Complaints & connections · borters.ch
In infants the early start decides, in adults it mostly passes by itself — and the creeping form is another matter.
Also known as: wry neck · torticollis · head tilted to one side · infant torticollis · postural torticollis
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The head stands permanently tilted to one side and mostly turned to the other. Several forms with very different courses are to be distinguished. In infants it is mostly a shortening of the large side neck muscle, often with a palpable thickening in it; it recedes under physiotherapy in the great majority, and an early start decides the outcome. In children a painful malposition occasionally appears after an infection of the upper airways and resolves under treatment. In adults an acute wry neck often arises overnight or after an unlucky movement, is very painful and mostly settles within a few days. A form of its own is the permanent, involuntary twisting from a disturbance of movement control — it begins creepingly, persists and needs a different treatment.
Position, carry and play so that the child looks to the difficult side of its own accord — put the light, the door and the voice on that side. Together with physiotherapy that is the treatment, and the earlier it begins the more complete the result. At the same time the shape of the head is watched, because a preferred lying side shapes it too.
The acute wry neck is painful but benign and mostly settles within a few days. Warmth, pain relief and cautious continued movement are more effective than immobilising; a collar tends to prolong rather than help.
Fever with a stiff neck, a malposition after an accident, accompanying double vision, difficulty swallowing, or a malposition that slowly increases over weeks and persists at rest — those are patterns that belong examined, because they do not fit the ordinary form.
Sleeping face down holds the neck turned all night — the commonest avoidable cause of a wry neck in the morning. The pillow height should hold the neck in line with the spine, in the position one actually sleeps in.
About half of head rotation comes from the atlas–axis joint, the rest is spread over the five vertebrae below. Bringing the chin to the chest and then turning largely switches off the lower ones — what remains comes almost only from above. A simple way to compare the sides.
A wry neck that worsens over weeks without a shortened muscle should be assessed. A deficiency is practically never behind it — medication, throat irritation or a movement disorder rather.
Congenital torticollis is palpated and observed: a firm band in the sternocleidomastoid, head rotation to one side only, often with a flattened back of the head. Ultrasound shows the muscle. No blood is drawn for this.
A sudden wry neck with fever and sore throat is not a posture matter. Then it is an inflammation in the throat, and the way leads straight to a doctor.
Congenital torticollis is a shortening in the muscle, not a deficiency. What helps is changing sides — when carrying, feeding and putting down.
In acute wry neck it is often taken because it feels like a cramp. An effect on it is not shown; the acute wry neck settles by itself within a few days, with or without. What reliably helps is warmth, pain relief and cautious continued movement.
Here the timing decides and not the ingredient: the earlier physiotherapy and positioning begin, the more complete the result. Infants receive vitamin D by recommendation anyway — that has nothing to do with the wry neck.
Acquired wry neck in adults is often a spasm rather than a shortened muscle. Spasms of this kind increase under tension and ease during sleep — that is a distinguishing feature.
Congenital torticollis has nothing to do with food — but it does with the side: when feeding, change sides consistently so the child turns its head both ways.
It is not the session that works but what continues at home afterwards. After four to six appointments you can judge whether anything is moving.
Heat for tense muscles, cold for fresh irritation. Neither changes the cause and both make the meantime bearable — that is an honest purpose.
Work on the short musculature under the occiput, usually in one session and without a thrust on the joint. No human studies exist; head rotation before and after is measurable.