Robert R. Wolff, MD, Pediatric Neurologist, Boston Children's Hospital
Unlike many health conditions that develop silently inside the body, pediatric torticollis is easy to see from the outside. You can recognize it when your child’s head persistently tilts to one side.
The word “torticollis” itself comes from two Latin root words, “tortus” and “collum,” that together mean “twisted neck.” This condition, sometimes called wryneck, is relatively common in children.
In general, torticollis is classified as either congenital (present at birth) or acquired (occurring later in infancy or childhood). By far the most common type is congenital muscular torticollis. Although children have this when they are born, parents may not notice it until children are several weeks old, as they start to gain more control of their head movement.
- Congenital muscular torticollis responds very well to physical therapy, especially when it’s started early. Sometimes it is associated with plagiocephaly, a common and treatable condition in which there is asymmetry in the shape of the head and face. This happens because the forces of gravity pull unevenly on a baby’s tilted head, causing a flattened appearance on one side of the skull or face.
- Acquired torticollis typically occurs in the first 4 to 6 months of childhood or later. It may come on quickly or slowly. In contrast to congenital muscular torticollis, there is usually no facial asymmetry with acquired torticollis.
- Acquired torticollis can be benign (not serious) or a sign of more serious health issues. Because the causes can be so different, it is very important to act quickly so that your child can get the proper care and treatment.
Note: Pediatric torticollis is different from another condition, called spasmodic torticollis, that affects adults.
How Children’s Hospital Boston approaches torticollis
We at Children’s are dedicated to acting quickly to find out the root cause of torticollis and coming up with a treatment approach that’s customized for your child.
In most cases, our clinicians deal with congenital muscular torticollis. We’ve found that most children with this type of torticollis respond very well to physical therapy programs, usually within a matter of months. Our dedicated team of physical therapists will provide an exercise plan that actively involves you in your child’s care.
We’ll also provide treatment plans designed for children who do not respond to physical therapy. Our orthopedic, neurosurgical and plastic surgery experts work closely together to develop a customized treatment approach that meets all of your child’s health needs.
Torticollis: Reviewed by Robert R. Wolff, MD
© Children’s Hospital Boston; posted in 2012