Patient education: Torticollis in children (The Basics)

What is torticollis? — Torticollis is the medical term for a twisted neck. The condition is sometimes called "wry neck." In torticollis, the head tilts to 1 side and the chin points in the opposite direction.

Torticollis is common in children, and babies can have it at birth (figure 1). The medical term for this is "congenital torticollis." The word "congenital" means that the person was born with the condition. Doctors do not know the exact cause of congenital torticollis, but it can run in families.

Torticollis can also be caused by another medical condition, such as a muscle strain, bad reaction to medicine, or a problem with the spine that makes the neck twist.

What are the symptoms of torticollis? — The symptoms of congenital torticollis can include:

●Head tilted to 1 side

●Chin pointed to the opposite side from the head tilt. For example, if a baby's head tilts to the right, the chin points to the left.

●Lump on the side of the neck that the head tilts toward. For example, if a baby's head tilts to the right, the lump is on the right side of the neck.

●Face that looks uneven, with 1 side that does not match the other

In babies born with torticollis, symptoms usually show up by 2 to 4 weeks after birth.

Symptoms of torticollis caused by a medical condition can include:

●Pain

●Trouble moving the head, neck, or both

●Throwing up, looking pale, being irritable or sleepy, and being less coordinated than normal. Babies and children can have "attacks" of these symptoms that last a few hours or days. Then the symptoms go away on their own.

●Tight jaw muscles, muscle spasms, and trouble speaking. These torticollis symptoms can be caused by a bad reaction to certain medicines.

Will my child need tests? — Maybe. The doctor or nurse should be able to tell if your child has torticollis by doing an exam. Depending on the type of torticollis, they might order imaging tests. These can include ultrasound, X-ray, CT, or MRI scans. Imaging tests create pictures of the inside of the body. They can show the cause of torticollis, including other conditions that need treatment.

How is torticollis treated? — Congenital torticollis sometimes goes away without treatment, but not always. If congenital torticollis is not treated, it can make 1 side of a child's face look different from the other side. This can be permanent.

Treatments for congenital torticollis can include:

●Stretches and position changes you do with your baby at home. These can help straighten out the neck. Your doctor or nurse will tell you if you should try these.

●Physical therapy

●Surgery

For torticollis caused by another condition, treatment depends on the cause. Treatments can include:

●Medicine to relieve pain, relax tight muscles, or fight infection, if the torticollis is caused by infection

●A collar that supports and straightens the neck, called a "cervical collar"

If a child's neck is twisted in an accident, they need treatment right away. Call for an ambulance (in the US and Canada, call 9-1-1) and do not move the child.

More on this topic

Patient education: Neck pain (The Basics)
Patient education: Newborn appearance (The Basics)

Patient education: Neck pain (Beyond the Basics)