What Is Torticollis?

Medically Reviewed by Poonam Sachdev on December 25, 2023
9 min read

Torticollis is a condition of the neck muscles that causes the head to tilt down. The term comes from two Latin words: tortus, which means twisted, and collum, which means neck. Sometimes it’s called “wryneck” or “loxia.”

If your baby has the condition at birth, it’s called congenital muscular torticollis. That’s the most common type. Congenital forms of torticollis are usually painless.

Babies can also develop infant torticollis after birth. Then it’s called “acquired,” rather than congenital. Acquired torticollis may be linked to other, more serious medical issues, and it could be quite painful.

Adults can also develop wryneck after a head or neck injury. Or, the condition might occur as a side effect of certain medications.

You have a long muscle on each side of your neck that runs from the back of your ear to your collarbone. It is called the sternocleidomastoid, or SCM.

When your baby has torticollis, this ropy muscle is shortened on one side. Why does the muscle become shortened? Your baby might have been cramped in the womb or may have been in an abnormal position, such as a breech position. That can put extra pressure on one side of your infant’s head, which can cause the SCM to tighten.

If your doctor used forceps or a vacuum device during delivery, those also might have put pressure on your baby’s SCM.

Torticollis causes in infants

Your baby’s womb position and the tools used during their delivery aren’t the only reasons behind congenital torticollis. Other possible causes include:

  • An abnormal development in the SCM
  • Klippel-Feil syndrome (a rare birth defect that causes the vertebrae in your baby’s neck to fuse) 
  • Hematoma (a buildup of blood in your baby’s neck muscles)
  • Fibrosis (thickening of your baby’s muscle tissue)

Some possible causes of acquired torticollis are:

  • Swelling in your child’s throat, which could be triggered by an infection, injury, or unknown cause
  • Vision problems
  • Gastroesophageal reflux disease (GERD: a condition where stomach acid irritates the lining of the tube that connects your mouth and stomach)
  • A reaction to certain medicines
  • Scar tissue
  • Arthritis in the neck
  • Sandifer syndrome (a movement disorder that causes muscle spasms due to acid reflux)
  • Grisel’s syndrome (a rare side effect of surgeries that involve the head, neck, ear, nose, or throat)

Many times, wryneck occurs without any known cause. Doctors call this idiopathic torticollis.

Torticollis causes in adults

A type of torticollis, called cervical dystonia or spasmodic torticollis, typically affects adults. This form causes a person’s neck muscles to spasm.

Some possible causes of cervical dystonia are:

  • A head or neck injury
  • A reaction to medications used to treat depression or other mental health conditions
  • An inherited genetic mutation

Torticollis symptoms in infants

You may not notice anything unusual about your baby for the first 6 or 8 weeks. It’s common for torticollis symptoms to become obvious once an infant gains more control of the head and neck.

Some of the symptoms you might see:

  • Your child’s head tilts to one side with their chin pointed to the opposite shoulder. In about 75% of babies with torticollis, the right side is affected.
  • Their head doesn’t turn side to side or up and down easily.
  • You feel a soft lump in your baby’s neck muscle. This isn’t dangerous and usually goes away within 6 months.
  • Your baby prefers to look over the shoulder at you. Their eyes don’t follow you because that would require turning their head.
  • Your baby has trouble breastfeeding on one side or prefers to feed on one side only.
  • Your baby works hard to turn toward you, struggles to turn their head all the way, and becomes upset because the movement is hard.
  • They might start getting a flat head on one or both sides, from lying in one position all the time. This is called “positional plagiocephaly.”
  • One of your baby’s shoulders is higher than the other.
  • Your baby has muscle tightness or stiffness.
  • Your baby has swollen neck muscles.
  • You notice that your baby has uneven facial features. For example, one eye might appear lower than the other.

Symptoms of acquired torticollis may include:

  • Your child has severe neck pain or headaches.
  • Their head tilts to one side, while their chin tilts to the other.
  • Your child’s neck muscles are tight, stiff, or swollen.
  • You notice that your child has limited movement in their head and neck.
  • One of your child’s shoulders is higher than the other.
  • Your child has head tremors (shaking or trembling movements).

Torticollis symptoms in adults

Some possible signs of torticollis in adults are:

  • Spasms or tremors that cause your muscles to twitch, jerk, or shake
  • Tense neck muscles
  • Pain or burning in your shoulders, neck, or back
  • Headaches
  • Tilting your head forward, backward, or side to side
  • Bending your neck and head forward, backward, or side to side
  • Turning your head

If you notice signs that look like your baby might have torticollis, set up an exam with your doctor.

The doctor will start by checking how far your baby’s head will turn. They also may order imaging scans, such as X-rays, CT scans, MRIs, and ultrasound, to check for other conditions. A special test, called an electromyogram (EMG), can reveal which muscles are most affected. Blood tests are also used to rule out other conditions that are linked to torticollis. About 1 in 5 babies with torticollis will also have a hip problem.

Most babies with torticollis don’t have other medical problems. But it is sometimes linked to infections, broken bones, allergic reactions to medicines, or genetic conditions such as Down syndrome or Klippel-Feil syndrome.

