Adult-Onset Torticollis

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Condition: Torticollis is an abnormal positioning of the head, caused by an involuntary and sustained contraction of the neck muscles.

Background: The condition can either develop slowly or immediately, such as due to an accident or traumatic injury. It can also develop as a reaction to certain medications, because of an infection or it can run in the family.

Risk Factors: Almost anyone can develop torticollis, and often no cause can be identified.

History and Symptoms: Common symptoms include pain when trying to hold the head straight or rotating it, as well tender neck muscles. Many patients also experience headaches. Some forms of torticollis can cause jerking of the head and spasms.

Physical Exam: Patients often come to an exam with tilting chin to one side, swollen neck muscles and one shoulder higher than the other. Often this is enough to determine the patient has torticollis.

Diagnostic Process: The physician may check the nerve and motor function to ensure the spinal cord has not be injured. If there was an accident, the doctor may take a neck X-ray to ensure there are no bone fractures or dislocation. 

Rehab Management: A primary component of rehabilitation is Botox injection, physical therapy and pain management. Therapies that often can help include applying heat, using massage, neck braces or stretching exercises.

Other Resources for Patients and Families: If a patient has chronic torticollis, his or her doctor may be able to recommend local support groups. Additionally, one particularly challenging form of torticollis is spasmotic torticollis. The National Spasmotic Torticollis Association offers information and resources that can help.

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