What's the treatment for torticollis?
Treatment of congenital torticollis involves stretching the shortened neck muscle. Passive stretching and positioning are treatments used in infants and small children. Surgical sectioning of the neck muscle may be done in the preschool
years, if other treatment methods fail.
Acquired torticollis is treated by identifying the underlying cause of the disorder. Application of heat, traction to the cervical spine, and massage may help relieve head and neck pain. Stretching exercises and neck braces may help with muscle spasms.
Drug treatments include anticholinergic drugs (baclofen). Injection of botulinum toxin is very effective to temporarily relieve the torticollis, but repeat injections every three months are usually required. Surgical treatments are rarely used. For a subgroup of patients, L-dopa provides effective relief. Denervation of the involved neck muscles may be performed with injection of alcohol or phenol on to the nerve.
Injection of botulinum toxin (BTX) is considered by many to be the treatment of choice. By preventing release of chemical messages from the nerve endings that stimulate the involved muscles, BTX partially paralyzes the muscles, therefore allowing more normal posture and range of motion. BTX treatment lasts several months, and may be repeated.
Physical therapy can help relieve secondary consequences of torticollis. Regular muscle stretching prevents contracture, or permanent muscle shortening. Pain and spasm may be temporarily lessened with application of heat or ice. Stress management techniques may help prevent worsening. An occupational therapist can suggest home or work modifications to reduce fatigue and improve function. Braces constructed to replace the patient's own sensory tricks may help reduce abnormal posture. |
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