoulder higher than the other
- swollen neck muscles
- chin tilting to one side
The faces of children with wry neck may appear flattened and unbalanced. They may also have motor skill delays or difficulties with hearing and vision.
Your doctor will want to take your medical history and conduct a physical examination. Be sure to tell your doctor of any injuries to the neck area. Several types of tests can also be used to determine the cause of your wry neck.
An electromyogram (EMG) measures electrical activity in your muscles. It can determine which muscles are affected.
Imaging tests such as X-rays and MRI scans can also be used to find structural problems that might be causing your symptoms.
Currently, there is no way to prevent wry neck. However, getting treatment quickly can keep it from becoming worse.
Congenital forms of wry neck can be improved by stretching the neck muscle. If started within a few months of birth, this treatment can be very successful. If this or other treatments don’t work, surgery can sometimes correct the problem.
Acquired wry neck is treated according to the cause, if known.
Treatments for wry neck include:
- applying heat
- physical therapy
- stretching exercises
- neck braces
Types of surgery include:
- fusing abnormal vertebrae
- lengthening neck muscles
- cutting nerves or muscles
- deep brain stimulation to interrupt nerve signals—this is used only in the most severe cases of cervical dystonia
- muscle relaxants
- medications used to treat the tremors of Parkinson’s disease
- botulinum toxin (injections are repeated every few months)
- pain medications
Wry neck caused by a minor injury or illness is likely temporary and treatable. However, congenital and more severe forms of wry neck can cause long-term problems to your health.
Chronic wry neck can result in complications such as:
- swollen neck muscles
- neurological symptoms from compressed nerves
- chronic pain
- difficulty in performing routine tasks
- inability to drive
- difficulty in socializing
It is easier to correct wry neck in infants and young children.
If your wry neck is not treatable, consider seeking out a support group. Many people with chronic conditions find them both comforting and informative. Your doctor or local hospital may be able to give you information about groups that meet in your area. You may also be able to find a supportive community online. Communicating with others who have wry neck or similar conditions can help you cope.