Torticollis causes the head to be tilted to one side with the chin turned to the opposite direction. This can be evident at birth or at some point in the person’s life. Aside from having an incorrect neck position, the affected individual will also find it difficult to move the neck because doing so is painful. Some form of torticollis causes the head to twist either to the left or to the right uncontrollably, or tilt in front or at the back involuntarily. The condition may also cause tingling or numbness in the neck.
There are several ways to treat torticollis, depending on the type and severity of the condition. Treatment is usually customized based on the specific needs of the patient. A team of doctors will work together to develop the most appropriate treatment plan. This group may include a neurosurgeon, a plastic surgeon, orthopedic doctors and surgeons, as well as physical and occupational therapists.
Causes of Torticollis
There several forms of torticollis that occur for a range of reasons. When the cause is totally unknown, the condition is said to be idiopathic.
As the name implies, the condition is present at birth. This account for most cases of twisted neck in children. This usually happens when the baby is improperly positioned inside the womb, causing the muscle that connects the collarbone and breastbone to the head to tighten. This could also be caused by an injury to the neck muscles before or during childbirth. The condition sometimes arises when the bones in the neck are stuck together or abnormally formed. Still, a few inherit the condition from their parents.
In children, acquired torticollis develops as a result of wrong sleeping position or injury to the neck or head which causes the neck muscles to tighten and the head to tilt to one side. Other possible causes include inflamed lymph nodes due to upper respiratory infection, abscess in the throat, and sometimes, tumors. Abusing certain drugs had been found to cause involuntary muscle contractions in the neck, face and back.
There is a neurological involvement in this form of torticollis that causes involuntary contraction of neck muscles (or muscle spasms), twisting of the head either to the left or right, and tilting forward and backward. This could be caused by severe neck, head or shoulder injury, tumor in the spine or brain, and prolonged use of anti-depression medications.
Symptoms of Torticollis
Neck and head movements are limited in babies born with the disorder. They usually sleep with their heads on the side and this causes positiplagiocephaly or irregular head shape to develop.
Children or individuals with the acquired form are reluctant to turn their heads to the side. They cannot move their necks and heads freely and complain of a number of symptoms like headache, muscle tightness, neck cramps as well as back and shoulder pain.
Affected persons are in great pain. They suffer from pain on the neck and shoulders as well as severe headaches, dizziness, tremors and muscle contractions that cause one shoulder to become elevated while the head is bent sideways to meet shoulder.
A painful torticollis warrants prompt medical evaluation and treatment so as to prevent complications. Besides, the embarrassment caused by the disorder make it difficult for many patients to fit in with others leading to isolation and depression.
Diagnosis of Torticollis
The doctor will try to diagnose the disorder as accurately as possible in order to decide on the best treatment strategy. He or she will check the patient’s full medical history and medications taken and will run a series of tests and diagnostic procedures to find out the underlying cause of the condition. These include:
- Physical exam
- CT scan
Treatment of Torticollis and exercises
Treatment will resolve the issues or reduce the severity and frequency of the symptoms caused by the contraction of neck muscles, including constricted head and neck movement, headache and head tremor, neck pain and stiff neck. A team of qualified healthcare professionals will design a treatment plan that will meet the specific needs of the patient. This may involve:
- Stretching exercises
Stretching has been found to help not only in managing muscle spasms but in neck positioning as well, especially among infants and children. This should be done as early as 3 months after birth.
Appropriate medications are given to relax the muscles and nerves as well as lower the anxiety and stress. This will likewise ease the tremors and involuntary muscle movements.
- Neck braces
Braces or traction are useful in correcting the neck positioning by helping the neck stay in an upright position.
Surgery is sometimes needed to correct bone abnormalities, problems with the structure or stretch short muscles.
The chances of survival among Torticollis patients are quite good, especially with the suitable and timely treatment.