What is the best torticollis treatment?
Torticollis, wry neck, stiff neck all the same
Torticollis, or wry neck, is an uncomfortable condition that can occur from before birth to anytime into adulthood, associated with muscle spasm of major postural muscles of the neck. This results in the neck having a limited range of motion while being kept in a posture turned or twisted to one side and the head is tipped backward to the opposite side (example, the neck is turned to the right while the head is tipped backward toward the left side), and the shoulder held higher on the side of neck rotation.
There are several categories of torticollis:
- Acquired – due to injury that results in damage to the neck muscles, or that part of the nervous system or upper spine that relate to the neck muscles; compression or a pinched nerve in the neck will also cause muscle spasm and contracture
- Inherited – due to genetic predisposition
- Congenital – due to malposition while developing in the uterus with the baby’s head kept in an abnormal or awkward posture, or if the neck muscles or blood supply to the neck muscles are injured while in the uterus
- Idiopathic – due to an undetermined cause
Torticollis treatment and remedies
Effective torticollis treatment is dependent on determining the cause, and setting about to reverse the reason the stiff neck developed. Since the most common type of torticollis is due to muscle and tendon strain and sprain injury, the most usual treatment of torticollis includes any of the following:
- Rest and avoidance of use of the neck postural muscles
- Ice/heat applications – directly applied to the tight and painful contracted side of the neck for the first 48-72 hours, or until the intense spasm is reduced then followed by a series of five minute alternations of cold/heat applications. How to use a heating pad as a torticollis treatment
- Gentle fingertip massage of involved muscles that cause the stiff neck, using massage oil or lotion to lubricate skin
- Gentle fingertip trigger point massage to all areas of soreness and nodule formation found in the shoulder, neck and base of the skull
- Spine manipulation of the upper back or neck by a Doctor of Chiropractic or Doctor of Osteopathic Medicine.
- Neck brace or cervical collar to avoid neck stress and limit movement
- Non-steroidal anti-inflammatory drugs like NSAIDs ( aspirin or ibuprofen) used briefly to take the edge off the neck pain
- Surgery is performed only in limited cases by cutting a few selected nerves that control neck muscle contraction. Although this surgery is often not effective, even when it is effective the results are usually temporary and the same or worsened degree of torticollis will frequently return after several months.
If the torticollis worsens or does not show signs of improvement after 7-10 days, inform your doctor or chiropractor. Most cases resolve in a few weeks, while others take a bit longer if an underlying condition of the soft tissue of the neck and spine is present like arthritis, history of chronic neck injury or prior torticollis. Your doctor will advise if additional torticollis treatment is indicated in your case.
Congenital torticollis should begin as early as possible to prevent adaptation and structural changes of the muscle and bone tissue of the neck. Stretching, manipulation and braces are usually sufficient when coordinated by your doctor or chiropractor.
There are many things a person can do to get relief from arthritis neck pain. Just because neck pain originates from arthritis in the neck does not mean that pain and a poor life style are inevitable.
Surgery of the neck is seldom needed, but possibly indicated if the torticollis is due to nerve system disease or a dislocated cervical vertebra.
The most common cause of torticollis is an acquired injury to the neck that results in a strain or sprain to the muscles that support the head and control neck posture, especially the trapezius, levator scapulae and sternocleidomastoideus muscles. Common ways in which this acute or chronic injury can happen:
- Automobile accident causing sudden and forceful backward and forward movement of head
Injury at work or during sports
- Sleeping while the neck and head or turned or tipped in an awkward or unusual posture, especially when overly tired and inclined to not move very often while in a deep sleep
- Continued physical or emotional stress leading to tense neck muscles
- Wearing a heavy helmet or hat while looking upward for a long time
- Stressful neck posture while standing, sitting, working, looking overhead, or talking on the phone while pinching the phone between the ear and shoulder
- Exposure to a cool draft when sitting near an open window or a moving automobile
- Drug abuse with cocaine, ketamine, or amphetamines, or commonly prescribed drugs that affect the nerve system like Compazine, Haldol, and Thorazine can result in inability to control muscle movement and involuntary muscle spasm.
Torticollis exercises – Wry neck treatment
To adequately treat torticollis it is necessary to perform two different types of exercise activity:
- Gentle soft tissue stretches of the neck, and shoulders – active and passive gentle stretches (moving the head from side to side, up and down, and a figure-8 pattern, or applying traction to the neck by holding the base of the skull in the palms of both hands and gently and slowly pulling the head away from the shoulders). All neck stretching must be done slowly, and immediately stopped at the first sign of discomfort.
After doing these torticollis stretches it is helpful to apply a moist heat pack to relax the neck muscles further and calm any agitated tissue that might have been overstretched.
- Gentle whole body and neck strengthening exercises – it is important to tone and strengthen all the core muscle groups of the body in addition to the obvious muscles of the neck, upper back and shoulders. Doing this make stronger the muscles that support the entire spine, promote better posture and reduce any neck spasms resulting from weakness.
- Swimming, walking, yoga, bicycle riding, Pilates, and Tai Chi all provide good total body workouts that will not stress or jar the neck and upper back. Any of these aerobic activities should be done three times per week, at least for 20-30 minutes each time. It is ideal to do the aerobic exercise early in the day before the neck and shoulder muscles can be affected by fatigue or stress.
- Performing neck flexion and extension exercise with the held on the head as a gentle resistance is a simple strengthening exercise that can be done within a limited and comfortable range of motion. In this way, by placing the hand on the forehead the neck flexor muscles can be exercised, and by placing the hand on the back of the head the neck extensor muscles can be exercised. As a modification, the side muscles can be exercised by placing the hand on the side of the head while exercising against mild resistance. Shoulder shrug exercises while holding light weights help increase neck, upper back and shoulder strength that will stabilize the neck.
Attempt to gradually increase neck motion into a larger arc of comfortable movement. Do not allow the neck to tighten up; every few hours make sure you gently and carefully move the neck in each direction and in a circular pattern. As much as comfort will allow push yourself to maintain a normal range of daily activities. As long as your exercises and stretches do not cause you pain while or after you do them, you will not injure yourself by doing neck exercises.
From an entirely different direction, determining what might have done to start your torticollis and taking steps to avoid that in the future is another great way of treat torticollis. Keep ahead of your torticollis by staying strong and flexible.