Have you ever noticed that your baby's head is tilted to one side, or their chin is turned to the other side? Sometimes, parents get a little worried when their little one is like that. What is the reason for this, is this something serious? That's the condition we're going to talk about today, called torticollis. This is something that many mothers can experience. So, let's learn more about it without fear.
What is Torticollis?
Simply put, torticollis is a condition in which the muscles in your baby's neck cause their head to be twisted and tilted to one side. It may look like their neck is twisted in an odd way. The top of their head may be tilted to one side, and their chin may be tilted to the other. This is also called 'wryneck'. The word 'torticollis' comes from the Latin word 'tortus', which means 'twisted', and 'collum', which means 'neck'. So it means 'twisted neck' .
This is actually a common condition among babies and young children. It's usually nothing to worry about. There are two main types of torticollis:
1. Congenital Torticollis: This means that this condition is present at birth.
2. Acquired Torticollis: This can occur after birth, sometimes within a few months of the baby's birth or later.
A little more about Congenital Torticollis
This type of torticollis, called congenital torticollis, is the most common type of torticollis in babies. The best part is that it usually doesn't cause any pain to the baby. You may not even notice it until a few weeks after your baby is born. You may only notice this condition when your baby gradually gains control of their head, which means their neck becomes stronger.
Let's also learn about Acquired Torticollis.
The other type, acquired torticollis, usually occurs during the first four to six months of a baby's life or later. It can appear suddenly or develop gradually. Sometimes acquired torticollis is harmless and will go away on its own. However, sometimes it can be a sign of a more serious health problem. That's why it's important to be aware of it.
What are the symptoms of torticollis?
Now let's see what symptoms a baby may exhibit if they have torticollis. These symptoms are more common in the congenital type, but in the acquired type, other symptoms may also be present.
- Your baby's head is tilted to one side and the chin is turned to the other. This is the main symptom.
- The baby may have difficulty turning his head and neck . It may seem as if the range of motion of the neck is limited. For example, when you show him a toy, he may easily turn his neck to one side, but may be reluctant to turn it to the other side.
- One of the baby's shoulders appears to be higher than the other .
- Neck muscles feel stiff or tight .
- Sometimes the neck muscles appear swollen.
- A small, pea-sized lump in one of the muscles in the baby's neck. This doesn't happen to all babies, but some may.
- Asymmetrical facial features.
In acquired torticollis, these symptoms may be accompanied by other symptoms, for example:
- As mentioned above, difficulty tilting the head and turning the neck.
- Sometimes this can be accompanied by severe neck pain . The baby may cry frequently and be restless.
- Head tremors.
- Headache (although this may be difficult to explain to young children, you can tell by their behavior).
Why does this torticollis occur? What are the causes?
Okay, now you're probably wondering why this happens to these little ones. Let's look at the reasons for it. The reasons for this vary depending on the type.
Causes of Congenital Torticollis
Congenital torticollis is often caused by a shortening of a muscle in your baby's neck called the sternocleidomastoid muscle (SCM) . The SCM are two large, important muscles on either side of our neck. They connect to the sternum and clavicle at the back of the head. Think about it, these muscles help us turn our necks, bend our necks, and tilt our heads to one side. So if one of these two muscles is shortened for some reason, the neck will be pulled in that direction, and the head will turn to the other side.
Researchers are still not sure why this muscle shortens in some babies. But here are some of the reasons they think it might be:
- Your baby's position in the womb can affect this. He may be stuck to one side due to lack of space in the womb.
- This may be an abnormal development of the SCM muscle.
- The baby's neck muscle may have a collection of blood (hematoma) , which is like a small bruise, and the muscle may shorten as it heals.
- It may be due to abnormal thickening of the baby's muscle tissue (fibrosis) .
- It could be due to a rare birth defect called Klippel-Feil syndrome , in which the baby's vertebrae in the neck are fused together.
Causes of Acquired Torticollis
Acquired torticollis is often caused by swelling in your child's neck . This swelling causes the tissues around the child's upper spine to become loose. This can cause the vertebrae to move slightly out of their normal position. This can cause the neck muscles to spasm and the head to tilt to one side.
This swelling can be caused by:
- An infection , for example, a throat infection or tonsillitis.
- Even an injury , even a minor accident to the neck.
- Sometimes it may not be possible to find a reason .
There may be other reasons:
- Gastroesophageal reflux disease (GERD) is a condition in which the stomach acid comes up into the esophagus. This can also be seen in young babies.
- Vision problems . If you have poor vision in one eye, you may need to turn your head to one side to see with the better eye.
- As a reaction to certain medications .
- Because of scar tissue.
- An arthritis condition in the neck, called cervical spondylosis (this is common in adults, rare in children).
- Sandifer syndrome is a rare condition in which neck muscle spasms occur along with GERD.
- Grisel's syndrome is another rare condition. This is a complication that occurs after head and neck infections or after ear, nose, and throat (ENT) surgeries.
How does a doctor diagnose torticollis?
If you have any doubts about your baby's neck, don't panic and first see a pediatrician or a general practitioner. The doctor will first do a physical examination of the baby . He will check to see how far the baby's head is twisted or tilted. He will also feel the neck carefully, looking for any swollen or tight muscles, or for that pea-shaped lump I mentioned earlier. He will also check the range of motion of the baby's neck.
Depending on the severity of the condition, or if there is suspicion of another cause, your doctor may order further tests. For example:
- A neck X-ray . This can check for problems with the bones in the neck.
