Medicines for Torticollis

What it is

Torticollis ("wry neck") is a condition in which the neck is tilted or twisted to one side, so the head is held at an angle. It occurs in different forms. In babies, "congenital torticollis" is common and usually caused by tightness or shortening of a muscle on one side of the neck (sometimes related to position in the womb or birth), so the baby tends to tilt their head to one side and turn their face to the other; it is usually painless and, importantly, often improves with gentle stretching and positioning, though it can be associated with flat head syndrome. In older children and adults, torticollis can come on suddenly ("acute torticollis" or a "crick in the neck"), often on waking or after an awkward movement, causing a painful, stiff neck that is stuck to one side, usually from muscle spasm — this is common and usually settles within days. Less commonly, persistent or recurrent torticollis in adults can be due to a movement disorder (cervical dystonia). The cause and approach depend on the type and age.

How it is treated

Treatment depends on the type. For congenital torticollis in babies, the mainstay is gentle neck-stretching exercises and positioning to encourage the baby to turn their head both ways — often guided by a physiotherapist — along with managing any associated flat head; most babies improve well with this, especially when started early, and it is rarely necessary to do more. For acute torticollis (a "crick in the neck") in older children and adults, it usually settles on its own within a few days, helped by gentle movement (keeping the neck moving within comfort rather than rigidly still), heat, simple pain relief, and reassurance. Persistent, recurrent, or progressive torticollis in adults, or torticollis with other symptoms, is assessed further, as it may be due to a movement disorder (dystonia) or, rarely, another cause. Any torticollis after significant injury, or with certain warning features, needs prompt assessment. The reassuring message is that torticollis in babies usually improves with stretching and positioning, and acute "wry neck" in adults usually settles within days.