Have you ever woken up one day and realized that you have a stiff neck, incapable of turning it? Does your baby seem to have an abnormal neck or head position? It could be a torticollis condition. This condition can be painful, and it could cause you or your baby discomfort. It could also lead to the permanent shortening of the involved neck muscles.
Luckily, it can be treated, and physical therapy is the most effective form of treatment. Not only will physical therapy relieve the associated neck and head pain, but it will also enhance your range of motion and eliminate this condition permanently.
At Suarez Physical Therapy, we are happy to help patients seeking physical therapy services for their torticollis condition in Las Vegas, NV. We have expert physical therapists who offer professional services that achieve the best possible outcome for our patients. Call us today to schedule an appointment and start your journey to effective treatment and recovery.
Torticollis, also called the wry neck, is a condition where neck muscles contract, causing the head to be painfully tilted or twisted to one side. The term originates from two Latin words – tortus, meaning twisted, and collum, meaning neck. Generally, the head tilts to one side, whereas the chin tilts to the other.
Even though it mostly occurs in children, torticollis also affects adults, and it can be acquired or congenital (meaning the baby can have it at birth). This condition can, at times, go away without any treatment. However, there is a possibility of relapse if this is the case.
Chronic torticollis can lead to difficulty performing day-to-day tasks and debilitating pain. Fortunately, therapies and medications can relieve stiffness and pain. Surgery may at times also correct this condition. Physical therapy treatment is more successful if it is started early enough, avoiding surgery. This is particularly true for minors.
Everyone has long muscles on either side of the neck. These muscles run from the back of their ear to the collarbone. They are known as the SCM or sternocleidomastoid, trapezius, and scalene. Torticollis occurs when this muscle tightens, thickens, weakens, or shortens, making the chin point to one shoulder, whereas the head tilts towards the opposite shoulder. In babies, this muscle shortens, thickens, or tightens due to being abnormally positioned, like the breech position or cramped in the womb.
When the baby is cramped or abnormally positioned in the womb, it exerts more pressure on one side of the head, causing the sternocleidomastoid, trapezius, and scalene muscles to tighten. If the doctor used a vacuum device or forceps during delivery, these might also have exerted pressure on the baby’s neck muscles.
Acquired wry neck could occur due to decreased blood supply to the neck muscles or damage of neck muscles. It could also be a symptom of more severe medical conditions or a side effect of given drugs. Any person can develop torticollis after a nervous system or muscle injury. However, in some cases, it’s not clear what causes this condition. This is called idiopathic torticollis.
There are many types of the torticollis condition, including:
- Congenital muscular torticollis (CMT) — this is the most prevalent type. It affects babies and is usually diagnosed within two months after birth. CMT is usually caused by remaining or sleeping in one position for an extended period or birth trauma.
- Acute torticollis — acute wry neck is also known as permanent or fixed torticollis. This form of the wry neck occurs due to an underlying problem with the bone or muscular structure. It could also occur if a tumor grows in the spine, exerting pressure on the nerves in the area. Twisting or bending your neck too far can also cause acute torticollis. If you have this form of wry neck, you may experience pain whenever you move your head up and down or sideways. The neck muscles may also be tender to touch. In minors, the acute wry neck may result in their faces having a flattened appearance or their features looking unbalanced. Minors may also have a delayed capability of using their facial muscles correctly.
Postural torticollis — this is a condition where the baby’s head tilt comes and goes. It’s diagnosed within five months after birth. It is usually caused by the lack of different resting positions, for instance, when the infant’s head is consistently rested in a baby container or an auto seat for an extended period.
- Spasmodic torticollis — also known as cervical dystonia, this condition occurs in adults and older children. It’s a painful condition in which neck muscles involuntarily contract, making your head turn or twist to one side. This condition may also lead to your head uncontrollably tilting backward or forward. Spasmodic torticollis can affect anyone. However, it mostly affects individuals aged 40 to 60 years. It is also more common in women than men. In most people with cervical dystonia, the cause isn’t known. Some people with this condition have a family history of it. Studies have discovered gene mutations linked to this condition. Spasmodic torticollis is also at times associated with head, shoulder, or neck injuries. Abuse of given drugs like cocaine, ketamine, and commonly prescribed neuroleptic medications like Haldol and Compazine can also cause spasmodic wry neck. This condition will sometimes go away without any treatment, but there is a risk of recurrence.
- Ocular torticollis — wry ocular neck results from a vision problem in one eye, leading to a person tilting their head to see better.
- Temporary torticollis — this form of torticollis generally disappears after two or one days. Causes include swollen lymph nodes, a cold, ear infection, or a neck or head injury that causes swelling. If you have temporary torticollis, you may have to rest while keeping your neck as still as possible. However, you might not need to undergo any specific treatment.
