Torticollis
Over 45,000 infants are born with congenital torticollis in the US each year. This
twisted or tilted neck, the so-called “fixed wry neck” is often ascribed to problems
during birth. The condition causes painful, involuntary spasms; impedes normal growth
and development and disturbs vision. The medical approach to this condition is often
surgery on neck muscles, nerves and tendons, and intensive physical therapy and drug
therapy.
Chiropractic correction of congenital muscular torticollis. Toto BJ. J Manipulative
Physiol Ther 1993 Oct;16(8):556-9
- OBJECTIVE: To present a case of congenital muscular torticollis and discuss the clinical
manifestations and chiropractic treatment.
- CLINICAL FEATURES: A 7-month-old male infant with significant head tilt since birth
was brought to a chiropractic physician for evaluation. The infant's history included
ear infections, facial asymmetry and regurgitation. Significant spasm of the left
sternocleidomastoid and trapezius muscles, a left lateral atlas and suboccipital
joint dysfunctions were present upon examination. A diagnosis of congenital muscular
torticollis was made.
- INTERVENTION AND OUTCOME: Treatments included chiropractic manipulation, trigger
point therapy, specific stretches, pillow positioning and exercises. Excellent results
were obtained.
- CONCLUSION: Suggests that chiropractic intervention is a viable treatment option
for congenital muscular torticollis. Further studies should be performed to compare
the effectiveness of other treatment options.
PMID: 8263436 [PubMed - indexed for MEDLINE]
Congenital muscular torticollis: a review, case study, and proposed protocol for
chiropractic management. Colin N. Topics in Clinical Chiropractic, September 1998:volume
5, number 3, pp27-33.
- A 7-month-old child subject became more confident and responsive, had better motor
control, and his head centered rather than being twisted and tilted after chiropractic
care.
Chiropractic care of the newborn with congenital torticollis. Fallon JM and Fysh
PN. Journal of Clinical Chiropractic Pediatrics Vol 2, No.1 1997. P. 113-115.
- Congenital torticollis has been estimated to affect approximately two percent of
newborn infants. The frank breech birthing position has been reportedly associated
with the highest incidence of torticollis, with up to 34 percent of infants born
in this position being affected…the most common type of congenital torticollis is
that associated with subluxation of the upper cervical spine. Chiropractic management
of congenital torticollis is primarily directed at reducing cervical spine subluxations,
which have been identified as commonly present with this condition…. Chiropractic
management of congenital torticollis, using a combination of spinal adjustments,
cranial re-alignment and soft tissue therapies can produce rapid resolution in many
cases of congenital torticollis and plagiocephaly (an asymmetrical and twisted condition
of the head and face due to irregular closure of the cranial sutures, frequently
occurs in con-junction with congenital torticollis) in the newborn infant. Spinal
adjustments have been demonstrated to be efficacious to the resolution of the congenital
torticollis…. The medical approach to a protracted torticollis is surgical intervention.
While surgical intervention is typically a solution of last resort, it is frequently
the only solution considered by the medical community. Chiropractic care is considered
essential to the health and maintenance of the child’s spine and nervous system.
It is therefore important that the doctor of chiropractic become part of the multi-disciplinary
team and that medical doctors become aware of chiropractic management as a solution
to the most common causes of congenital torticollis.
Congenital muscular torticollis: a review, case study, and proposed protocol for
chiropractic management. Colin N. Top Clin Chiro (1998); 5(3):27-33.
- From the abstract: A case study of a 7-month-old infant who had been medically diagnosed
with the disorder as birth-trauma related. Summary: Six sessions of chiropractic
management involving low force adjusting and gentle myofascial release work were
administered based on clinical mechanical findings derived from an apparent right
hand and right leg dominance of the child. The child had not previously responded
to several weeks of physical therapy. Following chiropractic care, the case completely
resolved. The response was sustained at 1year follow-up.
Pediatric traumatic torticollis: a case report. Moore TF, Pfiffner TJ, Journal of
Clinical Chiropractic Pediatrics Vol. 2, No. 2 1997.
- This is the case of a 4 year old male child who sustained a moderate trauma (falling
off a bed landing head first) with left lateral head tilt and right lateral rotation
the “cock robin” position that is typical or atlantoaxial rotary fixation.
- Results: Two weeks following the spinal adjustment, the patient returned to the clinic
reporting that complete resolution had occurred and no clinical signs or symptoms
were present to substantiate further radiographic study.
