From the FDA Drug Label
Cyclobenzaprine hydrochloride tablets are indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions The recommended treatment for acute torticollis may include cyclobenzaprine as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions, such as torticollis 1.
- Key points:
- Use cyclobenzaprine for short periods (up to two or three weeks)
- Rest and physical therapy are also recommended
- Cyclobenzaprine is used for relief of muscle spasm and its associated signs and symptoms.
From the Research
The recommended treatment for acute torticollis is botulinum toxin injections, which have been shown to be safe and effective in reducing symptoms and improving quality of life. According to the most recent and highest quality study 2, botulinum toxin injections have an overall effective rate of 84% in treating congenital muscular torticollis, with a low adverse reaction rate of 1%.
Treatment Approach
The treatment approach for acute torticollis should prioritize reducing inflammation, relaxing contracted muscles, and gradually restoring normal range of motion to the neck. This can be achieved through:
- Botulinum toxin injections, which can be used to relax the affected muscles and improve posture and range of motion
- Gentle stretching exercises, which should be performed several times daily to improve flexibility and reduce muscle spasms
- Physical therapy, which may be beneficial for persistent cases to improve range of motion and strength
Key Considerations
When treating acute torticollis, it is essential to:
- Avoid sudden movements and maintain proper posture during recovery to prevent exacerbation of symptoms
- Monitor for adverse reactions, such as injection site erythema and transient dysphagia, which are common with botulinum toxin injections
- Consider the use of pain management and muscle relaxation techniques, such as over-the-counter pain relievers and muscle relaxants, to reduce discomfort and improve outcomes
Evidence-Based Recommendations
The evidence-based recommendations for treating acute torticollis are based on the most recent and highest quality studies, including 2, which provides strong evidence for the effectiveness and safety of botulinum toxin injections in treating congenital muscular torticollis. Other studies, such as 3 and 4, also support the use of botulinum toxin injections in treating torticollis, but are less recent and of lower quality.