If your baby often tilts their head to one side or has difficulty turning their neck, they may have a condition called torticollis - also known as “wry neck.” While this may sound alarming to parents, most cases of infant torticollis can be successfully treated with early, non-surgical interventions. Understanding the signs, causes, and treatment timeline is key to ensuring your baby’s healthy development.
Let’s explore when torticollis in babies might require surgery, and what parents should do when they first notice symptoms.
What Is Torticollis in Babies?
Torticollis occurs when the neck muscles, particularly the sternocleidomastoid (SCM) muscle, become tight or shortened on one side, causing the baby’s head to tilt in one direction and rotate in the opposite direction.
There are two main types of torticollis:
- Congenital muscular torticollis: Present at birth, often caused by the baby’s position in the womb or a difficult delivery.
- Acquired torticollis: Develops later, possibly due to muscle strain, infection, or neurological issues.
Common Signs of Torticollis in Babies
Parents should look for the following signs, especially in the first few months of life:
- Baby consistently tilts their head to one side
- Difficulty turning head from side to side
- Flat spot on one side of the head (positional plagiocephaly)
- Uneven facial features
- Preference to breastfeed or look in one direction
- Limited neck range of motion
If you observe these signs, it’s important to schedule an evaluation with a pediatric craniofacial specialist or pediatric neurosurgeon to determine the underlying cause and best course of treatment.
When Does Torticollis Require Surgery?
In most cases, torticollis does not require surgery.
Surgery is typically considered only when:
- Conservative treatments fail – After consistent physical therapy for 12–18 months without improvement.
- Severe muscle tightness or fibrosis – When the SCM muscle has become permanently shortened.
- Persistent head tilt and limited motion – Despite aggressive stretching and therapy.
In such rare cases, a surgical release of the tight neck muscle may be recommended to restore full range of motion and symmetry.
At NJ Craniofacial Center, surgery is considered a last resort, only after a thorough evaluation and multidisciplinary discussion between our pediatric neurosurgeon, craniofacial specialists, and physical therapy team.
Non-Surgical Treatment Options
Most infants with torticollis respond well to early intervention.
Here are the most effective, non-surgical treatments:
1. Physical Therapy
- Gentle stretching and strengthening exercises help loosen the tight muscle.
- Parents are trained in at-home exercises to perform multiple times daily.
2. Positioning Techniques
- Encourage tummy time to strengthen neck muscles.
- Alternate feeding and sleeping positions to prevent muscle imbalance.
3. Helmet Therapy (if needed)
- If torticollis has caused head flattening (positional plagiocephaly), a cranial helmet may be recommended.
- Helmets help guide the baby’s skull into a more symmetrical shape during growth.
4. Regular Follow-Ups
- Ongoing monitoring helps track progress and adjust the therapy plan as the baby grows.
Early Intervention Is Key
The earlier torticollis is identified and treated, the faster the recovery.
- Before 3 months: Most babies recover fully with physical therapy.
- After 6 months: Progress is slower and may require additional interventions.
- After 1 year: If the muscle has become fibrotic, surgical options may be discussed.
What Happens During Surgery (If Needed)
If surgery becomes necessary, the procedure involves releasing the tight SCM muscle to allow free neck movement. It is usually:
- Performed under general anesthesia
- Takes about 30–45 minutes
- Followed by physical therapy for several weeks
Most children recover quickly and regain normal range of motion, with only a small scar hidden along the neck crease.
When to See a Specialist
Contact a pediatric craniofacial specialist in New Jersey if:
- You notice persistent head tilt or uneven head shape
- Physical therapy hasn’t improved your baby’s range of motion
- Your baby’s head flattening is worsening despite repositioning
At NJ Craniofacial Center, our specialists use advanced diagnostic imaging and personalized therapy plans to ensure every baby receives the right care at the right time.
Final Thoughts
While the thought of surgery can be concerning, remember that most babies with torticollis recover completely without surgery through consistent therapy and early intervention.
If you suspect your baby may have torticollis, don’t wait.
Early diagnosis and treatment can make a life-changing difference.
Schedule a Consultation
If you’re searching for “torticollis treatment near me” in New Jersey, the NJ Craniofacial Center offers expert diagnosis and no
Frequently Asked Questions
Q1. Can torticollis correct itself without treatment?
In mild cases, it may improve as the baby grows and gains neck strength, but medical evaluation is still recommended to prevent long-term asymmetry.
Q2. Is torticollis painful for babies?
Usually, no. However, babies may get frustrated with restricted movement.
Q3. How long does recovery take?
With early therapy, most babies improve within 2–6 months. Severe cases may take longer.
Q4. Will my baby’s head shape return to normal?
Yes, with proper repositioning and therapy - or helmet therapy if needed - head shape usually improves significantly.
