What is torticollis (wry neck)?

Torticollis (wry or stiff neck) is when the muscles of your neck spasm or cramp. It causes pain and stiffness and may make your neck twist to one side. It is a physical sign, not a disease.

Torticollis is a common cause of neck pain in young people and is usually not caused by a past neck injury. The pain can make it difficult to do your usual activities. It can also cause headaches.

Your symptoms will usually disappear completely within 7 to 10 days, depending on the cause.

What causes torticollis?

There are 3 main types of torticollis:

• Congenital torticollis — this happens in newborn babies. It may be caused by their position in the uterus, birth trauma or a spinal problem. It can also develop in the days or months after birth if your baby has limited tummy time or prefers to turn their head to one side.
• Acquired torticollis — this happens in children and adults. It may be caused by injury or trauma to a neck muscle. It may also be caused by something small, such as sitting in an awkward position during a flight or sleeping in a different position.
• Spasmic torticollis — this is a chronic (long-term) condition that may slowly get worse and often has no clear cause.

Sometimes inflammation (swelling) in your neck, nearby ligaments or muscles can cause torticollis. It can also happen as a reaction to some medicines.

Another rare but serious cause of torticollis is a tumour in the back of the head or spine.

When should I see my doctor?

You should see your doctor if your:

• neck pain or your child's neck pain is getting worse
• neck pain or your child's neck pain does not improve after 7 to 10 days
• baby has difficulty feeding on one side
• baby prefers turning their head to one side or you notice asymmetry in their face or head
• child is very unsettled or difficult to calm
• child has a fever or trouble breathing
• child has changes in feeling or movement

When to seek urgent care

These symptoms may be a sign of a more serious cause of torticollis, especially in babies, and need urgent medical care:

• fever
• more drooling than usual
• a sore throat
• trouble breathing
• trouble swallowing
• changes in vision
• changes in feeling or movement in your arms or legs
• If you need to see your doctor but cannot wait for an appointment, you may be able to get treatment at a Medicare Urgent Care Clinic. Use the Service Finder to find your nearest one.

How is torticollis treated?

Self-care at home

Usually, you can treat torticollis at home by applying a heat pack and gently massaging your neck.

Try to stay active and move your neck as normally as possible. Move your head and neck naturally to help prevent stiffness from getting worse.

How to help your baby at home

If your baby has torticollis, ask their doctor or child health nurse for advice on how to position them during feeding and sleeping. They can show you how to safely move their head to encourage the neck to stretch.

You can also try these tips at home:

• encourage tummy time (supervised playtime with your baby on their tummy)
• place toys next to your baby on the affected side to encourage them to turn their head
• avoid long periods in a car seat

Medicines

Torticollis can be treated with different medicines, such as:

• pain-relief medicines, such as paracetamol or anti-inflammatory medicines (NSAIDs)
• medicines to relax your muscles
• antibiotics if you have an infection

When other treatments do not work, your doctor may recommend botulinum toxin injections (Botox) to provide symptom relief.

Other options

Other treatment options may include:

• physiotherapy to reduce pain and stiffness
• using a neck collar or brace for stabilisation
• surgery

What are the complications of torticollis?

Untreated congenital torticollis can lead to a permanent head tilt and changes in the shape of the head and face. This can lead to:

• delays in coordination
• developmental delays
• problems with the spine, jaw and eyes

Can torticollis be prevented?

To lower your chance of neck pain, try these tips:

• Improve your posture. Stand and sit upright with your shoulders over your hips and your ears over your shoulders. Hold phones or tablets up when using them instead of bending your neck.
• Arrange your workspace. Use a footrest if your knees and hips are not level or if your feet do not sit flat on the floor. Move items that you use regularly closer so you do not need to twist or reach too far.
• Take frequent breaks. If you work at a computer or travel long distances, get up, take a short walk and stretch your neck and shoulders.
• Support your neck while sleeping. Sleep with a small pillow to support your neck. Your head and neck should be aligned with your body.
• Don't carry heavy bags on one shoulder. This can strain your neck.
• Quit smoking. Smoking can increase the risk of neck pain.

Resources and support

For more information about the causes and management of neck pain, visit:

• painHEALTH
• Musculoskeletal Health Australia
• Chronic Pain Australia

Lung Foundation Australia provides information and support to help quit smoking.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

The Agency for Clinical Innovation has information about pain management in a range of languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Our Mob provides information about pain and pain management for Aboriginal and/or Torres Strait Islander peoples.