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Congenital Torticollis

Our pediatric specialists are experts at identifying and treating congenital pediatric torticollis. Using a multidisciplinary approach, we address the cause and consequences of this common condition.

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What is Pediatric Congenital Torticollis?

Congenital torticollis is tightness of the largest muscle (sternocleidomastoid muscle) at the front of an infant’s neck that causes their head to turn or tilt to one side. Usually congenital torticollis is identified in the first few months of life and is the most common type of pediatric torticollis.  

Torticollis may be considered congenital or acquired. Under 1 year of age, it is more likely to be diagnosed as congenital torticollis. New onset tightness or spasms noted after 1 year of age should be evaluated by your child’s pediatrician to make sure they are referred to the correct specialist. They will rule out other potential underlying causes, such as paroxysmal acquired torticollis, trauma, bony-growth problems or illness.  

What are the signs and symptoms of Pediatric Congenital Torticollis?

  • Neck muscle tightness with a possible knot in the muscle
  • Head turns to one side more than the other
  • Head or face asymmetry (features of the face or head don’t line up)
  • Head tilt to one side
  • Eye gaze may be more in one direction 

How is Pediatric Congenital Torticollis diagnosed?

A comprehensive history and physical exam are usually enough to diagnose congenital torticollis. In rare cases, the doctor will order an X-ray to examine your child’s spine. An eye exam may also be recommended. 

What are the causes of Pediatric Congenital Torticollis?

Often the cause of neck muscle tightness in infants can’t be found. It may be related to your infant’s position in the womb, natural tightness of the neck muscle or trauma during birth. Occasionally, poor eyesight in one eye may cause your child to gaze more often in one direction, creating a neck muscle spasm. Children with Down syndrome, Morquio syndrome and Marfan’s syndrome may have torticollis more commonly. 

It’s important to have your child seen by a pediatrician if they have recently developed problems moving their neck or movement is becoming more difficult. A pediatric specialist can determine whether the neck tightness results from congenital torticollis or other conditions such as Klippel-Feil syndrome, infection, trauma, vision problems, gastroesophageal reflux (GERD) or cervical spine abnormalities. 

How is Pediatric Congenital Torticollis treated?

Your Children’s Health specialist will work closely with you to develop a plan to improve your child’s ability to move their neck. In most cases, congenital torticollis improves with a few months of physical therapy. If physical therapy doesn’t help, your child may be referred to pain management and rehabilitation (PM&R) for Botox or other treatments. If your child has persistent uneven face or head features because of the torticollis, they may also be referred for a helmet. 

Pediatric Congenital Torticollis Doctors and Providers

An experienced Physician Assistant and Physical Therapist will be an important part of your first visit. Your child’s care may include a referral to a Children’s Health PM&R specialist or an Ophthalmologist. Being a part of Children’s Health means access to highly coordinated care that will help put your child on the road to recovery as quickly as possible. 

Frequently Asked Questions

  • Is congenital torticollis linked to autism?

    Torticollis can result from any condition with persistent gaze to one side or is linked to muscle spasms.

  • Does congenital torticollis affect a child’s development?

    Neck muscle tightness that doesn’t go away may result in problems with eye gaze, head shape and the ability to turn the head. Although rare, severe cases of congenital torticollis can lead to balance concerns. 

  • How do you get congenital torticollis?

    Most cases of congenital torticollis don’t have an obvious cause. Any condition that limits neck motion or creates a need for prolonged gaze to one side could lead to neck muscle spasms. 

  • What happens if congenital torticollis is not treated?

    In rare cases where the neck’s movement is limited for a long time without medical help, a child could develop problems with eye gaze and head or face features that don’t line up. 

  • Can congenital torticollis cause speech delays?

    Congenital torticollis is not a direct cause of speech delays. If your child has speech concerns, they will need to be evaluated by a speech specialist and your pediatrician to determine why they have problems speaking.