Torticollis

​What is Torticollis?

Torticollis is commonly known as “wry neck”, a condition in which the head is tilted to one side.

​Signs and Symptoms of Torticollis

• Head tilted to the right or the left
• May have a preference of looking only at right or left 
• Flattening of the child's head and face due to his/her preference of head position
• Tightness of the Sternocleidomastoid muscle (SCM)
• Soft lump / tumor in the SCM

Causes of Torticollis

The causes are unclear but in some cases, it can be due to birth trauma or "packing disorder" (packing disorder refers to: first born baby; big baby >4kg at birth; decreased fluid space surrounding baby). These can lead to damage to the sternocleidomastoid muscle (SCM) in the neck; causing the head to be tilted to one side.

Secondary Causes

• Squint
• Plagiocephaly
• Cervical spine problems
• Hearing
• Brachial Plexus injury

Risk Factors of Torticollis

• Female
• Newborn and children under age 10
• Family member with torticollis or similar disorders
• Twin / Multiple pregnancies

Complications

• Plagiocephaly
• Facial asymmetry
• Contracture of SCM

​Tests and diagnosis for Torticollis

• Orthopaedic assessment
• Ultrasound scan may be used to investigate / measure the tumor / lump in neck
• X-ray of spine to check for bone disorder

Treatment options and drugs for Torticollis

• Usually, children below 1 year of age are referred to physiotherapy for stretching and strengthening exercises. The soft lump can be self-resolving.
• In severe or unresolved cases (usually >1 year old), surgery to lengthen the SCM muscle may be necessary.