Torticollis defines as rotational deformity of the cervical spine causes turning and tilting deformity of head and neck.
Causes of Torticollis
- The sternocleidomastoid muscles of the neck undergo contractures pulling it to the same side and turning the face to the opposite side.
- Birth trauma- Breech delivery, improper application of forceps.
- Middle part of the sternocleidomastoid supplied by an end artery branch of superior thyroid gets blocked due to trauma.
- Leads to fibromatosis within the sternomastoid muscles.
- TB of cervical spine, acute respiratory tract infection.
- Sprain, dislocation and fracture of cervical spine.
- Painful persistent and intermittent sternomastoid muscle contractions.
- Unilateral muscle paralysis e.g. polio
- Neuritis of spinal accessory nerve
- Ocular disturbances: child turns head one side to compensate for defective vision.
Torticollis Treatment Clinical Features
- Deformity is the only complaint initially. Later facial changes, macular problems in retina.
Torticollis Physiotherapy Treatment Measures
- During infancy stretching of sterno by manipulation. Surgeries delays till fibroma is well formed. If muscle is still contracted up to age of one year it is released. Exercises are successful when restriction of motion is < 300 when there is no facial asymmetry.
- Ultrasound heat massage – In acute pain wear collar. Gradual neck stretch and strengthening.