Torticollis

Torticollis develops most often between the ages of 30 and 60. However, it can occur at any age. The deformity causes a person's head to bend toward the affected side. The chin is rotated toward the opposite side.

The first sign of torticollis is usually stiffness of the neck muscle on one side. A sensation of pulling toward the affected side follows. This is accompanied by twitching or contraction of the muscles. The person may experience severe neck pain and head pain. Usually the individual has limited range of motion in the neck. An infant born with this condition may have limited neck movement. The shoulder on the affected side is usually elevated. There may be an enlargement of the neck muscle.

In some cases torticollis is congenital, meaning that the person is born with the condition.

The condition can also be acquired. This form falls into 3 categories:

• acute. This is the result of muscle damage caused by inflammatory diseases, such as tuberculosis. It can also be brought on by cervical spinal injuries that produce scar tissue.
• spasmodic. This is a result of muscle spasms cause by a central nervous disorder.
• hysterical. This is due to the inability to control one's neck muscles, for some reason that is ultimately psychological

There is no known prevention for this condition.

A physical exam will show a shortening of the neck muscles and the head tilting toward the affected side. X-rays of the neck may show an associated disorder such as tuberculosis, scar tissue, or arthritis.

If the condition becomes chronic, numbness and tingling sensations in the arm and hand may develop. This is caused by the nerve roots becoming compressed in the cervical spine.

There are no risks to others.

The goal of treatment is to stretch the shortened neck muscle. If an individual is born with the condition, intensive physical therapy is started within the first few months of life. If physical therapy is unsuccessful, the muscle may have to be repaired surgically.

The pain caused by the acquired form of the condition may be eased by the application of heat and gentle massage. Stretching exercises and a neck brace may help to relieve symptoms of the spasmodic and hysterical forms.

Medication such as anticholinergics, which block specific nerve impulses, or mild sedatives may be used. Muscle relaxants and antidepressants are occasionally prescribed. Surgically removing the nerves to the affected neck muscle is sometimes successful. This may be tried if other treatments fail. If emotional problems contribute to the spasms, psychotherapy may help.

Any surgery can be complicated by bleeding, infection, or an allergic reactions to the anesthetic. Each medication has a different array of possible side effects. Dry mouth, drowsiness, constipation, nausea, and stomach upset are some of the most common.

Torticollis varies from mild to severe. Some people get full relief after treatment. However, the condition may persist for life. It may produce continued pain, restricted movement of the neck, and postural deformities.

The person can monitor symptoms and contact the healthcare professional as needed.