Torticollis

Torticollis is a medical condition that affects the muscles of the neck. Abnormally tight muscles on one side of the neck cause the head to tilt or twist from its normal position.

The sternocleidomastoid muscles (SCM) run along each side of the neck, originating at the sternum and clavicle and inserting on the mastoid process of the temporal bone, just below the ear. These muscles are involved in turning the head side to side (cervical rotation) which is why irritation or tightness in the SCM is so often behind a stuck, tilted neck.

Types of Torticollis

Torticollis can be congenital or acquired, and there's a third type worth knowing about as well:

• Congenital torticollis is present at birth. The exact cause isn't always clear, though birth trauma or the baby's position in the womb can result in shortening or tightness of the sternocleidomastoid muscle. This form is typically managed with pediatric physical therapy and stretching.
• Acquired torticollis (acute "wry neck") occurs when the neck muscles suddenly tighten or spasm, causing moderate to severe stiffness. People often wake up unable to turn or move their head in certain directions, sometimes with no clear trauma or triggering activity. This is the type we most often treat.
• Spasmodic torticollis (cervical dystonia) is a different, neurological movement disorder involving involuntary, often chronic muscle contractions. It's typically diagnosed and managed by a neurologist, sometimes with medication or botulinum toxin injections, rather than through conservative musculoskeletal care alone.

Symptoms of Acquired Torticollis

• A painful, fixed head posture, typically tilted to one side
• Sudden neck stiffness, often noticed upon waking
• Visible muscle spasm on one side of the neck
• Pain that may radiate into the shoulder or upper back
• Difficulty or inability to turn the head in certain directions

Common Causes

• Sleeping in an awkward position
• A sudden or unguarded neck movement
• Muscle trigger points in the neck or upper back
• Cervical facet joint irritation
• Minor strain from everyday activity

How We Diagnose It

Diagnosis is largely clinical, we assess your neck's range of motion, muscle spasm, and posture, along with how and when your symptoms began. If your symptoms include fever, followed a significant injury, or come with neurological signs like numbness, weakness, or vision changes, further evaluation or imaging may be needed before starting treatment.

Treatment for Acquired Torticollis

We often treat cases of acquired torticollis with comprehensive treatment plans designed to reduce neck stiffness and restore normal movement. Depending on your evaluation, your plan may include:

• Heat, ice, or other passive therapies in the early, most irritated phase to calm muscle spasm.
• Myofascial release and soft tissue therapy for the neck and upper back muscles.
• Gentle chiropractic adjustment or mobilization once your neck tolerates it, to restore normal joint motion.
• Guided stretching for the muscles most often involved, the SCM, levator scapulae, and trapezius.
• Posture guidance to reduce strain that can prolong recovery or contribute to recurrence.

Most cases of acute wry neck improve significantly within one to two weeks of starting treatment. If stiffness or pain lingers beyond that, it's worth a follow-up evaluation to make sure nothing else is contributing.

Frequently Asked Questions

Is torticollis the same as a normal stiff neck? They're related, acquired torticollis is essentially a more pronounced form of acute neck stiffness, where the head becomes visibly tilted and movement is significantly restricted.

Can a chiropractor help with torticollis? For acquired (acute) torticollis, yes, gentle adjustment, soft tissue therapy, and guided stretching are a well-supported conservative approach. Spasmodic torticollis/cervical dystonia is managed differently and is best evaluated by a neurologist.

How long does recovery take? Most acute cases improve substantially within one to two weeks with treatment.

Should I be worried about my baby's torticollis? Congenital torticollis in infants is typically managed with pediatric physical therapy and stretching , talk with your pediatrician about the right referral for your child.

Dr. Neel Kumar is a New York City chiropractor treating medical conditions such as acquired torticollis for over 15 years. He has helped many patients achieve restored movement and mobility while experiencing less pain and discomfort.

Call or Text us Today for an Appointment (212) 245-5688