How are you viewing the world around you?

Are you or your child looking at the world from a different viewpoint? Is your head tilted to the side preventing you or your child from seeing straight? Torticollis, also known as “wryneck”, is a condition in which a child’s head is tilted.   Torticollis can also be seen in adults as well as children, but most commonly found in infants.  Congenital Torticollis is seen in infants and typically caused by either a tightening of the anterior muscles of the neck, a flattening of the back of the head or a combination of the two.  The flattening may be due to poor positioning of the fetus in-utero, damage to the muscles or blood supply to the fetus’ neck, or a low level of amniotic fluid.  The tightness of a specific muscle pulls the head sideways toward the shoulder, turning the face in the direction of the opposite shoulder, and bringing the head forward to the chest.  Habitually spending time in this position frequently causes other neck muscles to tighten.  The inability to turn the head symmetrically may restrict a child’s ability to freely see, hear, and interact with his/her environment.  This can potentially lead to a delay in development.

In adults and older children, torticollis is more often categorized as: Inherited, Acquired or Idiopathic.   Inherited Torticollis is due to specific changes in your genes.  Acquired Torticollis develops as a result of damage to the nervous system or muscles.  Idiopathic Torticollis is the name given for an unknown cause.

Treatment of the condition is determined both from presentation of symptoms as well cause of the torticollis.  Treatment may include medical intervention or physical therapy.  Physical therapy may include moist heat, mechanical or manual traction, soft tissue mobilization, massage, and stretching of the specific neck muscles.  With older adults, physicians may prescribe medication to relax the muscles or injections to temporarily relieve the torticollis prior to beginning physical therapy.  With young children it is extremely important to have the parent involved with developmental activities (ie. positioning/holding) and education.  Congenital Torticollis is most successfully treated if started prior to 3 months of age.   The key component in the recovery of this condition is early intervention, physical therapy, education, home exercise, and parent involvement.