What is torticollis?

Torticollis (twisted neck) is when the muscles of your neck spasm (cramp) and cause your neck to twist to one side. It’s a physical sign rather than a distinct disease.

Torticollis is a common cause of neck pain in young people, and it’s not generally associated with a previous neck injury or neck pain.

What are the symptoms of torticollis?

Torticollis usually causes pain on one side of your neck. You may feel pain in the middle of the neck and in your shoulders and head. Your neck may be very tender and if you try to massage the area to provide relief, it’s possible your neck muscles will spasm. You may also find it difficult to straighten your neck or turn your head a particular way.

Your symptoms will usually disappear completely within a week, and they usually ease considerably within 1 or 2 days. Sometimes your symptoms may last longer, but this is not common.

What causes torticollis?

Sometimes babies are born with torticollis, for example if there was birth trauma or if they have an abnormality in their spine.

In children and adults, torticollis is usually due to a sudden muscle spasm in your neck that may be due to injury or trauma to a muscle. The injury may be so minor that you don’t even recall it. Sometimes the cause may be inflammation in your neck or spasm due to inflammation nearby.

Sometimes torticollis can happen if you have a neurological problem called dystonia.

When should I see my doctor?

You should see your doctor if:

• your pain is getting worse
• your pain doesn’t improve in about a week
• you have tingling, ‘pins and needles’ or numbness in your arms or legs
• you start having difficulties with your bladder or bowel
• you have a fever as well as neck pain

How is torticollis diagnosed?

Your doctor will examine you and may order an x-ray or CT scan.

How can I treat torticollis?

Usually, you can treat torticollis by applying a heat pack, pain relief and massaging your neck.

If your baby has torticollis, get advice on how to position them during feeding and sleeping. You can also learn how to gently move their head to encourage the neck to stretch.

If you have torticollis, try to keep active and move your neck as normally as possible. Move your head and neck naturally to help prevent it from stiffening up.

If your torticollis doesn’t improve, if you’re worried, or if you have other symptoms together with torticollis, see your physiotherapist or doctor for further investigations.

How can I prevent torticollis?

To reduce your risk of neck pain, try these tips:

• Improve your posture with gentle stretching exercises, or try a yoga or Pilates class.
• If you work at a desk, arrange your workspace so that your desk and chair suit your needs. Use a footrest if you find that your knees and hips are not level and your feet do not sit flat on the ground. You may also need to move items that you use regularly closer to you, so that you don’t twist or reach too far to find items you need.
• Support your neck while sleeping with a support pillow, and sleep with just one pillow.
• Adjust your headrest in the car, so that it is at least at eye level and as close to the back of your head as possible. Don’t drive if you can’t turn your head freely.
• Use a headset or speakerphone, and don’t tuck your phone between your shoulder and ear.

Is my torticollis a sign of serious disease?

Very rarely, torticollis may be a sign that you have a more serious condition like an infection, abscess, or tumour in your head or neck, or a neck injury.

See your doctor urgently if you have torticollis with any of the following symptoms:

• fever
• headache
• double vision
• light sensitivity
• difficulty keeping your balance while walking

Resources and support

These websites provide more detailed information about the causes and management of neck pain.

• painHEALTH
• Musculoskeletal Australia
• Chronic Pain Australia