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When Your Child Has Congenital Muscular Torticollis

Your newborn has congenital muscular torticollis, a harmless and very treatable condition. Congenital means present at birth. Torticollis is twisting or bending of the neck. In this case, the bending is due to a neck muscle that is too tight or too short. This muscle pulls on the head and causes the head to turn and bend to the side. Torticollis is also called “wry neck.” In certain cases, your child may see a pediatric orthopedist (doctor specializing in treating bone and joint problems in children) for an evaluation.Baby with head twisted to side and contracted muscle in neck.

What causes congenital muscular torticollis?

It is not clear why some children are born with muscular torticollis. Possible causes include:

  • Tightening of the neck muscle due to the position of the baby’s head in the uterus during pregnancy

  • Problem with the development of a muscle in the neck, causing it to be shorter than normal

  • Damage to a muscle in the neck during childbirth

What are the signs of congenital muscular torticollis?

The signs of this problem may be noticed at birth. Or it may not be noticed for a few days to weeks. The signs include:

  • Tilt of the infant’s head to the side of the tight muscle, with the chin turning toward the opposite side

  • A lump in the neck muscle on the shortened side

The condition is not painful, and your child will likely have no discomfort.

How is congenital muscular torticollis diagnosed?

An examination is often enough to diagnose the condition. The diagnosis may be confirmed with one or more of these imaging tests:

  • X-ray to check the bones of the neck and shoulders, and rule out other problems

  • Ultrasound (images formed by sound waves) to show the neck muscles

  • MRI (magnetic resonance imaging) to show the neck muscles

How is congenital muscular torticollis treated?

  • Congenital muscular torticollis most often goes away on its own by the time the child is 1 year of age. During this time, exercises help the muscle stretch. Your child will see a physical therapist (PT) for stretching. The PT will also teach you exercises to do with your child at home.

  • The child should see the doctor for regular checkups to make sure no further problems have developed.

  • If the muscle does not loosen on its own by 11 months of age, surgery may be needed. This is done to release and lengthen the tightened muscle and relieve the pulling. If this is the case for your child, your doctor will tell you more.

What are the long-term concerns?

With treatment, a child with this condition will have no long-term problems. But the tight muscle may cause the child to lie on one side. This can result in flattening of the head on that side. This flattening is harmless and will usually go away over the next few years.

 

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