Torticollis

Torticollis, also known as wry neck, is a medical condition characterized by an abnormal posturing of the head and neck. It is typically marked by a twisted or tilted position of the head, with the chin pointing towards one shoulder.

Causes

• Congenital torticollis: present at birth, often due to abnormal development of the muscles in the neck during fetal development.
• Acquired torticollis: develops later in life, can be caused by muscle strain or injury, poor posture, or as a result of certain medical conditions such as cerebral palsy or stroke.

Symptoms

• Tilted or twisted head position
• Difficulty moving the head or neck
• Pain or stiffness in the neck and shoulders
• Facial asymmetry, with one side of the face appearing more developed than the other
• Plagiocephaly (flat spot on one side of the head) due to preferential sleeping position

Diagnosis

Diagnosis is typically made through a physical examination, where the doctor will assess the range of motion in the neck and check for any abnormalities. Imaging tests such as X-rays or ultrasound may be ordered to rule out other conditions.

Treatment

• Physical therapy: gentle stretching exercises to improve range of motion and strengthen the muscles in the neck.
• Occupational therapy: to help with daily activities and prevent further strain on the neck.
• Surgery: may be necessary in severe cases, to lengthen or release the affected muscle.
• Botulinum toxin injections: can be used to relax the affected muscle and improve range of motion.

Complications

• If left untreated, torticollis can lead to permanent facial asymmetry and limited range of motion in the neck.
• Can also increase the risk of developing other conditions such as scoliosis or spinal deformities.

Prognosis

The prognosis for torticollis is generally good, especially if treatment is started early. With proper therapy and management, most people are able to achieve significant improvement in their symptoms and range of motion.