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Torticollis | Types, Symptoms & Physiotherapy Treatment

Torticollis is also known as wryneck. Torticollis meaning implies a medical condition where the neck is twisted, causing the head and neck to tilt and rotate. This can result in the head tilted towards one side and the chin to the other, which can result in discomfort and pain, depending on the intensity of the cause. This often is a result of weakening neck muscles that can have various reasons.

The most common form of the condition is congenital muscular torticollis, which affects infants and is generally observed within the first 2 months of life.

Torticollis: Causes

 While the exact cause of this condition is unknown, it is most common in firstborn infants. It may occur due to the improper positioning of the fetus in the womb, which may result in the weakening of the neck muscles. 

In cases of acquired torticollis, it can occur due to reasons such as awkward sleeping positions, neck muscle injury at birth,  any injury that results in the weakening of the neck muscles, etc. It can also occur due to a herniated disk or a result of a viral infection.

These can have an impact on the muscle that runs from the breastbone and collarbone up into the back of the neck, and the muscles in these regions become tight or weak which results in the conditions.

Torticollis: Types

Temporary torticollis occurs when there is an ear infection, cold or swollen lymph. This usually goes away with the improvement of the health from the infection or cold.

Fixed torticollis is when there is a problem with the bone or the neck muscles that result in the condition. This can be due to several reasons such as injury, and improper development of the bones and muscles.

Klippel- Feil syndrome ( a form of congenital torticollis) occurs in babies when the neck of the babies are not formed healthy. This results in neck deformity as the muscle and the bones are not fully grown.

Cervical Dystonia or Spasmodic Torticollis is a rare condition that may occur when there is a spasm in the neck muscle, resulting in a severe tilt of the face towards one side.

Torticollis: Symptoms

The symptoms of Torticollis occur on different scales with different people. In most cases, there is a pain in the neck muscle region. It could be a result of muscle spasms or weakening of the muscles. In infants, it can be stiffness in the neck region, head tilt, and signs of the bones not growing well, which can result in deformity. Other symptoms are discomfort while moving the neck, awkward positioning of the neck, chin tilt, and delay in motor and hearing skills.

Some other symptoms are the inability to move the head, and swelling in the neck region.

Torticollis: Diagnosis

Torticollis can be diagnosed by physical examination by a trained professional. One can look out for physical symptoms such as tilt in the head, weakness in the neck muscles, locating the bones in the neck, and flexibility exercise.

Besides these, tests and scans can help ascertain the location and intensity of the ailment.

 Ultrasounds for the fetus can help understand if there is an issue in the fetus and can help in mitigating the intensity of the injury or treating it. Ultrasounds in adults and babies can also help locate soft tissue and muscle injuries that can help chart a treatment plan.

X-rays can help understand if there is any bone deformity or bone-related issue that may have arisen due to injuries and other causes.

Magnetic resonance imagining or MRI can help provide a better image of muscle and bone conditions and help identify the intensity of the injury, which can help plan a better treatment plan

Torticollis: When should You Call a Doctor

Usually, stiffness in the neck in children and adults can occur due to reasons that are treatable such as awkward sleeping position, neck pain due to a mild shock, etc. However, if these symptoms persist and are causing discomfort in day-to-day activities, it is important to visit a doctor to avoid the risk of torticollis in babies or adults. If the symptoms mentioned above persist, it is advisable to call a doctor and begin torticollis treatment.

It is also important to ensure that the fetus is healthy and visiting the doctor during and post-pregnancy is also important to avoid any risks that may arise due to complications in pregnancy.

Torticollis: Conservative Treatment

Since Torticollis cannot be prevented, it is important to ensure there is a treatment regime to prevent it from worsening. This is possible through medications such as muscle relaxants, and pain medication.

This is often followed by physical therapy.

Surgery may be used in extreme cases, where the neck muscles may be severed in order to release the muscles and aid movement. However, it is rare and physical therapy is often used to mitigate the extent of the damage. Torticollis treatment in a baby differs from torticollis treatment in adults.

Physiotherapy for Torticollis

A neck brace can help reduce the pain as it provides support for the neck muscles.

Thermotherapy or heat therapy can be used to bring relief to the stiff joints and necks

Ultrasound therapy can also provide gentle heat to deep tissues and aid the recovery process of the muscles

Chiropractic care can help adjust bone positions and relieve pain to a large extent. This can also aid in the recovery process.

Exercises such as rotation of the neck and head, movement in the head region, and circular movement of the head, can also help increase mobility and strengthen muscles. This can also be followed by an exercise that helps improve posture such as sitting upright.

Neck muscle strengthening exercises can also help deal with the problem and reduce pain and stress in the neck region.

Torticollis: Living with It

In most cases, it is important to ensure that the Torticollis does not worsen over time. It is important to engage the neck muscles in strength and mobility exercises over a period of time with the consultation of a medical professional. Chronic issues with it can be swollen neck, chronic pain, and difficulty to perform tasks. Having Torticollis can have a negative impact on the ability to socialize and can cause isolation. It is important to seek out a support group, or explain and understand the illness with family and friends.

With proper care and a support system, living with Torticollis can be made less hard.

A note for Wellness

Torticollis can have difficult impacts on one's life. It is important to ensure that it does not get worse over time. This can be achieved through medication and physical activities that are planned and designed to meet your needs by consultation with various stakeholders such as doctors and physiotherapists.

It is also important to ensure that one engages with a good support system and care, that can help reduce the stress of living with it. This can help make dealing with the pain a lot easier.

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