To diagnose torticollis in adults, doctors will typically perform a physical exam, ask about your family history, and assess your symptoms. Tests, such as MRI and EMG, usually aren’t necessary unless your doctor thinks your spinal cord is compressed or you have nerve damage.

It’s important not to ignore symptoms that may be serious. Meningitis, a condition that causes inflammation of the membranes that cover your brain and spinal cord, may look like torticollis. You should get medical help right away if you experience symptoms of meningitis, such as:

  • A sudden, high fever
  • Chills 
  • A stiff neck
  • Severe headache
  • Confusion or trouble concentrating
  • A skin rash

If you act early, you can help prevent any long-term effects of torticollis for your baby. Without treatment, your baby might get complications, including:

  • Less control of their head
  • Limited reach on the affected side and less tracking with the eyes
  • Delays in sitting and walking
  • A problem feeding
  • Poor balance
  • Crooked crawling
  • Rolling onto one side only
  • Facial deformities
  • Flat head syndrome (from lying on the same side too much)
  • Motor skill delays
  • Problems with hearing and vision

Torticollis in adults is linked to these complications:

  • Balance problems
  • Changes in the way you walk 
  • Bone spurs (bony lumps that develop on the edge of bones)
  • A more serious underlying condition, such as an injury, tumor, or infection
  • A disability that interferes with your everyday life
  • Emotional issues

Torticollis treatment in infants

If your baby has acquired torticollis, treatment will focus on the condition that’s causing it.

Most cases of congenital torticollis can be treated with stretching exercises or position changes that you can perform at home. The doctor may teach you some specific exercises to do with your little one. These moves will help lengthen the tighter, shorter muscle and also strengthen the muscle on the opposite side.

Once torticollis is diagnosed and stretching exercises start, most babies improve within 6 months. Two things can speed up recovery: an early diagnosis and sticking to the treatment plan.

Here are some other things you can do at home:

  • Use your baby’s appetite as an incentive. Offer the bottle or your breast in a way that gets them to turn away from the favored side.
  • Place toys so that your baby is forced to look both ways. Those with sounds and lights are really good at drawing their attention.
  • Get them to play with their hands and feet. Babies like to bring their hands together and their feet up to their hands. When your baby does this, it builds up muscles they will need to crawl.
  • Give them plenty of time on your tummy. Holding your baby this way will strengthen their back and neck muscles and keep the back of their head from flattening. Ideally, they should have 15 minutes of tummy time four times a day. You can support them on your chest, across your lap, or on a pillow if that makes it easier.

In addition to home treatment, your doctor may want your baby to see a physical therapist.

Very rarely, children with torticollis will need surgery to lengthen the SCM muscle. Doctors will usually wait until your child is a preschooler to consider this option.

Torticollis treatment in adults

Treatment for torticollis in adults may depend on the cause. Some possible options include:

  • Physical therapy, which may include heat therapy, massage, and traction devices to relieve pain
  • Stretching exercises
  • Braces or other devices to keep the neck in place
  • Medicines, such as baclofen, to help with muscle spasms
  • Anti-inflammatories to keep pain at bay
  • Botox injections
  • Trigger point injections
  • Spine surgery if the condition is due to a vertebral dislocation

Here are some home remedies that may help improve your symptoms:

  • Stretch your neck muscles
  • Apply hot and cold therapy
  • Get enough rest
  • Touch the opposite side of your face, neck, or chin to temporarily stop spasms
  • Reduce stress

While there’s no way to prevent torticollis in babies, you can avoid complications if you treat it early and stick to your treatment plan.

Adults may be able to lessen their risk of torticollis if they avoid neck injuries and strains. It’s also helpful to practice good posture and perform stretching exercises often. You might not be able to completely prevent torticollis, but prompt treatment can keep the condition from getting worse.

Torticollis can be present in babies at birth, acquired later in childhood, or even affect adults. It’s usually treated with at-home stretches and positioning. If these therapies aren’t successful for you or your child, let your doctor know. Other options may work better.

How serious is torticollis?

Torticollis is a relatively common condition that usually responds well to treatment. Rarely, torticollis can be a sign that you have a more serious underlying medical condition, such as a tumor, injury, or infection.

Does torticollis go away on its own?

Although torticollis can go away on its own, babies often need treatment to stretch their muscles. You should see your doctor for regular checkups to assess your baby’s progress.

What causes torticollis in babies?

There are lots of possible causes. The way your baby was positioned in the womb before birth is one. Other reasons include a problem with the muscles and nerves in the neck or a birth condition.

Should I be worried if my baby has torticollis?

You shouldn’t worry if your doctor tells you your baby has torticollis. Most of the time, the condition usually doesn’t cause any pain and shouldn’t pose long-term issues if treated promptly.

What triggers torticollis?

The way babies are positioned in the womb before birth can trigger congenital torticollis. Swelling in a child’s throat can prompt acquired torticollis. In adults, a head or neck injury can sometimes be the culprit.