Wryneck

What is it

Torticollis is a painful condition that restricts head movements, caused by contracture of the neck muscles.

There are various forms of torticollis, from that linked to trivial events, to those, rarer and more serious, congenital and spastic.

Causes

In the vast majority of cases, stiff neck is due to:

• sharp head movements;
• a wrong posture maintained for too long;
• a sudden cooling of the neck muscles (the classic “air stroke”);
• a state of anxiety that leads and stiffens the muscles of the neck and shoulders.

Sometimes at the origin of the disorder there can be a predominantly inflammatory problem or linked to a trauma to the joints, as in the case of “whiplash” following a car accident.

Congenital torticollis may be due either to an abnormal structure of the sternocleidomastoid muscle (myogenous) or to a malformation of the cervical vertebrae (osteogen).

Spastic torticollis, finally, can be the consequence of either a congenital torticollis, or of muscular or neurological suffering.

Most common symptoms

The main symptom is painful spasm in the neck muscles.

In spastic torticollis, there is a deviated posture of the head and sudden muscle spasms may occur, which cause abrupt rotations of the head.

Prevention

It is good to avoid maintaining a fixed and rigid posture for more than half an hour. When sitting at the desk it is good to use an ergonomic chair that allows you to look at the computer screen with your eyes slightly down. It is also good to keep your arms slightly resting on the desk top.

You are more rarely affected by torticollis if you perform regular physical activity, so as to keep all your muscles trained.

Treatment

Depending on whether the contracture or inflammatory component prevails in the torticollis, the part can be kept warm (with a scarf) or cold (with an ice bag) respectively.

In any case, you can relieve the discomfort by resorting to ointments and gels based on drugs that combine anti-inflammatory properties with analgesic ones, such as NSAIDs (ketoprofen) or, on the advice of the doctor, taking muscle relaxants.

In fact, in case of torticollis, anti-inflammatories for external use are widely used, such as those based on ibuprofen 10% lysine salt: they guarantee a good level of absorption greatly reducing the risk of side effects.

Applied externally, in fact, these NSAIDs do not arrive, except in small quantities, in the circulatory stream and therefore give few general side effects. In addition, they reach high concentrations at the site of action, i.e. the inflamed and painful muscle.

Massages and self-massages should generally be avoided, both because if they are not correctly performed they can worsen the situation, and because in some cases, as in whiplash, it is not appropriate to alleviate the contracture, which in this case has a protective function, before the absence of joint damage or the possible application of a brace (“collar”) has been ascertained.

Treatment of spastic torticollis may also include botulinum toxin injections and, in some cases, surgery, which may also be necessary in cases of congenital torticollis.