Infantile Torticollis

Torti-what?

“Torticollis”, latin for ‘twisted neck’, is a condition which may arise and present in an individual at any stage during their life, including infancy. While many diagnostic terms or anatomical names can leave you scratching your head as to how that name came to be, “twisted neck” is a visually descript representation for how the affected individual appears.

SCM – the “Twisted Neck” Muscle

Individuals, including babies, experiencing torticollis visibly show altered posture of the head and neck, where the head appears tilted to the side, and turned either right or left . This is because musculoskeletal torticollis usually involves contraction of the muscle “sternocleidomastoid” (aka SCM). Each person has two SCM muscles – one on the left and one on the right. The SCM on the left starts behind the left ear, and travels down the left side and front of the neck to connect to the left collar bone and sternum. The right SCM does the same, but on the right. This muscle allows you to bend your head forward if both muscles contract at the same time. When only one SCM contracts, it causes your head to tilt to the side and to turn slightly. The severity of the tilt and turn seen in torticollis cases can range from mild to severe depending on how contracted the affected SCM muscle is, but can be resolved with diligence and the right help.

Causes

In older children or adults torticollis can present in conjunction with an infection, in relation to a tumor or neurologic issue, or could stem from trauma to the neck region, and sometimes occurs for no obvious reason at all.

In babies, the most common type of torticollis is congenital torticollis – meaning the baby is born with it or it develops relatively soon after birth. The suspected causes of this type of torticollis relate to  potential postural stresses on the head and neck while in utero – particularly later on in gestation when baby is bigger and mommy’s tummy is comparatively less spacious. The other suspected cause is birth trauma. The birth trauma could be that baby’s head wasn’t at an optimal angle when exiting the birth canal, and this created trauma in the neck. Or it could be that forceful interventions (manual pulling, forceps, vacuum extraction) were used during the birthing process.

How would I know if my baby has torticollis?

The common signs and symptoms of torticollis in a baby can include:

  • postural distortions where the head is tilted to the side and / or turned
  • Facial features which are not level (e.g. the eyes are not level with each other)
  • Difficulty breastfeeding, particularly if one breast is preferred over the other
  • Colic, fussiness and crying
  • A preference to look in one direction over the other
    • This may show up in how baby sleeps, sits in their car seat, or where they will look when awake
  • Following you with their eyes without turning their head
  • Loss of hair on a particular region of the head, often accompanied with a flattening (plagiocephaly) of the balding region

Torticollis or various signs and symptoms of it may appear soon after birth, or may appear more gradually becoming increasingly evident as baby develops better head and neck control.

What to do

If you suspect that your baby may have torticollis, manual therapies such as chiropractic care can help resolve the underlying issue and help optimize other aspects of baby’s health.

Chiropractic treatments for torticollis involve gentle massage along the contracted SCM muscle, light stretching and specific adjustments to help restore motion to any joints which have subluxated. At home exercises as well as postural advice will also be reviewed and  provided.

To find out more about torticollis or how chiropractic care can benefit your baby, book a complimentary meet & greet with Dr. Alyssa

 

 

References

Akbari MR, et al. 2015. Facial Asymmetry in Ocular Torticollis. Journal Curr Ophthalmology. 27: 4-11.

Herman MJ. 2006. Torticollis in infants and children: common and unusual causes. Instr Course Lect. 55:647-53.

Siegenthaler MH. 2015. Chiropractic Management of Infantile Torticollis with Associated Abnormal Fixation of One Eye: A Case Report. Journal Chiro Med. 14: 51-56.

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