Torticollis (Wry Neck)

Torticollis happens when muscles on one side of the neck contract (tighten). This causes the neck to twist or tilt to the side. The muscles may also be quite sore. It affects mainly children and young adults, often appearing overnight. It can also affect infants who develop or are born with tight neck muscles on one side.

What causes torticollis?

Causes of torticollis include:

  • Congenital (present at birth). Injury to the neck muscles from an accident or other trauma, or even just sleeping in an unusual position

  • Side effect of certain medicines or drugs

  • Problems with the bones of the neck (which can happen after an infection or injury)

  • Spasm of the muscles due to an infection, such as an abscess in the neck

When to go to the emergency room (ER)

All neck problems should be checked by a healthcare provider within 24 hours. Seek emergency care if you can’t reach your healthcare provider or these symptoms are present:

  • Trouble breathing or swallowing or in smaller children, continuous drooling

  • Numbness or weakness in the arms and legs

  • Trouble walking or speaking

  • Fever

What to expect in the ER

The neck will be examined, and questions about any current or former medical problems will be asked. X-rays of the neck may be taken to check for broken bones.

Treatment

The goal in treating torticollis is to relax the neck muscles. The best approach will depend on the cause of the problem. In most cases, one or more of the following may be given:

  • Medicines to help relax the muscles and reduce swelling

  • Hot and cold compresses to help ease muscle tightness

  • Botulinum toxin injections to prevent further muscle spasms

  • Physical therapy to help stretch and relax the muscles

  • Treatment of any infection, which may need intravenous antibiotics or surgery

Follow-up

Depending on the cause, torticollis often goes away on its own. Follow up with your healthcare provider as instructed. If symptoms become worse, call your healthcare provider or return to the ER.



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