Wry Neck: Causes and Treatment

Does your baby tilt his or her head to one side for extended lengths of time? It could be a sign of a condition known as wry neck or congenital muscular torticollis.

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What is Congenital Muscular Torticollis?

Congenital muscular torticollis, commonly known as wry neck or twisted neck, is a condition in which an infant holds his or her head tilted to one side and has difficulty turning the head to the other side.

Causes of Wry Neck 

The causes of congenital muscular torticollis are unclear but, in some cases, it can be due to birth trauma or packing disorder. Packing disorder refers to a first-born baby who weighs more than 4kg at birth with decreased fluid space surrounding the baby while he or she is still in the womb. 

These factors can damage the sternocleidomastoid muscle (SCM) in the neck, which controls the rotation of the head to the opposite side and flexion of the neck. 

Some secondary causes of congenital muscular torticollis include:
Squint
Plagiocephaly
Cervical spine problems
Brachial plexus injury

Symptoms of Wry Neck

To deduce if your child may have congenital muscular torticollis, keep a lookout for these common symptoms. They may begin to show slowly and worsen over time if left untreated.
Your child’s head is tilted to the right or left
Your child may have a preference for looking only right or left 
A flattening of your child's head and face due to his or her preference for specific head positions
Tightness of the SCM 
A soft lump or tumour in the SCM

To assess and confirm your child’s condition, the doctor will conduct one of the following tests:
An orthopaedic assessment
Ultrasound scan to investigate and measure the tumour or lump in your child’s neck
An X-ray scan of your child’s spine to check for a bone disorder

Complications of Wry Neck in Babies

Some complications that may arise from congenital muscular torticollis are:
Plagiocephaly, also known as flat head syndrome
Facial asymmetry
Contracture of SCM

Risk Factors for Wry Neck in Babies

Some factors that may increase the risk of wry neck in babies are: 
Being born female
Being newborn and being under the age of 10
Family history of torticollis or a similar disorder
Twin/multiple pregnancies

Treatment Options for Wry Neck 

Usually, children below the age of one are referred to physiotherapy for stretching and strengthening exercises. The soft lump in their neck can be self-resolving. In severe or unresolved cases, usually among those older than a year old, surgery to lengthen the SCM muscle may be necessary.

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Wry Neck: Causes and Treatment

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