Bone, Joint and Muscle Conditions
What is torticollis?
Torticollis is a twisted and tilted neck. Torticollis can appear temporarily and go away again. It can also be present at birth (congenital). Both boys and girls get torticollis.
There are several types of torticollis.
For most children, torticollis goes away after a day or 2. All your child may need is some rest, and perhaps a towel wrapped around the neck to keep it still.
This temporary problem sometimes happens when your child’s lymph nodes are hot and swollen (inflamed) after they have had an ear infection or a cold.
Torticollis can also develop if your child hurts their head or neck. The joints between the bones in the neck swell and become sore.
Sometimes torticollis is permanent (fixed) because of a problem with muscles or bone structure. In rare cases, fixed torticollis is caused by an abnormal area in the back part of the brain or by a tumor in the spinal cord.
Torticollis is sometimes caused by eye muscle imbalance or stomach acids that get into the tube that connects the mouth to the stomach (esophagus).
The faces of some children with fixed torticollis may look unbalanced or flattened (plagiocephaly). Children may also have mild delays in developing the ability to use their muscles (motor skills).
Learn more about plagiocephaly.
Muscular torticollis is the most common type of fixed torticollis. It happens when your child’s neck muscles are especially tight on 1 side, or if something has caused scarring on 1 side of the neck. The tight muscles or scarring can cause your child’s head to tilt to 1 side.
Muscular torticollis happens more often if babies are crowded while developing in their mother’s womb.
Klippel-Feil syndrome is a problem that is present when a child is born (congenital). It happens when the bones in your child’s neck do not form correctly, causing the neck to twist.
Children with Klippel-Feil syndrome may have other problems, such as trouble hearing, because the bones in their ears may not form correctly.
Some children who have problems with their eye muscles tilt their heads in order to see straight.
Torticollis at Seattle Children’s
Seattle Children’s has a comprehensive team to care for children with torticollis, including doctors, surgeons, nurse practitioners, physician assistants, physical therapists and radiologists. We see about 100 new cases of torticollis each year.
All of our providers have special training in the emotional and social needs of babies and young people.
Depending on your child’s needs, they may be seen by experts in:
Seattle Children’s has the largest group of board-certified pediatric radiologists in the Northwest. We keep your child’s safety in mind at all times. If your child needs imaging that uses radiation, we use the lowest amount possible to produce the best image.
We also have a 3D low-dose radiation X-ray machine, called the EOS, for safer full-body 3D images.
Symptoms of Torticollis
Children with torticollis have a stiff neck and cannot move their necks very much. They hold their heads to 1 side. Their chins might point up a little bit.
Different types of torticollis may have different symptoms:
- The faces of some children with fixed torticollis may look unbalanced or flattened (plagiocephaly). Children may also have mild delays in developing the ability to use their muscles (motor skills).
- Along with a twisted neck, children with Klippel-Feil syndrome may have other problems, such as trouble hearing.
When you and your child come to our clinic, our doctors ask you questions about how your child has been developing. Doctors examine your child. The exam will likely include an evaluation of the nervous system and an eye test.
We may take X-rays and ask for an MRI (magnetic resonance imaging) scan of your child’s spinal cord and brainstem. This is especially likely if your child has had developmental delays or if their neck is moderately or severely twisted and the doctor can find no explanation for it.
We offer a full range of treatments for different types of torticollis and the problems that come along with them, including facial imbalance (asymmetry).
In about 90% of babies, muscular torticollis improves during the first year of life. The condition may improve faster if your baby gets physical therapy to stretch their neck muscles.
Surgery for torticollis
Our orthopedic spinal deformity team offers surgical treatment for children who do not respond to nonsurgical treatments. These operations include procedures to:
- Lengthen neck muscles
- Fuse abnormal vertebrae
- Apply devices that hold the neck in a corrected position for a limited period of time
Contact Orthopedics and Sports Medicine at 206-987-2109 for an appointment, second opinion or more information.
Providers, see how to refer a patient.