Torticollis
In this condition factsheet:
Diagnosing Torticollis
In order to diagnose torticollis, a doctor will ask detailed questions about past injuries and other neck problems. He or she may choose to send the person for various imaging tests such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) to look for specific causes of the neck muscle spasms. However, it's unlikely the cause of the muscle spasms will be isolated.
In children and infants, doctors can detect neck muscle damage that may cause torticollis in a routine physical examination.
Treating and Preventing Torticollis
Torticollis can usually be treated quite successfully when the cause, such as abnormal bone growth or an abscess in the back of the throat, is identified. However, if the cause is a nervous system disorder or is unknown, treatment for torticollis is less likely to be successful in controlling painful spasms.
Some people's neck muscle spasms are relieved temporarily by physical therapy and massage. One method of massage that has had some success involves slight pressure, which is applied to the jaw on the same side as the head rotation. A cervical collar (either soft or stiff) may be helpful.
If physical therapy and massage don't work, some medications are available that may help reduce muscle spasms and involuntary movements. Medications can help control the pain caused by the spasms. Anticholinergic medications, which block specific nerve impulses, and benzodiazepines, which are tranquillizers, are commonly used. Muscle relaxants are also used.
The substance that causes botulism has been known to be effective in reducing pain and spasms if it's injected several times. It will also allow the head to be held in a more natural (less tilted) position. Improvement as a result of this treatment may last as long as several months.
Another treatment option involves surgically removing the nerves that supply sensation to the affected neck muscles. This treatment is sometimes successful but it should be tried only if other treatments have not provided any relief.
If emotional problems are thought to be contributing to the spasms, psychiatric treatment and counselling should be considered.
In infants with congenital torticollis, intensive physical therapy to stretch the damaged muscle should be started within the first few months after birth. It's extremely important to start therapy early because if it's unsuccessful or started too late, the child's neck muscles may have to be repaired by surgical means.
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