What is Torticollis?
Wryneck, also known as torticollis, is a condition where the neck muscles cause an infant’s head to tilt and turn to one side. It can either be congenital, present at birth, or acquired later in life.
Torticollis
Your infant may have torticollis, a disorder in which the muscles in their neck twist and tilt their head to one side. It could appear as though your baby’s neck is turned at an odd angle. Their chin may be angled to one side, while the top of their head may be angled to the other.
Wryneck is another name for torticollis.
“Tortus,” which means twisted, and “collum,” which means neck, are the Latin terms from which “torticollis” is derived. Congenital torticollis can occur at birth. It might also arise later in childhood or infancy (acquired).
The most prevalent kind of torticollis is congenital. The baby normally doesn’t feel any pain. It could go unnoticed until a few weeks after the baby is born.
Acquired torticollis can either occur gradually or become noticeable suddenly, and typically develops within the first four to six months of a baby’s life.
Symptoms
Symptoms of congenital torticollis may include:
- Your baby’s head tilting to one side while the chin points to the opposite side.
- Restricted movement in the head and neck.
- One shoulder appearing higher than the other.
- Tightness or stiffness in the neck muscles.
- Swelling in the neck muscles.
- A small, pea-sized lump in one of the neck muscles.
- Asymmetrical facial features.
Symptoms of acquired torticollis may include:
- Your child’s head tilting to one side with the chin tilted to the opposite side.
- Restricted movement in the head and neck.
- One shoulder positioned higher than the other.
- Tightness or stiffness in the neck muscles.
- Swelling in the neck muscles.
- Intense neck pain.
- Head tremors.
- Headaches.
Causes
The exact cause of torticollis is often unknown. Congenital torticollis results from a shortening of one of the baby’s sternocleidomastoid muscles (SCMs) and is more common in firstborns. This condition may also be associated with congenital hip dislocation and is likely due to the baby’s position in the womb, which can strain the neck muscles.
Acquired torticollis may stem from irritation of the cervical ligaments due to a viral infection, injury, or vigorous movement. Other possible causes include:
- Sleeping in an awkward position
- Neck muscle injury during birth
- Burn injuries
- Injuries causing heavy scarring, leading to muscle or skin contraction
- Neck muscle spasms
Additionally, torticollis may arise due to:
- Slipped facets (small joints on either side of the spine)
- A herniated disk
- Viral or bacterial infections
How is Torticollis Diagnosed?
A physical examination and medical history are often used to confirm the diagnosis of torticollis. MRIs and X-rays could also be required.
How is Torticollis Treated?
In most cases, congenital torticollis can be managed with stretching exercises and position adjustments. Your baby’s healthcare provider can guide you in safely stretching the neck muscles. In some cases, surgery to lengthen the SCM muscle may be necessary, which would involve an pediatric orthopaedician specializing in the musculoskeletal system.
For acquired torticollis, treatment focuses on addressing the underlying cause and easing symptoms. Options may include:
- Neck collar
- Heat therapy
- Ultrasound therapy
- Physical therapy
- Surgery
- Medications
Conclusion
Seeing your baby’s head twisted or cocked to one side may be upsetting. Newborns with torticollis, however, typically don’t experience any pain. Positioning and stretches are usually good ways to address the problem. If your child’s at-home activities and other therapies don’t appear to be working, consult with their pediatrician.
FAQs for Torticollis: Causes, Symptoms, Diagnosis and Treatment Options
Torticollis, also called wryneck, is a condition where the neck muscles cause the head to tilt to one side while turning the chin to the opposite side.
Congenital torticollis is usually caused by the shortening of the sternocleidomastoid muscle (SCM) in the neck, often due to the baby’s position in the womb or muscle strain during birth.
Symptoms may include head tilting to one side, restricted neck movement, one shoulder appearing higher, and a small lump in the neck muscles.
Acquired torticollis can occur due to infections, injuries, poor sleeping posture, or muscle spasms. It can develop gradually or suddenly.
Congenital torticollis is generally not painful for infants. However, acquired torticollis may cause discomfort or neck pain.
A doctor diagnoses torticollis through a physical examination and medical history. Imaging tests like X-rays or MRIs may be used in some cases.
Treatment often involves stretching exercises, repositioning, and physical therapy. Surgery may be required in rare cases to lengthen the SCM muscle.
Treatment focuses on the underlying cause and may include neck collars, heat therapy, physical therapy, medications, or surgery.
Mild cases of congenital torticollis often improve with regular stretching and positioning exercises. However, professional guidance is recommended for effective treatment.
Parents should consult a pediatrician or a pediatric orthopedic surgeon for proper evaluation and treatment to prevent complications or delays in motor development.

Author: Dr. Sujith Omkaram
Consultant Pediatric Orthopedician