Torticollis is a tightened or twisted neck. When a child has torticollis, they have limited mobility in their neck and primarily hold their head to one side. This can result in flat head syndrome (plagiocephaly) as external pressure is always applied to one side of the child's head. Torticollis can be congenital, which means that it is present at birth. Approximately 2% of newborns are born with torticollis, and it may be more common for multiples who had limited room during development. Torticollis is typically diagnosed within the first two months of a baby's life.
In the neck, there is a paired muscle that controls the flexing and rotation of the head. This muscle is called the sternocleidomastoid muscle. It is possible that torticollis develops because blood is cut off to these muscles during development, causing tightness and limiting mobility. That may explain why multiples, who have less room in the uterus, may more commonly develop torticollis.
In 90% of babies, muscular torticollis improves during the first year of life, but the condition can improve more quickly with physical therapy, which can help to stretch the muscles of the neck. The exercises and stretches learned at physical therapy will need to be practiced at home daily in order to see results. Babies with torticollis also benefit from tummy-time. When a baby is placed on their stomach, it helps the muscles in the neck to develop properly.
Occasionally, children do not respond to non-surgical treatments such as physical therapy. In these cases, orthopedic surgery may be the best option. Surgery may be scheduled to lengthen the muscles of the neck or correct any abnormalities that may have developed in the spinal vertebrae. There are also corrective devices that can be applied to hold the neck in a corrected position for a limited period of time.