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Spasmodic Torticollis: Treatment, Procedure, Cost And Side Effects

What is Spasmodic Torticollis?

Spasmodic Torticollis refers to a painfully twisted and tilted neck or a painfully neck disorder. A person with Spasmodic Torticollis has his head tilted to one side whereas chin on the other. This condition has various reasons that may be congenital or the result of damage to neck muscles or blood supply.

Chronic wry neck caused by Spasmodic Torticollis can result in enfeebling pain and difficulty in performing daily tasks. However, the condition can be treated through various surgeries available and pain & stiffness can be relieved by medications and therapies. If started early at time, treatment is more likely to be successful.

What is the cause of spasmodic torticollis?

Spasmodic Torticollis can be genetic or it may get developed in womb if the baby's head remain, somehow, in the wrong position. The damage to the muscles or blood supply to the neck can also result in a way neck. Spasmodic Torticollis can happen to anybody due to a muscle or nervous system injury but the cause may remain unknown most of the time.

What are the symptoms of spasmodic torticollis?

Signs of Spasmodic Torticollis can begin gradually and can become worse with passage of time. Some common symptoms may arise in this condition such as:

  1. Lack of ability to move your head normally
  2. Neck pain or stiffness
  3. Headache
  4. Having one shoulder higher than the other
  5. Swollen neck muscles
  6. A tilting of your chin to one side

What are the treatment of spasmodic torticollis?

Unfortunately, Spasmodic Torticollis can not be prevented but, taking a treatment early can prevent it from worsening. If stretching the neck muscles started within a few months of birth, it can successfully improve congenital forms of Spasmodic Torticollis. In case, it doesn't work a surgery, sometimes, can help resolving the problem.

There are various types of treatment available to correct this condition such as applying heat, massage, physical therapy, stretching exercises, neck braces, etc. Several medications can also help to cure the situation like muscle relaxants, medications used to treat the tremors of Parkinson’s disease, pain medications, etc.

What are the various types of Spasmodic Torticollis?

  1. Spasmodic Torticollis has several types. Before going for a treatment you must know the type Torticollis you are suffering from.
  2. Temporary torticollis This is temporary situation and can go away in one or two days. An ear infection, cold, swelling may cause such condition.
  3. Fixed torticollis A problem with the muscular or bone structure may become the reason of Fixed torticollis.
  4. Muscular torticollis It is the result of scarring or tight muscles on one side of the neck.
  5. Klippel-Feil syndrome It happens due to the bones in your baby’s neck that form incorrectly.

What are the neck stretching exercises for Spasmodic Torticollis?

Exercises play a crucial role in treatment of spasmodic torticollis. Experts suggest several exercises that one can do to see improvement. Strengthening Exercises Yoga and Pilates are helpful in improving strength and lengthen muscles, helping reduce pain and tension in the neck. Exercise Program Swimming, yoga, walking and Tai Chi provide good workouts as your entire body should be strong to support spine. You can do such aerobic activities at least three times per week. Stretching If stretching the neck muscles started within a few months of birth, it can successfully improve congenital forms of Spasmodic Torticollis. It is more easier to correct in infants as compared to adults.

Popular Health Tips

Migraine - Identifying the Early Signs!

MBBS, MD - Internal Medicine, Fellow In Pain Management, DM - Neurology
Neurologist, Delhi
Migraine - Identifying the Early Signs!

Headaches and migraines can vary drastically depending on their duration, specific symptoms and the person they are affecting. The more you know about your specific type of headache or migraine, the better prepared you will be to treat them—and possibly even prevent them. The two types of migraine are- 

  1. Migraine without aura: The majority of migraine sufferers have Migraine without Aura. 
  2. Migraine with aura: Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.

Symptoms of migraine vary and also depend on the type of migraine. A migraine has four stages: prodrome, aura, headache and postdrome. But it is not necessary that all the migraine sufferers experience all the four stages.

