What are the treatment options for torticollis (wry neck)?

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Last updated: May 17, 2025View editorial policy

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From the Research

Treatment for torticollis should prioritize botulinum toxin injections, as they have been shown to be a safe and effective treatment option, providing significant relief by temporarily paralyzing overactive muscles, as demonstrated in the most recent and highest quality study 1.

Overview of Treatment Options

Torticollis treatment typically involves a combination of physical therapy, medication, and in some cases, surgical intervention. Physical therapy is the cornerstone of treatment, focusing on stretching exercises to improve range of motion and strengthen neck muscles.

  • These exercises should be performed daily, with each stretch held for 30-60 seconds and repeated 5-10 times.
  • Medications commonly prescribed include muscle relaxants such as baclofen (10-25 mg three times daily) or cyclobenzaprine (5-10 mg three times daily), and pain relievers like ibuprofen (400-800 mg every 6-8 hours) or naproxen (250-500 mg twice daily).

Role of Botulinum Toxin Injections

Botulinum toxin (Botox) injections have emerged as a highly effective treatment for torticollis, especially in cases resistant to physical therapy alone.

  • The use of combined botulinum toxin and physical therapy has been shown to provide correction and avoid more invasive surgery, with significant improvement in both head tilt and range of neck motion, as reported in the study 1.
  • The proposed minimally invasive protocol provided correction of resistant congenital muscular torticollis and obviated the need for more invasive surgical procedures.

Considerations for Treatment

When considering treatment options for torticollis, it is essential to prioritize the most recent and highest quality evidence, which supports the use of botulinum toxin injections as a safe and effective treatment option.

  • Early intervention typically yields better outcomes, and a combination of physical therapy and botulinum toxin injections can provide significant relief and improve quality of life for patients with torticollis.
  • The study 1 demonstrated that no patient required tendon lengthening surgery, and caregivers were satisfied with the treatment protocol, highlighting the effectiveness and safety of this approach.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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