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Torticollis

Disease Process

Infant torticollis is characterized by prolonged tightening (contraction) of the neck muscles that causes the head to turn to one side.


Causes

  • Idiopathic (unknown).
  • Genetic (Inherited).
  • Acquired (damage to the nervous system or muscles).
  • Congenital (present at birth – may be caused by positioning of head in uterus or prenatal injury).


Symptoms

If you suspect that your infant may have torticollis, look for the following:

  • Enlargement of the neck muscles on one side.
  • Asymmetry (unevenness) of the infant’s head from sleeping on affected side.
  • Elevation of the shoulder on the affected side.
  • Stiffness of the neck muscles.
  • Decreased range of motion (ROM) in the neck.
In general, there will be an obvious tilt of the head towards the affected side.


Diagnosis

  • Medical History
  • Physical Exam (look for shortening of neck muscles and head tilt to affected side).
  • X-rays and an MRI may be done to rule out other possible causes of the symptoms.
In infants, torticollis is usually diagnosed sometime between 2 weeks and 2 months old.


Current Treatment

  • Stretching of the affected neck muscles.
  • Positioning of the baby to decrease tendency to get into shortened muscle position.
  • Possible use of a helmet for head shaping.


How Can Physical Therapy Help

Physical Therapy can be very helpful for infants diagnosed with torticollis. Parents tend to worry when they think something is wrong with their child; however torticollis is often easily cured. A physical therapist can reassure the parents that their infant will be OK. They will be able to show parents proper stretching techniques for the shortened muscles (usually the sternocleidomastoid) both passively (meaning the parents or caregiver is doing the stretching) and actively, by getting the baby to actively look the other way. They can also demonstrate the proper techniques for infant positioning during feeding, sleeping, eating and playing to help stretch the muscles. Occasionally the infant may need to wear a specially made helmet to help the head return to a normal shape if the infant has had torticollis for a period of time.


Patient Resources

MedlinePlus
National Infant Torticollis Foundation
Torticollis Brochure (.PDF)
ABC’s of Infant Torticollis (.PDF)
Children’s Memorial


Disease Process
Causes
Symptoms
Diagnosis
Treatment
Physical Therapy
Patient Resources





Megan Hubbard, DPT © 2005   |  disclaimer