Torticollis - When Things Get In A Twist

Tuesday, June 22, 2021

If you have ever woken in the morning with severe pain in the neck and you head twisted to one side, you have probably experienced Torticollis. This is the name given to a deformity of the neck in which the head usually tilts toward one shoulder and the chin rotates toward the opposite shoulder.

Torticollis presents itself in several ways, based on age and underlying cause. There is a wide range of severity and outcomes.


The most common form of torticollis seen in chiropractor’s office is Acute Torticollis (also known as wyr neck.) this occurs mostly in older children and young adults. The pain and muscle spasm usually lasts 3-10days. The trigger factor may be some minor trauma such as twisting the neck while drying your hair or jarring the neck while hitting a tennis ball. Often the affected person will wake up with some mild stiffness that increases to sharp pain and torsion in the neck.


Chiropractic care can be useful in reducing muscle spasm, relieving pain and ensuring a quicker and more complete return to function. In addition to gentle and specific spinal adjustments, slow holding adjustments on the cranial (skull) bones and soft tissue techniques for muscle spasm at the front and back of the neck may also be useful.


Home advice will usually involve recommendations for rest, together with gentle mobilising exercises of the neck and shoulders. These should be within the comfortable range of motion. Alternating heat/ice might be useful initially. Often supporting the neck with a scarf or, if needed, a soft cervical collar is helpful.


Congenital torticollis


Congenital means ‘present at birth’. This form of torticollis is usually the result of birth trauma, commonly seen in breech births or where intervention such as forceps is used. The muscle at the front and side of the neck (called the SCM) is damaged causing bleeding inside the muscle (haematoma) and shortening of the muscle.


As these babies have often had a traumatic birth, they are more likely to have a congenital hip dislocation. An x-ray of the neck and the hips may be required in some cases.


Treatment is very important for these infants to prevent permanent shortening of the neck muscles involved. Facial and skull asymmetry is also common and congenital torticollis.


Chiropractic care may involve gentle massage and stretching of the SCM. Very light finger-tip adjustments to the neck are often useful, as are craniosacral adjustments to balance dural tension (the dura is the sac-like sheath that surrounds the brain and spinal cord). In some cases it may take months for neck posture and movement to return to normal.


Spasmodic Torticollis


This is a more severe form of torticollis and is also known as cervical dystonia. This typically affects adults between the ages of 30-50 years and is related to nervous system dysfunction at the brain level.


This is a particularly difficult condition to treat and can be associated with chronic pain and muscle tremors. Spasmodic torticollis can last for very long periods and in some cases is permanent. Chiropractic care offers relief in most cases, allowing the condition to be managed and pain levels kept at a minimum. In some cases medical co-management may also be required.


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