The muscles of the neck need to work properly in order for us to be able to move the head in all directions without a problem. If for any reason, the muscles of the neck are not working properly, a decreased range of motion of the neck occurs. This is commonly known as torticollis. Torticollis is a condition whereby the muscles of the neck become locked in an awkward position.
This causes the head to be cocked and locked to one side and the jaw to the opposite side. It then becomes painful to return the head to its original position, so the head is determined to stay in that position. The muscle being mainly affected is the sternocleidomastoid muscle. This muscle runs along the side and the back of the neck.
The condition is most common among children, but it can also develop in adults who showed no symptoms while in their childhood. This is torticollis in adults and is also referred to as cervical dystonia or spasmodic torticollis.
What are the causes of torticollis in adults?
The exact cause of torticollis in adults is not always known – sometimes, it can develop suddenly after an injury to the neck muscles or the nervous system, but this isn’t always the case. Most of the time, the signs and symptoms of this condition start to show during infancy and continue up until adulthood. For this reason, experts believe it may develop in the womb if the head of the fetus was awkwardly positioned.
In cases where torticollis develops in adulthood, yet, there were no symptoms during childhood, then the probable cause would be trauma to the neck area. Trauma to the neck muscles may cause inflammation, just like it would any other muscle in the body. However, if the condition persisted for weeks after the trauma event, then this might indicate damage to the nervous system. Thus, it may have caused torticollis to develop.
There have also been studies that have shown a genetic link in the development of torticollis. Patients affected by the condition are often related to others who also suffered from the same condition. Infections of the neck or head can cause torticollis too. As the infection spreads to the lymph nodes of the neck, the overlying muscles will get contracted.
Torticollis in adulthood can therefore occur due to an infection or abscess of the throat or upper airway. Sinus infections, mastoiditis, jaw infections, tooth infections or ear infections can similarly be the lead cause to torticollis.
Certain medications can cause torticollis. These medications are ketamine, amphetamines, cocaine, Haldol, Compazine, etc. Rarely, torticollis in adults is caused by a tumor of the neck, scar tissue, vascular problems or even arthritis.
Signs and symptoms of torticollis in adults
• The head tilts to one side while the chin tilts to the other. The individual has to maintain this awkward position because trying to move the head back causes pain
• The shoulders are not at equal levels, with one being raised over the other
• The neck muscles become swollen due to extensive straining which leads to inflammation
• The lymph nodes may also become infected, causing them to swell and become tender to the touch
• Headaches and head tremors due to maintaining this awkward position for extended periods of time
Treatment of torticollis in adults
Unfortunately, there is no cure for torticollis in adults or children, and individuals with the condition have to learn to live with it. If discovered early, simple management techniques such as stretching exercises, massage, and heat application can be practiced during physical therapy. Neck braces, too, may be recommended to help the strained muscles recover quickly from their locked position.
To address the pain associated with torticollis, various pain medications in the form of tablets and ointments may be prescribed. Muscle relaxants may also be used to help ease the tension of the neck muscles. Botox injections can also help to reduce the effect of torticollis by immobilizing the affected muscles.
You will need to have a Botox injection every 3 to 4 months, as the effect subsides gradually. In the worst cases where the individual experiences debilitating pain or recurrent episodes of torticollis, then surgery may be performed to fix the problem. The surgery may be done to either increase the length of the neck muscles or to interrupt nerves responsible for the condition.
As mentioned, torticollis has no cure. You will just need to learn how to live with it. Avoiding stress is important when it comes to torticollis. Stress, anxiety and nervousness will make your torticollis get worse. Heating packs can also be used and applied to the neck in order to relieve the muscle spasms and make the torticollis a little better.
In cases of an acute torticollis, in general, there is nothing to worry about. In most of the cases, the acute torticollis will go away within a few weeks. However, sometimes, it takes months or even years for torticollis and neck pain to go away.