- From the conclusion: “Any child presenting with a recent upper respiratory infection,
sore throat, otitis media or minor trauma with torticollis is a candidate for consideration
of atlanto-axial rotary fixation.”
Chiropractic adjustments and congenital torticollis with facial asymmetry: a case
study. Hyman C.A. ICA Review September/October 1996. Pages 41-45.
- A two-month-old black female presented with obstetrical brachial plexus injury (Erb’s
palsy) who had been under the care of several medical pediatricians without resolution.
The condition showed complete resolution under chiropractic care without any complica-tions
or residual impairments.
Kinematic imbalances due to suboccipital strain in newborns. Biedermann H. J. Manual
Medicine 1992, 6:151-156.
- More than 600 babies (to date) have been treated for suboccipital strain. One hundred
thirty-five infants who were available for follow-up were reviewed in this case series
report. The suboccipital strain’s main symptoms include torticollis, fever of unknown
origin, loss of appetite and other symptoms of CNS disorders, swelling of one side
of the facial soft tissues, asymmetric development of the skull, hips, crying when
the mother tried to change the child’s position, and extreme sensitivity of the neck
to palpation. 78 to 79 infants with torticollis responded favorably to a short course
of conservative chiropractic care. Most patients in the series required one to three
adjustments before returning to normal. “Removal of suboccipital strain is the fastest
and most effective way to treat the symptoms...one session is sufficient in most
cases. Manipulation of the occipito-cervical region leads to the disappearance of
problems....” 181
Chiropractic correction of congenital muscular torticollis. Toto BJ. JMPT. 1993:16:556-559.
- This is the case of a 7-month-old male infant with significant head tilt from birth.
The child’s health history included ear infections, facial asymmetry (flattening
of left side of face) and regurgitation (15 times per day), projectile vomiting (about
once each week), spasm of the left SCM muscle, left trapexius muscles, a left lateral
atlas and suboccipital joint dusfunctions. The child cried frequently and rarely
laughed. Diversified chiropractic adjustments were performed three times a week for
three months. After 5 months of chiro-practic care head tilt and associated muscle
spasm were absent with dramatic improvement in child’s general demeanor. Regurgitation
became much less frequent with some residual facial asymmetry remaining.
Chiropractic Care of the Newborn with Congenital Torticollis, Fallon, JM, Fysh, PN
Journal of Clinical Chiropractic Pediatrics.
- From the abstract: Chiropractic management of congenital torticollis using a combination
of spinal adjustments, cranial re-alignment and soft tissue therapies can produce
rapid resolution in many cases of congenital torticollis and plagiocephaly in the
newborn infant. Spinal adjustments have been demonstrated to be efficacious to the
resolution of the congenital torticollis. Before commencing a course of conservative
spinal care however, accurate identification of the cause of the torticollis must
be made to rule out complicating conditions which may result in high morbidity or
mortality. The typical course of spinal adjustments for torticollis is usually of
short duration requiring just a few treatments. Early correction of congenital torticollis
should be the goal since prolonged contraction of the SCM can be the cause of cranial
and facial anomalies as well as scoliosis. The medical approach to a protracted torticollis
is surgical intervention. While surgical intervention is typically a solution of
last resort, it is frequently the only solution considered by the medical community.
Chiropractic care is considered essential to the health and maintenance of the child’s
spine and nervous system. It is therefore important that the doctor of chiropractic
become part of the multi-disciplinary team and that medical doctors become aware
of chiropractic management as a solution to the most common causes of congenital
torticollis.
Blocked atlantal nerve syndrome in infants and small children. Gutman G. ICA Review,
1990; July:37-42. Originally published in German Manuelle Medizin (1987) 25:5-10.
- From the abstract: Three case reports are reviewed to illustrate a syndrome that
has so far received far too little attention, which is caused and perpetuated in
babies and infants by blocked nerve impulses at the atlas. Included in the clinical
picture are lowered resistance to infections, especially to ear-,nose-, and throat
infections, two cases of insomnia, two cases of cranial bone asymmetry, and one case
each of torticollis, retarded locomotor development, retarded linguistic development,
conjunctivitis, tonsillitis, rhinitis, earache, extreme neck sensitivity, incipient
scoliosis, delayed hip development, and seizures.
Pediatric Torticollis with Allergies and Head Injury; A Case Study
by Nancy Molina,DC
Understanding Torticollis
by Peter Fysh
Congenital Muscular Torticollis
by Warren Hammer, MS, DC, DABCO