Torticollis & Wry Neck – Causes, Symptoms, Treatment & Rehabilitation

What is Torticollis & Wry Neck?

Torticollis, or Wry Neck, is a condition where the muscles of the neck cause the head to twist or tilt to one side. It may be temporary or chronic, and its severity can range from mild discomfort to debilitating pain. The head may lean to one side, and the neck muscles may feel tight or painful. In some cases, the individual may also experience limited range of motion and difficulty turning their head.

There are two main types of Torticollis:

• Congenital Torticollis: Present at birth, this type occurs due to abnormal positioning in the womb or injury during birth that affects the sternocleidomastoid muscle, a large muscle in the neck.

• Acquired Torticollis: This type develops later in life and can be caused by muscle spasms, trauma, infections, or other health conditions like neck strain or cervical spine disorders.

Causes of Torticollis & Wry Neck

The causes of Torticollis or Wry Neck can vary, including:

1. Muscle Spasms: Sudden spasms in the neck muscles can result from overuse, poor posture, or sleeping in an awkward position. These spasms cause the head to tilt or rotate uncontrollably.

2. Trauma or Injury: Accidents, such as falls, car accidents, or sports injuries, can damage the neck muscles or spine, leading to muscle tightness and restricted head movement.

3. Cervical Spine Disorders: Conditions like cervical disc degeneration, herniated discs, or arthritis can irritate the nerves in the neck, leading to muscle spasms and Torticollis.

4. Infections or Inflammation: Infections affecting the throat or neck muscles, such as tonsillitis, may cause muscle tightness and stiffness, leading to Wry Neck.

5. Neurological Conditions: Certain neurological conditions, such as Parkinson’s disease or dystonia, can cause abnormal muscle contractions and result in a twisted neck.

6. Congenital Factors: In congenital Torticollis, the baby’s neck muscles are shortened or abnormally positioned, which causes the head to tilt to one side.

7. Poor Posture: Prolonged poor posture, particularly while sitting or using mobile devices, can lead to muscle imbalances and neck discomfort, which may cause Torticollis.

Symptoms of Torticollis & Wry Neck

The symptoms of Torticollis & Wry Neck can vary depending on the underlying cause but commonly include:

• Head Tilt: The most obvious symptom is a noticeable tilt of the head to one side, often accompanied by difficulty straightening it.

• Neck Pain & Stiffness: Pain and tightness in the neck are common, especially when trying to turn the head.

• Limited Range of Motion: The ability to turn the head or move the neck freely may be restricted.

• Muscle Spasms: The muscles in the neck may feel tight and may contract involuntarily, leading to further discomfort.

• Shoulder Pain: Torticollis can sometimes affect the shoulder area, causing pain or discomfort in the upper back or shoulder blade.

• Headaches: Tension from the neck muscles can lead to headaches or a feeling of pressure in the head.

• Difficulty Sleeping: Discomfort and pain in the neck may cause difficulty finding a comfortable sleeping position.

Diagnosis of Torticollis & Wry Neck

The diagnosis of Torticollis & Wry Neck typically begins with a thorough physical examination, where your healthcare provider will evaluate the position of the head, assess neck range of motion, and identify areas of tenderness or muscle spasms.

In some cases, additional imaging may be recommended to rule out any underlying structural issues:

• X-rays: X-rays are often used to check for any structural abnormalities in the cervical spine, such as disc herniation or misalignment.

• MRI (Magnetic Resonance Imaging): An MRI provides detailed images of the soft tissues, including the muscles, ligaments, and discs, and can help detect issues like nerve compression or disc degeneration.

• CT Scan (Computed Tomography): A CT scan can provide detailed images of the bones and help identify any fractures, dislocations, or abnormalities in the cervical spine.

• Electromyography (EMG): This test measures electrical activity in the muscles and can help diagnose nerve-related causes of Torticollis.

Treatment for Torticollis & Wry Neck

Treatment for Torticollis & Wry Neck depends on the severity of the condition and the underlying cause. At Palms Physiotherapy & Allied Health, we offer a range of treatments to relieve pain, restore mobility, and prevent future episodes.

Conservative Treatments

1. Physiotherapy
   Physiotherapy is a primary treatment option for Torticollis. Our physiotherapists use various techniques, such as:

   • Manual Therapy: Techniques like joint mobilization or soft tissue massage help reduce muscle tightness and improve mobility in the neck.

   • Stretching & Strengthening Exercises: Targeted exercises designed to stretch the neck muscles and strengthen weak muscles, improving posture and preventing future spasms.

   • Postural Education: Educating patients about correct posture to avoid muscle imbalances and minimize the risk of recurrence.

2. Exercise Physiology
   Exercise physiology can be beneficial in managing Torticollis. Our exercise physiologists may design a tailored exercise program that focuses on:

   • Neck Strengthening: Exercises that improve the strength of the neck muscles, providing better support to the cervical spine.

   • Stretching: Gentle stretches to reduce muscle tightness and increase flexibility in the neck and shoulders.

   • Functional Movement Training: Exercises that improve overall body mechanics and posture, reducing the risk of injury.

3. Heat/Ice Therapy
   Heat or ice therapy can help alleviate muscle pain and reduce inflammation. Applying ice to the neck can help reduce swelling, while heat can improve blood flow and relax tight muscles.

4. Medications
   Pain relievers such as NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) may help reduce inflammation and relieve discomfort. Muscle relaxants may also be prescribed to ease muscle spasms.

5. Shockwave Therapy
   Shockwave therapy uses high-energy sound waves to target areas of pain and stiffness, helping to stimulate healing and reduce muscle tension. This non-invasive treatment can be particularly effective in chronic cases of Torticollis.

6. eMTT Therapy
   Electromagnetic Tissue Therapy (eMTT) utilizes electromagnetic waves to stimulate tissue repair, reduce inflammation, and improve circulation in the affected muscles, aiding in faster recovery.

7. Botulinum Toxin Injections (Botox)
   In severe cases, Botox injections may be used to relax the affected muscles and reduce spasms. This is typically considered when conservative treatments have not been effective.

Surgical Treatments

Surgical intervention is rare and typically only recommended when conservative treatments fail, or if there is severe nerve damage or structural abnormalities. Surgery may be necessary in cases where:

• There is a herniated disc compressing the spinal cord or nerves.

• A significant structural issue, such as a deformity, is present in the cervical spine.

Preventing Torticollis & Wry Neck

While not all cases of Torticollis can be prevented, certain practices can reduce the risk of developing the condition or experiencing a recurrence:

• Maintain Proper Posture: Keeping good posture while sitting, standing, and sleeping helps reduce the strain on the neck muscles.

• Sleep in a Neutral Position: Avoid sleeping with your neck twisted or at awkward angles. Use a supportive pillow that aligns your neck and spine.

• Regular Exercise: Engage in activities that promote neck strength and flexibility, such as yoga or Pilates, to keep muscles in the neck and shoulders healthy.

• Take Frequent Breaks: If you work at a desk or spend long periods in one position, take regular breaks to stretch and change positions to prevent stiffness in the neck.

Conclusion

Torticollis & Wry Neck can cause significant discomfort and limit daily function. At Palms Physiotherapy & Allied Health, our dedicated team of professionals offers personalized treatment plans to help relieve pain, improve range of motion, and restore quality of life. Whether you are dealing with acute neck pain or managing a long-term condition, our clinic is here to support you every step of the way.

Book an appointment today at one of our clinics or contact us for further information on how we can assist in your recovery journey.