How To Treat Torticollis: 5 Simple Steps

February 2022

Torticollis is an involuntary contraction of the neck muscles that can be caused by poor posture when sleeping or when using the computer. It usually causes pain on one side of the neck which may result in difficulty in rotating your head.

It is common to wake up with torticollis and have difficulty moving the neck. In some cases, the muscles get so tight that the person cannot move the neck to either side and needs to remain stiff or facing one way. 

In order to cure torticollis and eliminate neck pain, the contraction happening in the muscles needs to be relieved. Mild torticollis can be treated only by using warm compresses and gentle neck massage, but when the torticollis is more severe, a more specific approach is needed.

To treat torticollis there are 5 simples steps that can be followed:

1. Tilt your body forward with your head hanging

Simply stand with your legs apart and lean your body forward, leaving your head hanging down. Allow your head and shoulders to be loose, and stay in this position for about 2 minutes. This will cause the weight of your head to act as a pendulum, which may increase the space between the cervical vertebrae and decrease the spasm of the neck muscles.

While hanging you head, you can rotate it, as if saying "no", to further relax the neck and shoulder muscles. 

2. Apply pressure to the neck muscles

This technique consists of using your thumb to apply pressure for 30 seconds to the middle of the muscle. Then, press the part where the muscles begin, in the nape of the neck, for another 30 seconds. While applying pressure, you can be standing or sitting, and your head should be facing forward.

3. Physiotherapy

Physiotherapy is important because it can help you stretch your neck using a technique called muscular energy. This involves placing a hand on the head (on the side of the torticollis)  and exerting force by pushing the head against the hand. Hold this position for 5 seconds and then relax, resting for another 5 seconds. Repeat this exercise 4 more times. Little by little your range of motion will improve.

If your movement is still limited after you finish this exercise, you can repeat this technique on the opposite side. 

4. Massage and compresses

Massaging the neck using sweet almond oil or some other moisturizer is also a good way to decrease pain and discomfort. The massage should be performed on the shoulders, neck, back of the neck and head. You should only perform a massage as the final part of treatment, after using the techniques above.

This type of massage should not be performed with a lot of force, but you can press your palm a little on the muscles of the neck, from the shoulders towards the ears. Cupping techniques can also be used with low pressure to increase blood flow and help loosen the muscle fibers.

To finish off, a warm compress can be placed on the neck for about 20 minutes.

5. Medication use 

Medications for torticollis should only be used as recommended by a doctor. This condition can be treated with anti-inflammatory creams like Voltaren, muscle relaxants, or anti-spasmodics. Applying a medicated compress is also a good strategy to cure the torticollis more quickly.

These remedies are also recommended for individuals with spasmodic torticollis that is characterized by persistent twitching of the neck muscles, causing your head to move in different positions. It is also known as cervical dystonia.

When to go to the doctor

Usually the torticollis improves after the first 24 hours, but it can last for up to 5 days. If the torticollis takes more than 1 week to heal, or if you have symptoms like tingling, loss of arm strength, difficulty breathing or swallowing, fever or incontinence, you should seek medical help.

How long does torticollis last

Torticollis can last for up to 5 days. It can cause a lot of pain and discomfort, making activities of daily living very difficult. Applying warm compresses on the neck and using the strategies indicated above can help to treat the torticollis faster.

What causes torticollis

It is very common for a person to wake up with torticollis, but it can also happen due to:

  • Congenital problems, like when a baby is born with congenital torticollis, requiring treatment, sometimes surgical;
  • Injuries involving the head and neck;
  • Spinal changes, such as disc herniation, scoliosis, alteration of the C1 & C2 vertebrae in the neck;
  • Respiratory infections, which cause torticollis and fever, or others such as meningitis;
  • An abscess in the mouth, head or neck;
  • Diseases like Parkinson's, where the muscles are more prone to spasms;
  • Certain medications, such as traditional dopamine receptor blockers (e.g. metoclopramide, phenytoin or carbamazepine)

The most common type of torticollis usually lasts 48 hours and is easy to fix. But, when it occurs with other symptoms like fever, you should go to a doctor for assessment. 

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Edited by Tua Saude editing team in February 2022. Clinical review completed by Marcelle Pinheiro - Physiotherapist in February 2022.

References

  • BMJ BEST PRACTICE. Torcicolo adquirido. 2018. Available on: <https://bestpractice.bmj.com/topics/pt-br/1088>. Access in 15 Apr 2019
  • KISNER, Carolyn; COLBY Lynn Allen. Exercícios terapêuticos: Fundamentos e Técnicas. 6ª.ed. São Paulo: Manole, 2016. 318-323; 491-496.
Show more references
  • Mark Dutton. Fisioterapia ortopédica: exame, avaliação e intervenção. 2ª.ed. Porto Alegre: Artmed, 2010. 383-404.
  • KENDALL, Florence Peterson; MC CREARY, Elisabeth Kendall; PROVANCE, Patricia Geise. Músculos: provas e funções, com postura e dor. 4.ed. São Paulo: Manole, 333-339.
  • MONTUFAR HUASASQUICHE, Diego Alonso. Distonia cervical: Tratamento Fisioterapeutico. 2017. Universidad Inca Garcilaso De La Vega.
Clinical review:
Marcelle Pinheiro
Physiotherapist
Physiotherapist degree provided by the University of Estácio de Sá (Brazil). Licensed to practice under CREFITO #170751.