Torticollis | Neurology & Neurosurgery | Loyola Medicine


Overview and Facts about Torticollis

Torticollis is a condition in which the neck twists to one side, making it extremely difficult to straighten the head. People can develop torticollis over time, or they can be born with it. The former is called spasmodic torticollis, while the latter is called congenital torticollis. In some cases, torticollis can even occur as a result of an injury or overextending the neck.

Unless torticollis is treated promptly, the twist in the neck might become permanent, meaning a person will never be able to regain their range of motion.

Signs and Symptoms of Torticollis

The biggest symptom of torticollis is being unable to move the head very much. You may find it sticks at an odd angle and you can’t straighten it. Other symptoms can include:

  • Headaches or neck pain
  • Involuntarily twitching or shaking of the head (tremors)
  • Shoulders that are uneven
  • Stiffness or swelling in the muscles of the neck

Overall, torticollis is extremely uncomfortable and will limit your overall range of motion.

Causes and Risk Factors of Torticollis

Many cases of torticollis are caused by genetic defects passed down from a parent, meaning the disease can be inherited. However, torticollis is also frequently caused by trauma or damage to the muscles of the back or neck, upper spine, or nervous system. This kind of trauma can cause the muscles to spasm and pull the neck into a twisted shape.

Infection is another possible cause of torticollis, as this can inflame the lymph nodes in the neck, putting pressure on the nearby muscles, causing them to contract.

Tests and Diagnosis of Torticollis

Testing for torticollis requires a visit to a neurology department that specializes in movement disorders. Your neurologist will perform a physical exam to see how your head is tilted and if your neck muscles look longer or shorter than usual. They may also perform tests to confirm the diagnosis, such as:

  • Blood tests to see if you might have another condition that could be causing torticollis
  • CT scan to look at the structures of the head and neck
  • Electromyogram (EMG) to see which muscles are affected
  • Magnetic resonance imaging (MRI) of the head and neck to examine the connective tissue
  • X-ray of the neck to see how the bones are aligned

Treatment and Care for Torticollis

In most cases, treatment for torticollis involves repairing the damage that’s been done to the neck. This might include:

  • Physical therapy to relieve pain and stretch muscles
  • Wearing a neck brace to control muscle spasms
  • Getting botox injections or taking a medicine called baclofen to help relax the muscles
  • Receiving trigger point injections to minimize pain

For cases caused by a dislocated vertebrae or other spine issues, you may need surgery to help move them back in the right place. Another type of surgery can be done to destroy some of the nerves in the neck, so they no longer receive messages from the brain to contract.