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known as "wryneck," is a condition in which your baby's head is tilted. The
chin points to one shoulder, while the head tilts toward the opposite shoulder.
Treatment is necessary to prevent your baby's face and skull from growing
unevenly and to prevent limited motion of the head and neck.
"Congenital" means a condition that is present at birth. Congenital
torticollis occurs at or shortly after birth.
See a picture
of congenital torticollis.
torticollis occurs when the neck muscle that runs up and toward the back of
your baby's neck (sternocleidomastoid muscle) is shortened. This brings your
baby's head down and to one side. This is known as congenital muscular
Experts don't know exactly what causes the shortened neck muscle. The muscle may get injured before or during the baby's birth. The injured muscle may bleed and swell. And scar tissue may replace some of the muscle, making it shorter.
Some cases of
congenital torticollis are caused by a bone problem in the neck portion of the
spine (cervical spine). This is known as a congenital
malformation of the cervical spine.
also occur later in life, but this is not congenital torticollis.
Your baby's head is tilted
to one side. The chin points to one shoulder, and the head tilts toward the
opposite shoulder. Usually the head tilts to the right and the chin points
left, meaning the muscle on the right side is affected. You may notice that
your baby cannot move his or her head as well as other babies. You may also
notice a lump in your baby's neck muscle.
caregiver usually first notices that the infant always holds his or her head
tilted to one side. Be sure to see your doctor for an
exam, because other conditions may also cause this head position.
Your doctor will examine your baby and may ask you
questions about your baby's birth. He or she may want an
X-ray of the cervical spine to rule out bone problems.
Your doctor may also check your baby's hips. Some babies who have congenital torticollis also have an
abnormal development of the hip (hip dysplasia).
To treat congenital torticollis, you'll learn to stretch your baby's tight neck muscle several times a day. Your doctor or a
physical therapist will teach you how to safely do the exercises.
Another way to help you stretch your baby's neck
is to do things so that he or she rotates the chin toward the shoulder of the
affected side. For example:
If your baby does not improve after a
few months of stretching, contact your doctor. There
may be another problem, or surgery may be needed to stretch or lengthen the
The lump in the muscle usually goes away on its
If the congenital torticollis is not caused by a shortened
neck muscle but by a cervical spine abnormality, the spine abnormality is
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
Other Works Consulted
Loder RT (2006). The cervical
spine. In RT Morrissy, SL Weinstein, eds., Lovell and Winter's Pediatric Orthopaedics, 6th ed., vol. 2, pp. 871–919. Philadelphia:
Lippincott Williams and Wilkins.
Mercier LR (2008). The cervical
spine. In Practical Orthopedics, 6th ed., pp. 29–43.
Staheli LT (2006). Upper limb.
In Practice of Pediatric Orthopedics, 2nd ed., pp.
227–240. Philadelphia: Lippincott Williams and Wilkins.
July 26, 2013
John Pope, MD - Pediatrics & Robert B. Keller, MD - Orthopedics
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