From the Research
Torticollis treatment should prioritize a combination of physical therapy, stretching exercises, and botulinum toxin injections for persistent cases, as evidenced by the most recent and highest quality study 1. The treatment approach for torticollis involves addressing the underlying causes of the condition, which can include muscle spasm, inflammation, and abnormal positioning.
- For acute torticollis, pain management using NSAIDs like ibuprofen or naproxen for 5-7 days can help alleviate symptoms.
- Applying heat therapy for 15-20 minutes several times daily can relax muscles, and gentle stretching exercises should be performed 3-4 times daily to improve range of motion.
- Physical therapy is often beneficial, focusing on cervical range of motion exercises and postural correction.
- In congenital torticollis, early intervention with stretching exercises and positioning is crucial, and for persistent cases, botulinum toxin injections may be considered to relax contracted muscles, as shown in the study 1, which demonstrated significant improvement in head tilt and range of neck motion in children with treatment-resistant congenital muscular torticollis.
- Surgery is rarely needed but may be an option for severe, treatment-resistant cases, as noted in the study 2, which highlighted the importance of postsurgical physical therapy management for children with severe congenital muscular torticollis. The use of botulinum toxin injections, as described in the study 1, has been shown to be a safe and effective adjunct to physical therapy in treating recalcitrant cases of congenital muscular torticollis, and can help avoid more invasive surgical procedures.
- The study 1 found that multiple botulinum toxin injections were utilized in 54% of patients, and no patient required tendon lengthening surgery, with significant improvement in both head tilt and range of neck motion at the final evaluation.
- The proposed minimally invasive protocol provided correction of resistant congenital muscular torticollis and obviated the need for more invasive surgical procedures, with caregivers reporting satisfaction with the treatment protocol.