Torticollis, also known as wryneck (a direct translation), is a condition characterised by the neck being titled upwards and towards on side so that the chin is exposed, similar to the position a dog might look when trying to look cute. This can be congenital (meaning it is that way from birth) or acquired, however even congenital wryneck is considered often to be the result of a birth trauma which damages the sternocleidomastoid muscle in the neck, which results in a shortening or excessive contraction in one side of the neck.
However acquired torticollis can have many causes. This could be the result of a bad or uncomfortable bed, a tumour at the base of the skull or the side effects of antipsychotic drugs. Of course torticollis may also be caused by injury which damages the neck region, for example by trauma to the vertebrae closest to the skull to slide and tear their stabilising ligaments. Infection can also cause torticollis when it affects the posterior pharynx as it irritates the nerves connected to the neck muscles, or the ears.
Torticollis should not be mistaken for a head tilt which is a tendency to tilt the head in a similar way usually unconsciously. This can be a symptom of double vision or ‘diplopia’, where both eyes are not perfectly aligned as a result of differences in the muscle. Some people also have a psychological tendency to tilt their head which often is an unconscious behaviour.
Wryneck should be treated early on to prevent facial asymmetry from developing as well as further neck and muscular problems. Facial asymmetry will develop in children under the age of 18 if it is not addressed, and correcting the problem can actually undo any damage done to the symmetry if it is caught before this age. Usually wryneck will be treated with physiotherapy to realign the muscles and correct the head position, but in around 10% of cases will need to be treated with surgery. Of course other treatments will reflect the cause of the problem and for example antibiotics will be used to treat infections while the tumours may have to be removed. Interestingly some bloggers are currently suggesting that Barack Obama may have wryneck or a head tilt – check out one of his speeches and see what you think!