Torticollis | Treatments

What are the treatment options for torticollis?

Congenital muscular torticollis

Once your doctor has determined that your child has congenital muscular torticollis, you and your child will begin a program of physical therapy designed to lengthen the shortened SCM muscle.

Physical therapy programs will include specific exercises you can do at home on a set schedule, such as during diaper changes. In addition, you will learn how to hold your baby and tailor his environment to encourage him to turn his head and stretch the SCM muscle.

Your child's physical therapist may recommend using a simple device called a “TOT collar.” TOT stands for Tubular Orthosis for Torticollis, which is really just a small piece of plastic tubing that fits around your baby's neck. The TOT collar is designed to help babies straighten their heads and strengthen their neck muscles. Your physical therapist will teach you the proper way to use a TOT collar.

At Boston Children's, we're also dedicated to the needs of children who have torticollis with asymmetry of the face and head, known as plagiocephaly. We have found that these kids usually respond very well to non-surgical, minimally invasive interventions like:

  • customized, corrective helmets and molding cups
  • sleep position changes
  • special exercises

Sometimes other measures, such as surgery, are required to correct the shortened SCM muscle in torticollis and any asymmetry that may happen with plagiocephaly. Boston Children's offers a range of treatment options in our Orthopedics and Plastic Surgery programs to address your child's specific treatment needs.

Acquired torticollis

Your child's treatment plan will vary based on the cause of the torticollis. Some common therapies include: 

  • nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and discomfort related to musculoskeletal injury
  • antibiotic therapy for children whose torticollis is caused by infection
  • medications to stop gastroesophageal reflux for children whose primary cause of torticollis is reflux