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Wry Neck (Torticollis)

What is wry neck?

Highlights

  1. With wry neck, the top of the head generally tilts to one side while the chin tilts to the other.
  2. Wry neck can be present at birth or occur after a muscle or nervous system injury.
  3. There’s no way to prevent wry neck, but quick treatment can keep it from becoming worse.

Wry neck, or torticollis, is a painfully twisted and tilted neck. The top of the head generally tilts to one side while the chin tilts to the other side.

This condition can be congenital (present at birth) or acquired. It can also be the result of damage to the neck muscles or blood supply. Wry neck sometimes goes away without treatment. However, there’s a chance of relapse.

Chronic wry neck can cause debilitating pain and difficulty performing daily tasks. Fortunately, medications and therapies can relieve pain and stiffness. Surgery can also sometimes correct the condition. Treatment is most successful if it’s started early. This is especially true for children.

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Causes

What causes wry neck?

Wry neck can be inherited. It can also develop in the womb. This may happen if your baby’s head is in the wrong position. It can also be due to 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 unknown. This is referred to as idiopathic torticollis.

Types

Types of torticollis

Temporary torticollis

This type of wry neck usually disappears after one or two days. It can be due to:

Fixed torticollis

Fixed torticollis is also called acute torticollis or permanent torticollis. It’s usually due to a problem with the muscular or bone structure.

Muscular torticollis

This is the most common type of fixed torticollis. It results from scarring or tight muscles on one side of the neck.

Klippel-Feil syndrome

This is a rare, congenital form of wry neck. It occurs when the bones in your baby’s neck form incorrectly, notably due to two neck vertebrae being fused together. Children born with this condition may have difficulty with hearing and vision.

Cervical dystonia

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, but there’s a risk of recurrence.

Cervical dystonia can happen to anyone. However, it’s most commonly diagnosed in people who are roughly ages 40 to 60. It also affects more women than men.

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Symptoms

Symptoms of wry neck

Symptoms of wry neck can begin slowly. They may also worsen over time. The most common symptoms include:

  • an inability to move your head normally
  • neck pain or stiffness
  • a headache
  • having one shoulder higher than the other
  • swollen neck muscles
  • a tilting of your chin to one side

The faces of children with congenital wry neck may appear flattened and unbalanced. They may also have motor skill delays or difficulties with hearing and vision.

Diagnosis

What to expect at the doctor’s office

Your doctor will want to take your medical history and conduct a physical exam. Be sure to tell them about any injuries to your neck area. Several types of tests can also 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.

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Treatment

Treatments for wry neck

Currently, there’s no way to prevent wry neck. However, getting treatment quickly can keep it from becoming worse.

You can improve congenital forms of wry neck by stretching the neck muscles. If started within a few months of birth, it can be very successful. If this or other treatments don’t work, surgery can sometimes correct the problem.

Your doctor can treat acquired wry neck according to the cause if it’s known.

Treatments for wry neck include:

  • applying heat
  • massage
  • physical therapy or chiropractic care
  • traction
  • stretching exercises
  • neck braces

Your doctor may recommend surgery, such as:

  • fusing abnormal vertebrae
  • lengthening neck muscles
  • cutting nerves or muscles
  • using deep brain stimulation to interrupt nerve signals (used only in the most severe cases of cervical dystonia)

Medications can be helpful. They can include:

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Outlook

Living with wry neck

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 health problems.

Chronic wry neck can cause complications, including:

  • swollen neck muscles
  • neurological symptoms from compressed nerves
  • chronic pain
  • difficulty performing routine tasks
  • an inability to drive
  • difficulty socializing
  • isolation
  • depression

It’s easier to correct wry neck in infants and young children.

If your wry neck isn’t 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.

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Q&A

Q&A: Stretches for babies

  • What stretches will help treat my baby’s wry neck?
  • Your doctor may advise stretching the sternocleidomastoid muscle. This is the muscle that is tight in torticollis. A physical therapist can teach you to do the stretches safely and correctly. These stretches may be helpful to keep up at home. One example is gently turning the baby’s neck to the affected side. Another stretch involves gently tilting your child’s head to the opposite of the affected side. Perhaps more importantly, you can hold your baby or change their environment in a way that will encourage them to stretch the muscle. For example, allow for lots of tummy time. And when feeding your baby, hold them on the side that will make them turn their head toward the desired side.

    - Euna Chi, M.D.
  • Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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