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Congenital Torticollis (sometimes referred to as “wryneck”) is a condition that causes your baby to have a tilted or turned head. It happens when one of the neck muscles that rotates and tilts the head is too tight. It is equally common in both boys and girls. It is typically found in a newborn baby and is not painful.
Babies with Congenital Torticollis will hold their head unevenly, tilting and rotating their head to one direction at rest. It may be hard to notice in a small baby, but a mother may notice that the baby seems to prefer one breast over the other or isn’t able to track objects to one side with their head.
Your pediatrician will examine the baby’s head motion by turning his or her head from side to side. They may notice that one of the neck muscles is tighter than the other. Since one Torticollis may be due to tight positioning in the womb, your pediatrician will check for other things that can also be found with tight positioning including hip problems and metatarus adductus (toes turn in). (link to Hip Dysplasia, metatarsus adductus)
No x-ray or other imaging is necessary in the initial work-up for Congenital Torticollis.
Congenital Torticollis most often requires no treatment and is goes away by itself. Some providers may be recommend home stretches for you to do with your child. Other strategies can help as well including repositioning the baby’s crib so that the most interesting, stimulating things in the room are away from the neck tightness. When the baby tries to look at those things, they will be stretching their own neck. Likewise, feeding the baby from the side away from the tight muscle will allow that muscle to get a good stretch several times a day. As baby’s heads develop they are supposed to be symmetric and round. It is important to have your baby be able to turn his head equally well to both sides to avoid developing a flat spot on the head. Occasionally your doctor will recommend additional help with formal physical therapy. It may take up to a year for your baby to have symmetric neck motion with or without treatment. Additional treatments involve Botox injections to loosen the tight muscle and it is rare that a baby needs surgery to loosen the tight muscle.
Typical Congenital Torticollis has no long-term problems and with proper stretching should be normal by one year of age. The head shape will also become normal with time if the tightness goes away. Persistent torticollis after one year requires referral to a pediatric orthopedic surgeon.
Torticollis is a tightness in one of the muscles that rotates and tilts your baby’s neck. It results in the baby’s head looking tilted and/or rotated. It is sometimes known as “wryneck”.
Torticollis is thought to result when the baby is packed tightly in the womb. That can happen with big babies, first babies and twins. There are other conditions that can limit the baby’s room to develop, which may result in a tight neck muscle.
Torticollis does not cause any pain to the baby.
The most common solution for a tight muscle anywhere in the body is to stretch it. Depending on the tightness of your baby’s neck muscle, that may involve stretching at home or with formal physical therapy. Your therapist or pediatrician can offer some strategies to help you stretch. With persistent tightness, botox injections may also be considered. On very rare occasion surgery may be considered for cases that fail to resolve with non-surgical treatments.
Typical Congenital Torticollis has no long-term issues. Muscle tightness should go away by one year of age and there is no effect on a child’s growth or development.
