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2288 pages added, reviewed or updated during the last month (last updated: 19/4/2021)


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torticollis

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Torticollis is a descriptive term for when the chin is irresistibly twisted upwards and towards one side. This condition may be congenital - infantile torticollis - or secondary.

Possible causes of secondary torticollis include:

  • an acute disc prolapse - the most common cause in adults
  • inflammation of the neck glands
  • infection of the vertebrae
  • cervical spine injury
  • ocular disorders

Torticollis can also occur in adults for various reasons, such as following a neck injury or simply sleeping in an awkward position

  • a patient may find that upon awakening it is extremely difficult to lift one's head or is extremely painful to move it
    • may be secondary to a vertebral facet joint pinching its capsule resulting in soft tissue inflammation and muscle spasm around it

Management of adult with torticollis in primary care:

  • analgesia
  • NSAIDs
  • muscle relaxants such as diazepam may be used if severe muscle spasm
  • gentle manipulation of the neck may be helpful
    • taking the weight of the head and applying a little upward traction while gently and slowly rotating the head to each side in the horizontal plane
      • generally produces an increase in range of movement, reduction in pain and straightening of the posture - may be temporary
  • generally symptoms improve within a few weeks

 

Notes:

  • spasmodic torticollis (cervical dystonia) is a chronic neurological condition that is a clinically distinct form of torticollis

Last reviewed 01/2018

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