Congenital Muscular Torticollis

What is congenital muscular torticollis?

Congenital torticollis means that a baby is born with an odd position of the neck. The odd position is because of a tight, short neck muscle. It affects the right side more often than the left side. It may range from mild to severe. The condition is sometimes called wryneck or twisted neck.

What causes congenital muscular torticollis?

Healthcare providers don't know what causes the condition. It may be from an abnormal position in the womb. Or it may be from an injury to the neck muscle before birth. This causes scar tissue to form and tighten the neck muscle.

What are the symptoms of congenital muscular torticollis?

Congenital muscular torticollis may be seen at birth. Or you may not notice it until your baby is at least a few weeks old. Each child may have slightly different symptoms. Symptoms may include:

• Tilting of the baby’s head to one side

• Turning of the baby’s chin toward the opposite side of the head

• Trouble moving the head

• Firm, small, lump in the middle of the neck muscle

In severe muscular torticollis, a baby may also have:

• Flattening of the side of the head

• Differences between the sides of the face

• Oddly positioned ear

• Other abnormalities of muscles, bones, and joints

The symptoms of congenital muscular torticollis may look like other conditions. Make sure your child sees their healthcare provider for a diagnosis.

How is congenital muscular torticollis diagnosed?

Your baby’s healthcare provider will usually find the abnormality when examining your baby. Your child may need these tests for diagnosis:

• X-rays. This will check for abnormalities in the bones of the neck and shoulders.

• Ultrasound exam. This test uses sound waves to check the neck muscle.

How is congenital muscular torticollis treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Gentle stretching. This will help ease tightness and lengthen the neck muscle.

• Environmental adaptation. The home environment can be adapted to encourage your baby to turn their head in the direction that stretches the neck muscle. This will help your baby learn to move and stretch the muscle.

• Physical therapy. Your baby may be referred to an outpatient physical therapist for treatment.

• Surgery. Rarely, surgery is needed to correct the shortened muscle.

What are possible complications of congenital muscular torticollis?

If the problem is not fixed, the baby will be unable to move their head normally. It will lead to permanent muscle tightening. It will cause the neck and face to develop unevenly.

How is congenital muscular torticollis managed?

You can help your baby loosen and stretch the muscle by:

• Doing stretching exercises that your baby's healthcare provider shows you

• Putting toys where your baby has to turn their head to look at them

• Holding your baby so that the baby has to turn their head

• Putting your baby in the crib so that the baby has to turn their head to look at you

Talk with your baby’s healthcare provider about seeing a physical therapist. They can help you with exercises and positioning. And your baby may also receive therapy.

Your baby’s healthcare provider will recheck your baby regularly to make sure the torticollis is getting better.

When should I call my child’s healthcare provider?

Call your baby’s healthcare provider if you notice symptoms of muscular torticollis. And if your baby has the condition, call the healthcare provider if it is not getting better.

Key points about congenital muscular torticollis

Congenital muscular torticollis is a condition in which a baby’s neck muscle is tight and short. This causes the neck to twist.

• Healthcare providers don't know what causes the condition.

• Congenital muscular torticollis may be seen at birth. Or it may not be found until a baby is at least a few weeks old.

• Usually gentle stretching exercises and positioning are all that is needed to treat the shortened muscle.

• If the problem is not fixed, the baby will not be able to move their head normally. It can lead to permanent muscle tightening and uneven development of the neck and face.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.