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Guide to Torticollis

What is Torticollis?

Torticollis means ‘twisted neck’ and is sometimes called “wry neck”. It is caused by involuntary, one-sided contraction of neck muscles, particularly the sternocleidomastoid (SCM) and trapezius.

‘Acute’ means the symptoms have developed rapidly, over a period of hours to days. It is common for patients to wake up suffering from acute torticollis the following day.

There are three forms of Torticollis:

  1. Congenital torticollis is caused by tight fibrotic adhesions in the SCM or the trapezius muscle. It is recognized at birth or shortly after and is usually related to injury to the muscles during delivery.
  2. Spasmodic torticollis also known as cervical dystonia is characterized by painful progressive involuntary repeated contractions of the SCM. Cervical dystonia is a neurogenic movement disorder that may have a genetic link and is thought to be a faulty guarding mechanism.
  3. Acute torticollis is a common and benign condition that usually affects younger to middle-aged patients. Onset is frequently sudden and often presenting upon arising.

What causes Acute torticollis?

The cause is often unknown. It can happen to anybody even in people with no previous history of neck complications. Practitioners theorize that the condition results from cervical spine facet joint restriction generating a cycle of pain, inflammation and further restriction. Trigger point activation in the SCM or trapezius is an alternate theory.

The condition is thought to be precipitated by a minor traumatic insult like sleeping in an awkward position or sleeping under a draft from an open window or a fan. Some patients may experience symptoms after unusual or strenuous activity the day before. Other possible causes may include; poor posture at work and carrying heavy unbalanced loads such as a briefcase.

How is Acute Torticollis diagnosed?

The diagnosis of Acute torticollis can be made by our practitioners once a complete history and a physical examination has been conducted based on the presenting symptoms. Our practitioners would conduct numerous examinations ranging from neurological assessment to specific orthopaedic testing to rule out any serious pathologies. Tests such as X-rays are not necessary and only recommended if a condition other than torticollis is suspected.

How is Acute Torticollis treated?

Acute torticollis usually goes away on its own over a few days and sometimes may even take longer. The muscle spasms usually improve within a day or two but may take up to a week for the symptoms to go away completely. In some people, the symptoms may last longer than usual and has the potential to reoccur at a later time with no known cause.

The treatment will aim to help relieve some of the pain and to reduce the stiffness and muscle spasms that you are experiencing. Practitioners will use a variety of treatment modalities that will best suit you from myofascial release, dry needling (acupuncture) and spinal manipulation.

The practitioners would also give you advice on gentle neck stretches that can be performed at home and advice on the use of heat packs and preventative care to reduce the likelihood of a reoccurrence at a later time.

References

Torticollis (Wry Neck Symptoms, Exercises, Treatment, and Prevention). Accessed 4/2013 from: www.emedicinehealth.com/torticollis/page2_em.htm.

Cerf J. Adult Torticollis. Dynamic Chiropractic Canada. Accessed 4/2013 from: www.chiroweb.com Brunker P, Kahn K. Clinical Sports Medicine. Sydney: McGraw-Hill Book Co.; 2001, p240.

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