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Could That Neck Pain Be Idiopathic Adult Torticollis?

6/30/2018

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Between all my recent testing for an heart evaluation, I did throw in a bit more concern about that neck pain that occurred and continues to plague me although not as severe.

My primary mentioned it could be a touch of idiopathic Torticollis. Wry neck, or torticollis, is a painfully twisted and tilted neck. The top of the head generally tilts to one side while the chin tilts to the other side.

This condition can be congenital (present at birth) or acquired. It can also be the result of damage to the neck muscles or blood supply. Wry neck sometimes goes away without treatment. However, there’s a chance of relapse.

Chronic wry neck can cause debilitating pain and difficulty performing daily tasks. Fortunately, medications and therapies can relieve pain and stiffness. Surgery can also sometimes correct the condition. Treatment is most successful if it’s started early. This is especially true for children.

Wry neck can be inherited. It can also develop in the womb. This may happen if your baby’s head is in the wrong position. It can also be due to damage to the muscles or blood supply to the neck.

Anyone can develop wry neck after a muscle or nervous system injury. However, most of the time, the cause of wry neck is unknown. This is referred to as idiopathic torticollis
​
Types of torticollis

Temporary torticollis

This type of wry neck usually disappears after one or two days. It can be due to:
  • swollen lymph nodes
  • an ear infection
  • a cold
  • an injury to your head and neck that causes swelling

Fixed torticollis

Fixed torticollis is also called acute torticollis or permanent torticollis. It’s usually due to a problem with the muscular or bone structure.

Muscular torticollis

This is the most common type of fixed torticollis. It results from scarring or tight muscles on one side of the neck.

Klippel-Feil syndrome

This is a rare, congenital form of wry neck. It occurs when the bones in your baby’s neck form incorrectly, notably due to two neck vertebrae being fused together. Children born with this condition may have difficulty with hearing and vision.

Cervical dystonia

This rare disorder is sometimes referred to as spasmodic torticollis. It causes neck muscles to contract in spasms. If you have cervical dystonia, your head twists or turns painfully to one side. It may also tilt forward or backward. Cervical dystonia sometimes goes away without treatment, but there’s a risk of recurrence.

Cervical dystonia can happen to anyone. However, it’s most commonly diagnosed in people who are roughly ages 40 to 60. It also affects more women than men.

Symptoms of wry neck

Symptoms of wry neck can begin slowly. They may also worsen over time. The most common symptoms include:
  • an inability to move your head normally
  • neck pain or stiffness
  • a headache
  • having one shoulder higher than the other
  • swollen neck muscles
  • a tilting of your chin to one side
The faces of children with congenital wry neck may appear flattened and unbalanced. They may also have motor skill delays or difficulties with hearing and vision.

What to expect at the doctor’s office

Your doctor will want to take your medical history and conduct a physical exam. Be sure to tell them about any injuries to your neck area. Several types of tests can also determine the cause of your wry neck.

An electromyogram (EMG) measures electrical activity in your muscles. It can determine which muscles are affected.

Imaging tests such as X-rays and MRI scans can also be used to find structural problems that might be causing your symptoms.

Treatments for wry neck

Currently, there’s no way to prevent wry neck. However, getting treatment quickly can keep it from becoming worse.

You can improve congenital forms of wry neck by stretching the neck muscles. If started within a few months of birth, it can be very successful. If this or other treatments don’t work, surgery can sometimes correct the problem.

Your doctor can treat acquired wry neck according to the cause if it’s known.

Treatments for wry neck include:
  • applying heat
  • massage
  • physical therapy or chiropractic care
  • traction
  • stretching exercises
  • neck braces

Your doctor may recommend surgery, such as:
  • fusing abnormal vertebrae
  • lengthening neck muscles
  • cutting nerves or muscles
  • using deep brain stimulation to interrupt nerve signals (used only in the most severe cases of cervical dystonia)
Medications can be helpful. They can include:
  • muscle relaxants
  • medications used to treat the tremors of Parkinson’s disease
  • botulinum toxin injections repeated every few months
  • pain medications

Living with wry neck

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Wry neck caused by a minor injury or illness is likely temporary and treatable. However, congenital and more severe forms of wry neck can cause long-term health problems.

Chronic wry neck can cause complications, including:
  • swollen neck muscles
  • neurological symptoms from compressed nerves
  • chronic pain
  • difficulty performing routine tasks
  • an inability to drive
  • difficulty socializing
  • isolation
  • depression

If your wry neck isn’t treatable, consider seeking out a support group. Many people with chronic conditions find them both comforting and informative. Your doctor or local hospital may be able to give you information about groups that meet in your area. You may also be able to find a supportive community online. Communicating with others who have wry neck or similar conditions can help you cope. - Healthline

diet.mayoclinic.org
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