Torticollis: what it is, symptoms, causes and what to do

Torticollis is the very strong involuntary contraction of the neck muscles, limiting their movement and causing symptoms such as pain in the affected region and difficulty moving the head to the side.

Generally, torticollis is caused by poor posture, stress or overloading the neck during physical exercise, but it can also appear after blows, be a sign of a problem with the spine and, in more serious cases, indicate brain tumors, for example.

If your torticollis takes a long time to improve or is associated with other symptoms, such as a headache or fever, it is important to consult your general practitioner. Depending on its cause, treatment may involve the use of muscle relaxants, botulinum toxin injection and even surgery.

Main symptoms

The main symptoms of torticollis are:

• Neck ache;
• Difficulty moving the head;
• Stiffness and swelling of the neck muscles;
• One shoulder may be higher than the other;
• The face can be asymmetrical, with the top of the head to one side and the chin to the other.

It is common for torticollis symptoms to appear in the morning due to poor head position when sleeping or after intense or incorrectly performed physical exercise. Furthermore, depending on the cause of the torticollis, other symptoms may appear, such as fever, headache or sore throat, difficulty walking, loss of balance or double vision.

Possible causes

The main causes of torticollis are:

• Stress;
• Neck overload when performing vigorous exercises or sleeping in inappropriate positions;
• Sudden neck movements;
• Congenital problems, when the baby is born with torticollis;
• Strabismus;
• Accidents;
• Spine diseases, such as herniated discs and scoliosis;
• Scars in the neck region;
• Respiratory or skin infections;
• Abscess in the mouth, head or neck region;
• Neurological diseases, such as Parkinson’s or stroke sequelae;
• Some medications, such as metoclopramide, phenytoin or carbamazepine;
• Brain or spine tumors.

Although torticollis is not always a serious problem, it can also have serious causes such as infections or tumors, for example. Therefore, identifying the cause of torticollis is essential to indicate the most appropriate treatment.

What to do to treat torticollis

Torticollis usually improves within a few days even without specific treatment. However, if symptoms such as fever, headache, difficulty walking or double vision occur, it is important to consult a general practitioner for a detailed evaluation and start appropriate treatment.

Treatment for torticollis depends on the cause identified, but may involve:

1. Stiff neck remedies

Anti-inflammatories, muscle relaxants and analgesics are typically used to relieve intense muscle contraction and pain. Depending on the cause of the torticollis, other medications such as benzodiazepines and anticholinergics may also be prescribed. See the main options for remedies for stiff neck.

2. Exercises and stretches

Exercises and stretches guided by a physiotherapist can improve head posture, relieve pain and strengthen the neck muscles, and may be indicated in some cases of torticollis.

Watch the video and check out some exercises to relieve stiff neck:

3. Botulinum toxin injection

When torticollis is caused by excessive muscle contraction and does not improve with medication or physical therapy, botulinum toxin injection may be indicated. In this case, the injection helps to relax the contracted muscle, correcting the position of the head and relieving pain.

4. Surgery

Surgery is normally only indicated in cases where torticollis does not improve despite adequate treatment. It serves to correct the position of the head and improve the range of movement of the neck.

Other treatment options

When torticollis is caused by stress, overload or sudden movements of the neck, measures such as massaging the affected region and lightly pressing the neck muscles can be helpful in relieving pain and discomfort. See more tips to get rid of torticollis.