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Torticollis

What is torticollis?

Torticollis is a twisted and tilted neck. When your child has torticollis, he cannot move his neck very much, and holds his head to one side.

His chin might point up a little bit. Torticollis can appear temporarily and go away again, but it can also be present at birth (congenital).

There are several different types of torticollis:

Temporary torticollis

For most children, torticollis goes away after a day or two. All your child may need is some rest, and perhaps a towel wrapped around his neck to keep him still.

This temporary problem sometimes happens when your child’s lymph nodes are hot and swollen (inflamed) after he has had an ear infection or a cold.

Torticollis can also develop if your child hurts his head or neck and the joints between the bones in the neck swell and become sore.

Acute torticollis.
Acute torticollis.

Fixed torticollis

Sometimes torticollis is permanent (fixed) because of a problem with muscles or bone structure.

In rare cases, fixed torticollis is caused by an abnormal area in the back part of the brain, or by a tumor in the spinal cord.

Torticollis is sometimes caused by eye muscle imbalance or reflux of stomach acids into the tube that connects the mouth to the stomach (esophagus).

The faces of some children with fixed torticollis may look unbalanced or flattened (plagiocephaly). Children may also have mild delays in developing the ability to use their muscles (motor skills).

Learn more about plagiocephaly.

Muscular torticollis

Muscular torticollis is the most common type of fixed torticollis. It happens when your child’s neck muscles are especially tight on one side, or if something has caused scarring on one side of his neck. The tight muscles or scarring can cause your child’s head to tilt to one side.

Klippel-Feil syndrome

Klippel-Feil syndrome is a problem that is present when a child is born (congenital). It happens when the bones in your child’s neck do not form correctly, causing his neck to twist.

Children with Klippel-Feil syndrome may have other problems, such as trouble hearing, since the bones in their ears may not form correctly.

Eye conditions

Some children who have problems with their eye muscles tilt their heads in order to see straight.

How do you evaluate torticollis?

When you come to our clinic, we will ask you questions about how your child has been developing. We will examine your child. The exam will likely include an evaluation of his nervous system and an eye test.

We may take X-rays, and ask for an MRI of your child’s spinal cord and brainstem, especially if he has had developmental delays or if his neck is moderately or severely twisted and the doctor can find no explanation for it.

Who gets torticollis?

Both boys and girls get all types of torticollis. Muscular torticollis happens more often if babies are crowded while in the womb.

What is your experience with torticollis?

Children’s Hospital has a comprehensive team that can evaluate children with torticollis. The team includes staff from several divisions at Children’s:

Our team sees about 100 new cases of torticollis each year.

How do you treat torticollis?

We offer a full range of treatments for different types of torticollis and the problems that come along with them, including facial imbalance (asymmetry).

Non-surgical treatments

In about 90% of babies, muscular torticollis improves during the first year of life. The condition may improve faster if your baby gets physical therapy to stretch his neck muscles.

Surgery for torticollis

Our orthopedic spinal deformity team offers surgical treatment for children who do not respond to non-surgical treatments. These operations include procedures to:

  • Lengthen neck muscles
  • Fuse abnormal vertebrae
  • Apply devices that hold the neck in a corrected position for a limited period of time