Torticollis in Babies: Symptoms, Causes, and Treatment

"Torticollis is an abnormal posture of the head and neck that results from multiple causes."

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Torticollis

Positional torticollis is a condition when the neck becomes tight and shortened. That muscle is called the sternocleidomastoid muscle. Sometimes an infant will be born with torticollis because of its position inside the uterus or during birth. Other times, an infant will develop torticollis because they favor looking to one side. The baby will tend to turn their head to one side, may even have difficulty turning it to the other direction, and a head tilt will be seen. If left untreated, torticollis can cause another condition called positional plagiocephaly which is often referred to as flat head.

Physical therapy can be very helpful in treating torticollis. Preventative measures include alternating sides during feedings, changing the direction the baby sleeps in their crib, and putting fun and interesting objects on the side they avoid so their attention is drawn in that direction. Tummy Time is very important for babies. At least two hours each day, broken down into smaller sessions, is recommended.

Abnormal or constricting intrauterine position of a fetus may result in congenital torticollis, noticeable at birth. Idiopathic, spasmodic torticollis results from spasm and shortening of the sternocleidomastoid muscle (SCM) and rotation of the head. Additional causes may include upper respiratory infections, infections of the cervical spine, compression of brain or brainstem due to aberrant blood vessels or tumors, hemorrhage into the cervical musculature compensation for unbalanced, abnormal eye movement and “double vision”.

In nearly all cases the SCM becomes foreshortened due to local irritation of the muscle or its controlling nerve. If left untreated torticollis may persist or worsen and cause secondary problems with head and neck positioning, jaw development, eye movement or visual processing, abnormal skull shape or respiratory function. If an underlying cause is identified and treated the torticollis will usually resolve. Physical therapy can be extremely useful in the treatment of torticollis as well as relaxation training, psychiatric evaluation and trans-epidermal neuro-stimulation. Botulinum toxin may work in select cases and more aggressive surgical measures (brainstem / cranial nerve decompression) are rarely needed.

Frequently Asked Questions - Infant Torticollis Treatment

What is torticollis?

Torticollis is a condition in which a baby's neck muscles become tight or shortened, causing the head to tilt to one side and the chin to rotate toward the opposite side. It is common in infants and is often treatable with early intervention.

What causes torticollis in babies?

Infant torticollis may develop due to positioning in the womb, birth-related muscle tightness, or prolonged preference for turning the head in one direction. In some cases, underlying medical conditions may contribute to the problem.

How is torticollis treated?

Torticollis is typically treated with stretching exercises, repositioning techniques, tummy time, and pediatric physical therapy. Early treatment can help improve neck mobility and support healthy development.

How long does torticollis last in babies?

The duration varies depending on the severity of the condition and how early treatment begins. Many babies show significant improvement within a few months when therapy and home exercises are started promptly.

Does torticollis cause flat head syndrome?

Yes. Torticollis can lead to positional plagiocephaly (flat head syndrome) because babies often prefer resting their head on the same side. Early treatment can help reduce the risk of head shape asymmetry.

Can torticollis cause facial asymmetry?

Yes. If left untreated, torticollis may contribute to facial asymmetry as the baby consistently favors one side of the head and neck. Early intervention can help promote more balanced growth and development.

What is the best treatment for torticollis in babies?

Early intervention with stretching exercises, repositioning techniques, and pediatric physical therapy is often the most effective treatment for torticollis in babies.

Can torticollis go away without treatment?

Some mild cases may improve, but many babies benefit from professional evaluation and therapy to prevent complications such as facial asymmetry and head shape changes.

How long does infant torticollis treatment take?

Treatment duration varies based on severity, but many infants improve significantly within a few months when therapy begins early.

Can torticollis affect my baby's head shape?

Yes. Torticollis can contribute to positional plagiocephaly and facial asymmetry if left untreated.

When should I see a specialist for torticollis?

Parents should seek evaluation if their baby consistently tilts their head to one side, has difficulty turning their neck, or develops head shape asymmetry.

Is physical therapy necessary for torticollis?

Many infants benefit from physical therapy to improve neck range of motion, strengthen muscles, and support normal development.

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