Prodrome: The signs of this begin to appear a day or two days before the headache starts. The signs include depression, constipation, food cravings, irritability, uncontrollable yawning, neck stiffness and hyperactivity.
Migraine Aura: Auras are a range of symptoms of the central nervous system. These might occur much before or during the migraine, but most people get a migraine without an aura. Auras usually begin gradually and increase in intensity. They last for an hour or even longer and are 

  • Visual: Seeing bright spots, various shapes, experiencing vision loss, and flashes of light
  • Sensory: Present in the form of touch sensations like feeling of pins and needles in the arms and legs
  • Motor: Usually related with the movement problems like the limb weakness
  • Verbal: It is related with the speech problems

Headache: In case of a migraine attack one might experience:

  • Pain on both sides or one side of the head
  • Pain is throbbing in nature
  • Vomiting and nausea
  • Sensitivity to smells, sound and light
  • Vision is blurred
  • Fainting and lightheadedness

Postdrome: This is the final phase of the migraine. During this phase one might feel fatigued, though some people feel euphoric.

Red flags that the patient may be having underlying serious disorder not migraine

  1. Onset of headaches >50 years 
  2. Thunderclap headache - subarachnoid haemorrhage 
  3. Neurological symptoms or signs 
  4. Meningism 
  5. Immunosuppression or malignancy 
  6. Red eye and haloes around lights - acute angle closure glaucoma 
  7. Worsening symptoms 
  8. Symptoms of temporal arteritis

These patients require CT scan / MRI or CSF examination. Most Migraine patients do not need these tests. 

Diagnosis of Migraine: Usually migraines go undiagnosed and thus are untreated. In case you experience the symptoms regularly then talk to the doctor, who evaluates the symptoms and can start a treatment. You can also be referred to a neurologist who is trained to treat the migraines and other conditions. During the appointment the neurologist usually asks about the family history of headaches and migraines along with your symptoms and medical history.

The doctor might advise for some tests like:

  1. Blood Tests: These reveal problems with the blood vessel like an infection in the spinal cord and brain.
  2. CT scan: Used to diagnose the infections, tumors, brain damage, and bleeding that cause the migraines.
  3. MRI: This helps to diagnose the tumors bleeding infections, neurological conditions, and strokes.
  4. Lumbar Puncture: For analyzing infections and neurological damages. In lumbar puncture a thin needle is inserted between the two vertebrae to remove a sample of the cerebrospinal fluid for analysis.


Migraine treatments can help stop symptoms and prevent future attacks.

Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:

  • Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
  • Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.

Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.

Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Consult a doctor find the right medication for you.

1962 people found this helpful

Botox - Is It Really Beneficial?

Diploma In Trichology - Cosmetology, PG Diploma In Clinical Cosmetology (PGDCC), Diploma In Aesthetic Mesotherapy, PG Diploma In Clinical Research
Aesthetic Medicine Specialist, Ahmedabad
Botox - Is It Really Beneficial?

Are you planning on undertaking a cosmetic procedure for rejuvenating your skin? Botox treatment is considered to be effective for this purpose. Botox is a drug made from a certain neurotoxin, and it is produced by a bacteria known as Clostridium botulinum. Botox is also used for medical purposes, especially for the treatment of muscle related conditions. It is primarily used for removing wrinkles via a procedure in which your facial muscles are temporarily relaxed.

Major uses
Except for reducing the appearance of your wrinkles and facial lines, which appear because of aging, botox is used for the treatment of conditions which include leaky bladders, migraines, excessive sweating, and eye squints. Over 20 medical conditions utilize botox as a part of treatment.

How it works?
Botulinum toxin or botox is a poisonous substance. A single gram of botox can kill over one million people. But it acts as an ideal therapeutic protein when utilized in a proper, required dosage.

About botox procedure
Botulinum toxin powder is diluted in saline to be administered. It is injected into a patient’s neuromuscular tissue and takes around 72 hours to show results. This time reflects the amount of time that is required for disruption of your body’s usual synaptosomal process. It takes around 5 days for the full effect of botox treatment to show. Pregnant or lactating women, and people who are allergic to it from a previous treatment should avoid any form of botox treatment.

Side effects and associated risks
Although injections containing botox are well tolerated, there are several side effects involved. They are as follows:

  • A person having a genetic predisposition in which a mild, transient response to botox is received. Some patients taking type A botox injections are likely to develop antibodies to the toxins. This makes the treatment ineffective. Antibody development is also indicated in cases of patients taking a type B botox injection for treating cervical dystonia.
  • Along with the intended effects, botulinum toxin may cause some other side effects, which are quite undesirable. They may include headache, malaise, mild cases of nausea, transient numbness, mild pain, local edema and erythema at the site where the injection is given.
  • Temporary fatigue, of your surrounding musculature are also likely because of the toxin and its actions.
  • Temporary upper lid and brow ptosis or drooping is another side effect involved with botox.

