Torticollis. While it might sound like a strange Italian dish, it’s not.
Imagine waking up one morning with your ear pressed to your shoulder as if cradling a telephone receiver. The only problem is, there is no telephone to be found, only an unrelenting, painful neck spasm with absolutely no ability to bring your head back to any semblance of socially accepted posture.
Most would agree it’s a pretty disturbing situation to find yourself in. Thankfully, in most cases, the fix can be simple.
Torticollis is a hefty Latin word that simply means “twisted neck,” which creates some confusion.
Torticollis is really more of a description than a diagnosis. Many things can cause a neck to stay in an unsightly, twisted position, including everything from fractures, tumors, and herniated discs to infections, neuro-ocular problems, and certain medication side effects.
Thankfully, these causes are relatively uncommon. Nevertheless, they must all be considered when a patient is evaluated for torticollis. The majority of torticollis cases involve cervical subluxation, something we chiropractors work on nearly every day.
Most of the time, a mechanical locking of the joints in the neck with a displacement of the center-most disc material has occurred. This, in turn, causes the tissues of the joint to become painfully inflamed and for the muscles of the neck — mainly the sternocleidomastoid muscle — to clamp down in a state of prolonged spasm.
Many schools of thought put the blame on the muscle spasm itself. While this might be the case in certain situations, focusing treatment efforts on the muscle alone fails to address the underlying mechanical disorder that is spurning on the shortened muscle in the first place. In other words, trying to massage and stretch out the spastic muscle will not remedy this problem. On the other hand, a carefully administered adjustment aimed at rectifying the mechanical dysfunction by a chiropractor with torticollis experience will often bring about relief and correction in short order.
The cause of torticollis — outside of the rare situations mentioned above — is open for debate and, for the most part, unknown. What we tend to see is that many patients have been subjected to some sort of disproportionate neck chill from a draft of, say, an open window or fan. Some patients have had an occupational activity that put their neck in a prolonged twisted position. For example, the tractor-driving farmer who frequently looks over his shoulder while plowing.
Still, in other cases, there has been trauma involved, whether it was whiplash, a sports injury, heavy lifting, or even fetal delivery.
This later, potentially traumatic event is often the cause of what doctors tag as “congenital torticollis” and is seen when infants constantly favor turning their heads to one side. Failure to address this can lead to facial asymmetry from malformed cranial development, not to mention difficulty nursing on the unfavored side. Again, chiropractic can be very effective at treating this.
Many who are afflicted with torticollis were primed and ready for the event because of longstanding spinal curve issues, such as reversed neck curve or scoliosis.
Beyond the stretching and massage to the spastic muscle mentioned above, other medical approaches tend to focus on the muscle in a much more invasive way.
These treatment methods range from temporarily paralyzing the involved muscle for several months with Botox injections to selectively severing the nerves that go to the involved muscle. In extreme cases of congenital torticollis, surgeons will actually attempt to lengthen the shortened muscle.
Even though solid scientific literature is scant on the topic of torticollis for both medicine and chiropractic, what we do know is that chiropractors have helped many with this posturally frightening condition. And while some may need the extreme measures of medicine, most would do well to at least try chiropractic first.
Thomas R. Lamar is a chiropractor at Anchor Chiropractic in Kingston’s Health Services Center.
