What is torticollis?

Torticollis is when the muscles of the neck spasm and cause the neck to twist to one side.

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 the shoulders and head. Your neck may be very tender and if you try to massage the area, to provide some 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.

Symptoms of a twisted neck will usually disappear completely within a week, and they usually ease considerably within 1 or 2 days. Sometimes symptoms last longer, but this is not common.

What causes torticollis?

Sometimes babies are born with torticollis, for example if there was birth trauma or they have an abnormality in their spine. Children can develop torticollis after a minor injury or inflammation.

In adults, a sudden muscle spasm in the neck may be caused by:

• sitting or sleeping awkwardly, without sufficient support for your head
• poor posture, such as at a workstation that is not ergonomically suited to you
• carrying bags with unequal amounts of weight that cause your neck to strain, for example, a handbag on one side and heavy shopping bags on the other
• inflammation or infection in the neck
• a neck injury

Sometimes torticollis can happen due to a neurological problem called dystonia.

When should I see my doctor?

You should see a doctor if:

• the pain is getting worse
• the pain doesn’t ease up in a week or so
• you have numbness, tingling or pins and needles 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 possibly order an x-ray or CT scan.

How is torticollis treated?

Usually there is no treatment for torticollis other than a heat pack, pain relief and massaging the neck. If a baby has torticollis, you may be advised how to position them during feeding and sleeping and shown how to gently move their head to encourage the neck to stretch.

You should keep active and move your neck as normally as possible. Don’t make sudden movements for a day or so, but then try to carry on with your normal routines and move your head and neck to prevent it stiffening up.

Try gently moving your neck in circles and moving it backwards, forwards and to either side to loosen the muscles and keep your neck supple.

If the torticollis doesn’t improve or you’re worried, you may need to see a physiotherapist or doctor or have further investigations.

Can torticollis be prevented?

To reduce your chances of future episodes of neck pain, you can:

• improve your posture with gentle stretching exercises, such as those popular in activities such as yoga or Pilates
• arrange your workspace so that your desk and chair are suitable for your needs. Ask for 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
• make sure your neck is supported in the car by adjusting the headrest 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 properly

Complications of torticollis

Very rarely, torticollis may be the sign of something more serious like an infection, an abscess in the head or neck or a neck injury.

Resources and support

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

• painHEALTH
• Musculoskeletal Australia
• Chronic Pain Australia