- Klippel-Feil syndrome — Klippel Feil syndrome is a rare, congenital type of torticollis. It arises due to the incorrect formation of the bones in the baby’s neck, particularly because of the two neck vertebrae fusing. Infants born with Klippel-Feil syndrome may have challenges with vision and hearing.
Abnormalities linked to torticollis include:
- Neurogenic abnormalities — wry neck can be associated with neurologic abnormalities like progressive spine diseases or a spine tumor that may lead to acute episodes, typically in older minors. Affected children might experience vomiting, headaches, and neurological signs such as speech difficulties and limb weakness (on one or both sides). Seek urgent medical care should your child experience any of the symptoms.
- Osseous abnormalities — these abnormalities arise due to improper cervical spine alignment when an infection causes damage to ligaments. Examples of infections that may cause these abnormalities are severe ear, sinus, or upper respiratory infections, cervical abscess, and cervical adenitis. Any inflammatory processes that irritate the muscles, vertebrae, or nerves, such as trauma or surgery, can generate reflux spasms, leading to these abnormalities.
The wry neck may result in additional problems, like:
- Irregular vision changes.
- Difficulty with balance
- Lack of interaction and self-awareness or delayed body awareness
- Limited capability of turning your head to interact with the surroundings, hear, and see can cause delayed cognitive development
- Developmental hip dysplasia.
- Movements that favor only one side of your body, impacting the trunk, hips, and arms. This can result in strength imbalances, like side-bending of your trunk and elevated shoulder. These movement patterns can result in delayed motor development.
- Flattening of your skull (brachycephaly or plagiocephaly) in infants.
Symptoms of torticollis can begin gradually. They might also worsen with time. Common symptoms are:
- Your chin tilting to one side.
- Swollen neck muscles.
- Neck stiffness or pain.
- Having one of your shoulders higher compared to the other.
- A headache.
- Inability to move your head normally.
- Difficulty or pain when trying to straighten your neck.
- Noticeable lump in the neck muscle (known as a pseudotumor).
- General pain might or might not be experienced based on the form of wry neck involved.
- The face and head of a child with torticollis may appear unbalanced and flattened. He/she might also have difficulties with vision and hearing or delays in motor skills.
When to Seek Help
Generally, acute torticollis isn’t life-threatening. If your symptoms are pain and muscle stiffness only, see a specialist within a day of their appearance. If you’ve injured your neck and are experiencing muscle spasms, go to the doctor immediately. Other health conditions may mimic wry neck and will require urgent medical care.
A doctor should evaluate you if you experience neck muscle spasms involved with breathing or swallowing or symptoms involving the central nervous system. These symptoms indicate irritation or injury to the central nervous system and must be medically assessed immediately, particularly if they unexpectedly develop:
- Trouble swallowing or breathing.
- Numbness or needles-and-pins feeling in your legs and arms.
- Fecal or urinary incontinence, urinary hesitancy.
- Weakness in your legs and arms.
- Difficulty walking.
- Impaired speech.
- If the neck muscle spasms are associated with swollen glands, fever, neck stiffness, difficulty swallowing, headache, or tongue/mouth swelling, seek medical care immediately.
Wry Neck Diagnosis
In adults, torticollis is usually diagnosed by a doctor. Expect the doctor to check your medical records and perform a physical examination. Ensure you inform them of any injuries you have to the neck area. The doctor can also conduct several tests to determine what is causing your torticollis. The EMG (electromyogram) measures electrical activities in your muscles. Your doctor can use it to determine what muscles have been affected. He/she can also use imaging tests like MRI scans and X-rays to find any structural-related problems that may be the cause of your symptoms.
In babies and children, skilled and experienced pediatric physical therapists may diagnose and treat postural and CMT wry neck conditions. Although, some states necessitate a doctor’s prescription for the physical therapist to go ahead with the treatment.
After the doctor determines the wry neck type you have, your therapist can then provide treatment. Mostly, a wry neck is a muscular-related problem, and physical therapists are musculoskeletal experts.
Physical therapy Treatment for Torticollis
Irrespective of how old the affected person is, physical therapy is the main treatment option for all wry neck types. Physical therapists provide treatment that addresses the impairments brought about by wry neck. Early treatment delivers the best results. If left untreated, the wryneck can transform to being a permanent condition. The physical therapist works with the adult patient or the affected child’s caregiver to establish and realize mutual goals. They design a personalized treatment plan that:
- Enhances the alignment of the body by relieving muscle tension and discomfort.
- Improves postural symmetry and control.
