Torticollis, also known as wry neck or loxia, is derived from the Latin word “tortus” which is defined as a twisted neck. It is a painful condition where the head rotates and tilt to one side at an odd angle, it occurs when the neck muscles twist beyond their normal capacity. This condition may be temporary or permanent and they may be congenital (present at birth) or acquired. Commonly, most cases of torticollis resolve within several days to a few weeks, but there are a few that persist for months to years which can cause difficulty in performing daily tasks due to the debilitating pain. The specific torticollis treatments will be based on the type and causes and several factors such as your age, medical history, the extent of the condition, and tolerance for certain medications, therapies, or procedures.
Generally, acute torticollis is non-life-threatening. However, some medical conditions involving the central nervous system or an acute infection may appear as a sudden development of torticollis. Seek immediate medical attention if the following symptoms occur together with torticollis:
- Difficulty breathing or swallowing
- Numbness or weakness over arms or legs
- Difficulty walking
- Trouble with controlling urination or bowel movement
- Trouble with speaking or understanding speech
- Fever or headache
- Neck stiffness
- Swollen tongue, mouth or neck
In treatment for torticollis, the main aim is to relax the contracted neck muscles involved to relieve pain and stiffness. Treatment is most successful if they are started early, especially for children. Generally, treatment for torticollis can be divided into conservative, medical, or surgical.
- Conservative treatment
Some home remedies to try out include heat or ice packs which may help to relieve pain and loosen the contracted muscles. Touching the opposite side of the neck, chin or face can trick the body to stop spasms temporarily. Stretching exercises include exercise to gradually move the head in the opposite direction more each time which helps to improve motion and soothe the discomfort. Simply sleeping and getting plenty of rest provides relief as torticollis often disappear during sleep and stress-reduction techniques help as stress can cause muscles to tighten and may worsen the torticollis. Some physical devices such as neck brace or collar may help to keep the neck fixed in place. Certain therapies such as massage therapy, physical therapy, chiropractic therapy, or ultrasound therapy may also aid in the treatment of torticollis. Physical therapy is often the primary treatment for torticollis as a physical therapist will recommend and demonstrate the proper way for daily stretches and exercises to improve symptoms, or they can also perform more intensive treatments.
- Medical treatment
If you have spasmodic torticollis caused by trauma or side effects of medications, muscle relaxants, or anti-inflammatory drugs via injection or oral form can be prescribed to relieve symptoms completely usually within a few days. For chronic cases of neck muscle spasms, a local injection of botulinum A toxin (Botox) may be given to provide relief and prevent the condition from progressing, which aids in a complete recovery.
- Surgical treatment
Surgery can help to treat torticollis if other forms of treatment do not work. Some of the upper neck nerves or muscles are selectively cut to prevent muscle contraction. This treatment often helps, but frequently the neck may return to its twisted position after a few months. Rarely, deep brain stimulation is done to treat torticollis by inserting a wire into the part of the brain where movement is controlled and sending electrical signals to disrupt brain signals that cause torticollis.
If your symptoms do not improve or worsen, you should inform your healthcare provider. If your torticollis is not treatable, consider joining a support group that may be comforting and informative. Communicating with others with a similar condition may help you cope better.