What is torticollis?

Torticollis is a painful and uncomfortable neurological condition. About three out of every 10,000 babies have torticollis.

There are many causes of torticollis, including poor fetal posture in the mother's belly, long-term overcrowding in the uterus for twins, and primary muscular hypertrophy and shortening.

The main symptoms are intermittent or persistent neck muscle contractions resulting in pain in the neck muscles and the head turned to one side. In addition to limited head rotation, it is often found that the baby with torticollis is willing to turn only one side, but not the other side, and his/her face and eyes are asymmetrical. 

The sooner treatment begins for torticollis, the better the hope of a cure. If appropriate physical therapy is given within 6 months, the prognosis is usually good and there may even be no sequelae.

Physical therapy focuses on correcting a head tilt, increasing muscle elasticity and flexibility, increasing neck mobility, and eliminating muscle lumps. If treated before the age of one, 70 percent of patients do not need surgery. If the treatment is significantly delayed, not only will surgery be required, but neck and face deformations are often irreversible.

In addition, parents' performance of home-based treatment can not only increase their baby's acceptance of treatment, but also appropriately enhance parent-child relationship. Here are some home care methods for parents’ reference:

Home care

• Hot compress: apply a warm towel to the affected side of the baby to relax its muscles, which can also be performed before massage or traction to reduce the uncomfortable feeling of the baby.
• Hard massage: giving a deep-tissue massage along a direction perpendicular to the muscles can loosen the tissue with excessive tension without applying too much force lest the pressure to the baby’s throat and trachea causes discomfort.
• Passive pulling movement: A baby diagnosed with right torticollis will have its head turned to the right and then to the left, so the passive pulling movement is to push the baby's head to the left and then to the right. The baby with left torticollis moves in the opposite direction. When pulling, the baby can be in a supine position, first fix its shoulder, turn its face to the affected side, and then to the opposite side.
• Active action guidance: use voice or colorful toys to draw the baby to turn its head to the affected side.
• Proper positioning for a long time: when your baby is sleeping, try to make it sleep on its stomach with the ear on the affected side facing up. When holding your baby and feeding, hold it with right torticollis in the left hand and left torticollis in the right hand, so that the baby can hear its mother's voice and actively turn the head to the right position. Or place the toy on the affected side, and put the bed against the wall (wall on the healthy side of the baby) so that the light source is on the affected side.

Instructions for daily life (for left torticollis)

• Let the baby lie flat on its stomach and sleep, with the ear of the affected side facing up and turn 90 degrees to lengthen the muscles. (Figure 1).
• When picking up the baby, keep the affected side facing down and pull the shortened muscles along the way; or hold it in your chest to turn the baby's head to the affected side to pull the shortened muscles. (Figures 2.3).
• Music, toys and lights are placed on the affected side, or the family members go to the affected side to attract it to turn around.