Torticollis / Wryneck

Written by Dr. Jason Ngan, DC

What is Torticollis?

Torticollis (aka wryneck) is a condition where one of the SCM muscle is contracted and causes the head to rotate to one side. The term torticollis is derived from the Latin words tortus (twisted) and collum (neck). The SCM (sternocleidomastoid) muscle runs from the mastoid process of the temporal bone (back of the ear) to the sternum (chest bone) and clavicle (collar bone). The nerves that controls the SCM are cranial nerve XI (accessory nerve) and C2-C3 branches of the cervical plexus. There are two types of torticollis, congenital and acquired. Congenital torticollis is present from birth while acquired is derived later in life.

What Causes Torticollis?

In congenital torticollis, the sternocleidomastoid (SCM) muscle is shortened usually due to pulling on the infants head during delivery or a cramping position in the womb. In acquired torticollis, the SCM is contracted or spastic usually from a poor sleeping position.

What are the Signs and Symptoms?

  • Patients will report that they “slept funny” or “slept wrong”

  • Neck pain

  • Head stuck in one position / unable to turn head / chin points to one side

  • In congenital torticollis, parents may not notice until the infant is over 1 month old.

How is Torticollis Diagnosed?

Torticollis is diagnosed with a thorough medical history, physical examination, orthopedic testing.

  • Decrease range of motion in the neck especially rotating to one side.

What are the Treatment Options?

Chiropractic care is highly effective for torticollis. The goal is to relax and stretch the SCM.

  • Chiropractic manipulation and mobilization

  • Post isometric relaxation

  • Stretching

  • Myofascial release therapy

  • Gua-sha

  • E-stim

  • Ultrasound

  • Sleeping position/ergonomic/postural counseling

  • Rehabilitative exercises

Other treatments that patients may seek (not provided at Ngan Chiropractic) include acupuncture, and anti-inflammatory medication.  

References

  1. Cunha B, Tadi P, Bragg BN. Torticollis. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539857/

  2. Amaral, Daniela M. MD∗; Cadilha, Rui P.B.S. MD; Rocha, José Afonso G.M. MD; Silva, Ana Isabel G. MD; Parada, Fernando MD. Congenital  muscular torticollis: where are we today? A retrospective analysis at a  tertiary hospital. Porto Biomedical Journal 4(3):p e36, May-June 2019. |  DOI: 10.1097/j.pbj.0000000000000036

  3. Tomczak KK, Rosman NP. Torticollis. Journal of Child Neurology. 2013;28(3):365-378. doi:10.1177/0883073812469294