How long does the treatment take?
The duration of the symptoms and the chances of a complete cure depend strongly on the cause of the torticollis. An acute torticollis as well as the bacterially caused infectious torticollis can be completely cured within a short time. The acute torticollis usually disappears after a few days.
In the case of infectious torticollis, the duration until recovery depends on the prescribed antibiotic therapy. This usually takes about 2 weeks. Unfortunately, many forms of torticollis cannot be completely cured because the underlying cause cannot be eliminated. For this counts for example the spastic torticollis. However, the symptoms can be contained by treatment in order to limit the patient’s quality of life as little as possible.
Symptoms of a torticollis
In general, patients often complain about a malposition of the head to the neck. This malposition is either caused organically, e.g. by a muscle that is too short, or it is taken actively, e.g. to spare an irritated nerve.
For this reason, a torticollis can occur with or without pain, but in all cases it is an unpleasant situation that makes seeing and communicating with other people considerably more difficult.There are many different outer forms of the wryneck, all of which have their own name, depending on how the neck and head are related. Among them are: Classically, one does not observe an isolated form, but a combination of several of these movements.
- The Laterocollis, where the head is tilted either to the right or left towards the shoulder
- The rotatory torticollis, where the head moves permanently, as if you were shaking it
- The Anterocollis, where the head and neck are tilted forward
- Retrocollis with the head and neck tilted backwards
Causes of a torticollis
A torticollis can have many different causes, some of them can be congenital, others are acquired only in the course of life. Therefore, a general distinction is made between congenital and acquired forms of torticollis. Congenital muscular torticollis (Torticollis muscularis congenitus) The causes of a congenital torticollis are not yet fully understood, but it is believed that the congenital torticollis is caused either by an incorrect position of the embryo in the mother’s abdomen or by various traumas during birth.
This almost always affects one of the two large lateral neck muscles (Musculus Sternocleidmastoideus). The muscle can be damaged by various mechanisms, whereupon it is often shortened and rebuilt into connective tissue, i.e. its function decreases. Normally, both muscles pull the head with the same force and thus fix it to the neck.
However, if one of the muscles is weakened or shortened as a result of the injury, an imbalance between the two muscles occurs; a torticollis is formed. The shortening of a muscle causes the head to tilt in this direction. At the same time, the head turns in the other, healthy direction.
Even simple damage to this neck muscle, for example due to trauma during birth, can cause a torticollis. Usually the torticollis disappears by itself when the bruise in the muscle disappears after a few weeks and thus both muscles have the same strength again. In most cases, the torticollis is not noticed in the newborn immediately after birth, but only after 7 – 10 days.
It is particularly noticeable during sleep, as newborns with torticollis always keep their head in the same position when sleeping. Acquired torticollis The acquired torticollis develops in the course of life and can have many different causes. Among the most common causes of acquired wryneck are
- Bony disorders
- Inflammation of the salivary glands and tonsils
- Different forms of rheumatism
- Abscesses or
- Brain Tumors
In osseous torticollis, a malformation or malposition of the bones in the neck region is the decisive cause of torticollis.
There are many different causes of osseous torticollis, the most common being vertebral injuries and vertebral fractures that subsequently heal in a malposition rather than straight. Since the bony structure is responsible for most of the fixation of the head to the trunk, even small deviations in healing from the normal axis can lead to an osseous torticollis. If the torticollis is due to an inflammation of the soft tissues of the neck (larynx, tonsils or salivary glands), it is called an infectious torticollis.
The cause is usually a bacterial infection. The infection causes swelling and pain, which often leads to the head being brought into a relieving position that is similar to a tilted position. In spastic torticollis, the head is not permanently tilted to one side, but there are recurring movements of the head to one side, i.e. spasticity.
A spastic torticollis is more common in children than in adults. The most common causes of a spastic torticollis are brain damage as a result of an accident or due to an inflammation of the brain (encephalitis). This then leads to spasms in the neck muscles (tonic-clonic spasms).
The acute torticollis, often referred to as stiff neck in the vernacular, can have various causes. Often, the acute torticollis is caused by severe muscle tension as a result of poor posture or strong drafts, and the resulting torticollis is more of a relieving posture so as not to strain the muscle further. This usually disappears by itself within a few hours or days.However, an acute torticollis can also occur in connection with a cervical spine syndrome (cervical spine syndrome).
In this case, certain nerves (meningeal nerves) are irritated by wear and tear (degenerative changes) in the cervical spine area, which causes the affected patient to automatically tilt the neck to the side. If this relieving posture is taken for some time, this leads to additional extensive tension of the muscles in the shoulder and neck area.
- Osseous torticollis
- Inflammatory torticollis
- Spastic wryneck (Torticollis spasticus)
- Acute torticollis (Torticollis acutus)
The rheumatic torticollis appears just like the acute torticollis usually suddenly.
The cause of rheumatoid torticollis is severe pain in the vertebral joints, caused by rheumatic inflammation. In order to avoid further pain, the patients take a relieving posture here as well. As the name suggests, the causes of scar torticollis are scars in the neck area.
However, scar torticollis only occurs if the scar tissue makes up a large part of the neck. Causes of scar torticollis can be injuries, burns or accidents of all kinds with scarring as a consequence, but also larger surgical interventions in the neck area. A wryneck can also often be caused by the fact that a patient often adopts the same posture, for example, sales assistants at the cash register who always look in the same direction.
After some time, this temporary posture at work can change into a fixed incorrect posture, which can cause neck and back pain. If a patient complains of unilateral hearing loss, a torticollis often develops to compensate for the hearing loss. (Torticollis acusticus) Vision problems can also be the cause of a torticollis (Torticollis opticus). If, for example, an eye muscle is paralyzed and eye movements are disturbed, the affected person can try to straighten the field of vision through a torticollis opticus.
- Rheumatoid torticollis rheumaticus
- Scar torticollis (Torticollis cutaneus)
- Other shapes