- Achieves painless movement.
- Corrects muscle imbalance.
- Strengthens neck muscles.
They can attain these goals through:
- Gently stretching the back and neck muscles.
- Massaging the affected place.
- Strengthening the back and neck muscles.
- Taping to elongate muscles to enable stretching.
- Guidance to achieve correct positioning in infants.
- Conducting heat therapy.
- Asking you to wear neck braces.
- A program for home exercises to continue with rehabilitation at the comfort of your home.
After the wry neck is diagnosed and stretching exercises begin, most patients improve within six months. Two things speed up recovery: early diagnosis and sticking to the treatment plan.
What You Can Do at Home for the Baby with Torticollis
Your physical therapist will teach you to do the following simple position changes and therapy exercises at home to help build and stretch your baby’s neck muscles and establish preventive behaviors:
- Environment — whenever putting the baby down to sleep, turn his/her head, so he/she isn’t always looking in one direction.
- Posture/Righting — whenever picking the baby up from the crib, changing table, or floor, roll them to one side first, then lift them. Switch sides regularly.
- Handling/Positioning — vary the play and sleep surfaces. Limit duration in plush surfaces, bouncers, and swings to fifteen to twenty minutes since these restrict body and head motion and enhance poor posture with time if overused.
- >The side-lying position is ideal for having the child off their back and bringing their hands to the middle of their body for midline play. Use a pillow or towel roll to help the child maintain this position.
- The football hold position helps keep the baby’s head up and strengthen the weak and long side while stretching the shorter side.
- Sitting activities — the child will generally lean his/her trunk or fall away from the shorter side and towards the longer side. Put a toy on the short side to encourage weight-shifting to that side and tightening muscles on the weaker side.
- Strengthening — place the baby on a pillow or soft incline ramp/wedge for tummy time to encourage arm weight-bearing and head movement. Increase the challenge by reducing the size of support.
- Range of motion – If the baby prefers rotating his/her head in a single direction, intentionally hold him/her on your chest, turning his/her head to rest facing the opposite direction for an easy, gentle stretch.
- Avoid leaving the baby in an infant seat, car seat, carrier, or swing, where the head is more likely to rest on the same spot.
- Alternate sides when feeding the baby with his / her bottle and change the hip that you hold the baby on
For adults, home remedies that can help relieve symptoms include:
- Stress-reduction techniques — identify what makes you anxious or stressed since this can cause tension and worsening of symptoms.
- Applying heat — applying hot water or heat packs to the neck can help in loosening tight muscles.
- Touching the opposite side of the neck, chin, or face. Doing this will trick the body and can temporarily stop spasms.
- Laying on your back — often, symptoms disappear when sleeping. Therefore, taking a break to lie on your back might provide relief.
Other Treatment Options
Apart from therapy treatment and home exercises, your doctor may recommend other treatment options like surgery and medications. However, this is very rare. Your health care provider may recommend surgery to:
- Fuse abnormal vertebrae
- Lengthen neck muscles
- Cut muscles or nerves
Medications can also help. Your doctor can prescribe drugs such as:
- Muscle relaxants
- Pain medications
- Botox injections
- Medicines used to treat Parkinson’s disease tremors
Living with Torticollis
Torticollis resulting from an illness or minor injury is likely to be temporary and can be treated. However, CMT and more severe types of torticollis can result in long-lasting health issues. Chronic torticollis can lead to complications, such as:
- Difficulty socializing
- Difficulty doing routine tasks
- Inability to drive
- Chronic pain
- Neurological symptoms due to compressed nerves
- Swollen neck muscles
If your torticollis is not reversible, consider joining a support group. Most people living who have chronic conditions are informative and comforting. Your therapist, local hospital, or doctor may give you info about various groups that can suit your needs. Communicating with other people with torticollis or similar conditions helps you cope.
Find a Professional Physical Therapist Near Me
The first time you experience torticollis, you immediately realize there is something wrong. Even the slightest movement can be excruciatingly painful. You may be incapable of turning your head without feeling pain. You may even feel like you’re incapable of moving out of bed without help if you wake up with torticollis. If you are feeling this way, it’s a clear indication that you need to be checked up by a specialist and start physical therapy before your situation worsens. Also, be observant of your baby, for they could be in pain too.
At Suarez Physical Therapy, we treat the torticollis condition in both adults and children through therapy. If you are looking for physical therapy services in Las Vegas, NV, to manage this condition, please call us right away at 702-368- 6778 to set up an appointment. Our physical therapists will evaluate you or your child and develop a personalized treatment plan meant to permanently eliminate your wry neck condition, leaving you pain-free, comfortable, and with perfect movement.