- A CT scan (Computed Tomography - CT scan) of the head and neck.
- An MRI scan (Magnetic Resonance Imaging - MRI scan) of the head and neck. These types of scans can provide a clearer picture of the muscles and soft tissues.
How is Torticollis treated?
The good news is that most of the time, this condition called congenital torticollis can be treated with stretching exercises and position changes. That sounds reassuring, doesn't it?
Your doctor or a physiotherapist will teach you how to stretch your baby's neck muscles. All you have to do is gently, repeatedly turn your baby's head to the other side and tilt it towards the shoulder opposite the side that is tilted. You should do this torticollis exercise several times a day. Over time, you can gradually increase these movements. Think of it as being gentle and loving, like handling a flower. Never press until it hurts.
Speaking of posture changes:
- When putting your baby to sleep (naps and bedtime), turn your baby's head to the opposite side, that is, the side that is tilted. However, you should never put your baby to sleep on their stomach, as this increases the risk of sudden infant death syndrome (SIDS). Always put your baby to sleep facing up.
- When your baby is awake, when you play with him, place the toys in a way that he can turn his head to the other side. For example, if your baby doesn't like turning his head to the right, you can talk to him from the left side and show him the toys.
- "Tummy time" is when your baby is turned to their stomach while they are awake. This helps strengthen the neck muscles. This is also important for babies with torticollis.
If these methods don't work, your doctor will refer you to a specialist .
Physical therapy may be recommended first. Other specialists include:
- Physiatrist: These are doctors who specialize in Physical Medicine and Rehabilitation (PM&R).
- Pediatric Neurologist: These are doctors who specialize in children's brain, spinal cord, and nerve disorders.
- Orthopedic Surgeon: These are doctors who specialize in the bones, joints, and musculoskeletal system. Sometimes, if there is no improvement after 6-12 months of exercise, surgery may be needed to lengthen the baby's SCM muscle. However, this is very rare.
Acquired torticollis is treated based on the underlying condition and to reduce symptoms. Treatment may include:
- Antibiotics if there is an infection.
- Botulinum toxin injections to relax tight neck muscles (this is also rare).
- Heat therapy .
- Massage .
- Neck braces or collars .
- Physical therapy .
Can Torticollis be prevented?
There is currently no known way to prevent congenital torticollis. It is caused by things that happen while the baby is in the womb. However, early treatment can prevent the baby's condition from getting worse. It can also prevent the need for surgery later.
"Start torticollis exercises as soon as possible, meaning within a few months of the baby's birth (usually within 2-3 months). Doing so can also prevent the possibility of long-term complications."
Avoiding things like infections that cause acquired torticollis can reduce the risk of developing that type of torticollis.
What should I expect if my child has torticollis?
Torticollis is a common condition in babies and young children. It can often be treated by simply stretching the baby's neck and changing the position. You should see a significant improvement in your baby's condition within a few months. If treatment is started early, that is, within the first 6 months, more than 90% of babies recover completely and do not develop any long-term problems.
What are the possible complications of torticollis?
If a baby has torticollis, and it is not treated properly, the muscles may not move properly, which can lead to facial deformity/asymmetry . This means that one side may be slightly flat, or the eyes and ears may be slightly out of alignment.
Another major complication that can occur is flat head syndrome, also known as plagiocephaly. As you know, the skull of a baby is very soft and easily deformed. So, when one side of the head is pressed against a surface for too long (for example, in a bed, in a crib), that pressure can cause that side of the head to flatten. This is what happens when babies with torticollis hold their heads to one side.
Also, if left untreated, it can have a small impact on the baby's motor development.
When should I see the doctor?
If your baby's condition doesn't improve after about a month with the neck stretching exercises and posture changes you're doing at home, be sure to see your doctor again. He or she can then decide whether further treatment is needed to correct the problem or whether you should refer them to a specialist.
And also,
- If the baby's neck pain seems to be getting worse.
- If the baby has a fever.
- If the baby refuses to eat or drink.
- If other new symptoms appear.
In cases like this, it's best to see a doctor as soon as possible.
Let's learn a little about other types of torticollis.
We've been talking about torticollis in babies for a while now, but there are also types of it that affect adults and sometimes even older children.
- Spasmodic Torticollis: This is a type of torticollis that occurs in adults. It is also called cervical dystonia . It is caused by sudden tightening (spasms) of the neck muscles. This causes the head to twist painfully to one side. The head may also tilt forward or backward uncontrollably. There is no permanent cure for this. It is sometimes treated with botulinum toxin injections.
- Acute Torticollis: This is something that comes on suddenly. If you wake up in the morning with a stiff neck and pain on one side, that's what it is. This stiffness causes the neck to twist to one side. It can be caused by minor neck sprains or minor irritations of the muscles. This condition usually doesn't require medical treatment. Pain relievers and rest can help relieve symptoms.
The most important things you need to remember (Take-Home Message)
It can be a bit disconcerting to see your baby's head tilted to one side. But remember, torticollis, a condition that most babies experience, is not painful. And, it can usually be treated with neck stretching exercises and posture changes.
The most important thing is to see a doctor as soon as you notice this condition and start treatment as soon as possible. If you do, your baby can recover quickly without any long-term problems. If you don't see the expected improvement with the exercises and other treatments you do at home, don't forget to visit the doctor again. Then he can see if your baby needs any further treatment. Your concern and quick action are the best medicine for your baby's recovery!
` Torticollis, wryneck, wryneck, congenital torticollis, acquired torticollis, SCM muscle, baby health, neck exercises
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