Also known as twisted neck or wryneck, is a problem involving the muscles of the neck. It results from unilateral shortening and increased tone of the sternocleidomastoid muscle and presents as lateral flexion of the head to the ipsilateral side with rotation to the contralateral side.
If a baby has the condition at birth, it’s called congenital muscular torticollis. That’s the most common type.
Babies can also develop the condition after birth. Then it’s called “acquired,” rather than congenital. Acquired torticollis may be linked to other, more serious medical issues.
It is the third most common congenital musculoskeletal condition in new-borns with an incidence ranging from 0.3 to 16%.
What causes torticollis?
The exact cause of torticollis is unknown.
Congenital muscular torticollis is more likely to happen in firstborn children. This may also be accompanied by a congenital hip dislocation.
The cause is likely from the fetus’s position in the uterus resulting in injury to the neck muscles.
Acquired torticollis may be caused by irritation to the cervical ligaments from a viral infection, injury, or vigorous movement.
Additional causes may include:
️Sleeping in an awkward position.
️Neck muscle injury at birth.
️Burn injury.
️Any injury that causes heavy scarring and skin or muscle shrinkage.
️Neck muscle spasm.
Torticollis may also be a secondary condition that results from the following:
Slipped facets (two small joints on the side of the spine).
Herniated disk.
Viral or bacterial infection.
What are the symptoms of torticollis?
️May not notice anything unusual about babies for the first 6 or 8 weeks. It’s common for torticollis symptoms to become obvious once an infant gains more control of the head and neck.
️he following are the most common symptoms of torticollis. However, each person may experience symptoms differently.
️ Symptoms may include:
Child’s head tilts to one side with their chin pointed to the opposite shoulder. In about 75% of babies with torticollis, the right side is affected.
Their head doesn’t turn side to side or up and down easily.
Can feel a soft lump in baby’s neck muscle. This isn’t dangerous, and goes away within 6 months, usually.
Baby prefers to look over the shoulder at you. Their eyes don’t follow you because that would require turning their head.
They have trouble in breast-feeding on one side or prefers to feed on one side only.
Baby works hard to turn toward you, struggles to turn their head all the way, and becomes upset because the movement is hard.
They might start getting a flat head on one side or both sides from lying in one position all the time. This is called “positional plagiocephaly.”
Physiotherapy management of torticollis.
physiotherapy is a first line treatment for torticollis. The sooner it starts, the faster the normal cervical biomechanics become established, as well as achieving better.
Education.
Education, guidance and support is likely to reassure and help parents.
Educate the parents/caregivers about positioning and handling skills that promote active neck rotation toward the affected side and discouraging children from tilting their head toward the affected side.
References
https://www.webmd.com/parenting/baby/what-is-torticollis
https://www.google.com/amp/s/www.hopkinsmedicine.org/health/conditions-and-diseases/torticollis-wryneck%3famp=true
Amal Adithya.
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