Torticollis, or wry neck, is a condition in which the neck is limited by tightness. The muscle affected is the SCM, which runs from just below the ear to the front of the chest. It’s the one that stands out if you turn your head to one side. When this muscle is contracted, the head might be stuck turned to one side, and tilted the same way. Less severe cases might just cause some resistance rather than totally limiting movement.
This can affect both adults and babies. In adults it is often the result of sleeping awkwardly, but some babies are born with it. This is usually due to the position they were in for their last few days or weeks in the womb. Sometimes it is associated with birth itself, especially if there was an assisted delivery. Less commonly, torticollis can develop a while after birth.
Symptoms of Infant Torticollis
It can be difficult to tell if your young baby’s torticollis was there when they were born or whether it developed in the first few weeks of life. This is because symptoms are subtle while baby’s head control is limited in the early days. As they begin to strengthen the neck muscles, the relative shortening of SCM becomes apparent. This can cause:
- Persistent turning of the head the same way when placed on their back
- Preference for feeding on one side
- Reluctance to turn the head to one side when sitting (assisted or not)
- Hitching one shoulder up, especially when moving the neck through the stiff movement
- Visible or palpable tension in the SCM muscle
- Effects on milestones: for example only rolling one way
Treatment
When the shortening of the muscle is a direct result of positioning, it is usually fully reversible. Osteopaths work with tight muscles all day, and this is no different.
Working with babies can be challenging, but our paediatric osteopaths are well trained and experienced. We can help to loosen the tight muscle during your appointment, as well as giving you advice to help to accelerate improvement at home.
Asking a baby to perform exercises won’t help! Luckily, we have methods to encourage them to move. You may be able to get your baby to work through the tension by using a bright or noisy toy. Holding this in a position where they need to turn through the uncomfortable zone might be enough to start making changes. Your osteopath will advise you how frequently to do this and how long it should take to see progress. Alternatively, your baby may respond well to feeding into their uncomfortable position. This will likely need to be a gradual move into rotation, but may be a relatively simple way to make the change.
Red Flags and Long Term Effects
If torticollis develops later on in infancy, it can rarely be a sign of something more serious. You should present any problems with your baby to the GP or health visitor in the first instance, but be sure to mention any of the following if they apply:
- Signs of severe discomfort, especially affecting sleep
- Vomiting and weight loss
- Low muscle tone
- Reduced control of arms or legs
Note that one of the first signs of meningitis can be neck stiffness. If your baby’s case develops very suddenly, and is accompanied by lethargy, fever, a rash, or reduced urination, call 999.
Torticollis is closely linked to plagiocephaly. This is where the soft bones of baby’s head are misshapen by repeated or prolonged pressure. As babies with torticollis are likely to apply pressure to the same part of their head whenever laying or sitting in a lounger, they are more vulnerable to plagiocephaly. Both conditions are treatable, so speak to your osteopath as soon as you can if you have any concerns.
You can make an appointment here with one of our paediatric osteopaths