The results obtained from treatment by type B botox is said to be more effective than botox A treatment. You may expect better results when your muscles remain contracted instead of being relaxed. If you wish to discuss about any specific problem, you can consult a dermatologist and ask a free question.

2634 people found this helpful

What Can You Expect From A Botox Treatment?

Mch - Plastic Surgeon , MS - General Surgery, MBBS
Cosmetic/Plastic Surgeon, Hyderabad
What Can You Expect From A Botox Treatment?

Are you planning on undertaking a botox treatment? Botox is a drug which is made from a neurotoxin. This is produced by the bacteria called Clostridium botulinum. Botox is used for medical purposes, commonly for treating muscular conditions. It is also used for cosmetic procedures, which help in removing wrinkles. This process is carried out by paralyzing the facial muscles temporarily. Botulinum toxin is also sold commercially under certain names.

Medical and Cosmetic Uses-

Botox is most commonly used as a treatment procedure for reducing the appearance of facial lines and wrinkles in middle-aged adults. It is also used for medical purposes, for the treatment of conditions such as eye squints, excessive sweating, leaky bladders and migraines. Botox is used for treating more than 20 medical conditions.

How Does Botox Work?

Botox or botulinum toxin is a very poisonous substance, and a single gram of it is capable of killing more than one million people. It is considered to be an effective therapeutic protein when used in ideal dosage, and frequency. It is used in several medical procedures and treatment therapies.

How is Botox Procedure Undertaken?

Botulinum toxin is administered by diluting the power in saline. It is injected directly into your neuro-muscular tissue. A duration of 24 to 72 hours is required for it to take effect. This time reflects the time required for disruption of the normal synaptosomal process of the body. It may take over five days for experiencing the full effects of botox. Botox must not be used in women who are pregnant or lactating, or by people having a previous allergic reaction to it.

Risk and Side-Effects:

Injections which contain botox are usually well tolerated. They have several side effects as well.

  1. In some cases, a person may have a genetic predisposition which causes a mild, transient and unusual response to Botox. Some people who are receiving botox type A injections may develop antibodies to the toxins, which may make the treatment ineffective. In people who are using botox type B for cervical dystonia, antibody development may occur.

  2. Along with the effects intended, botulinum toxin may lead to several other undesirable effects. They may include conditions such as transient numbness, headaches, malaise, mild cases of nausea, mild pain, local edema and erythema on the site of injection.

  3. Temporary tiredness, fatigue or the paralysis of nearby musculature may also be experienced because of the reaction of the toxin.

  4. Drooping or temporary upper lid and brow ptosis are also indicated.

Among the two types of botox treatments, the results from abobotulinum toxin A is considered to be more effective than onabotulinum toxin A treatment. Better results are experienced when the muscles are contracted instead of being at rest. If you wish to discuss about any specific problem, you can consult a dermatologist and ask a free question.

2828 people found this helpful

Tonsillitis - What Are The Forms Of It?

MBBS Bachelor of Medicine & Bachelor of Surgery, Diploma In Otorhinolaryngology (DLO), DNB - ENT, Allergy Testing
ENT Specialist, Gurgaon
Tonsillitis - What Are The Forms Of It?

Tonsillitis is a disorder of the tonsils present on the back of your throat. The tonsils acts as a defensive mechanism in the body as they prevent the body from infections. This is a contagious condition and can occur at any age. It is widely prevalent among school going kids.

Tonsillitis may be classified in to two types:

1. Chronic tonsillitis

This type of tonsillitis tends to last for an extended duration with symptoms of bad breath and tenderness in the lymph nodes.

2. Recurrent tonsillitis

This is a form of acute tonsillitis which repeats itself over a year.


Tonsils prevent various virus and bacteria from entering the body through the mouth by producing antibodies. The tonsils, however, may become vulnerable to these infections. A virus that causes common cold or the bacteria that causes strep throat may result in tonsillitis. The most common cause of this disorder is the strep bacteria.

School going children are especially vulnerable to this disorder because they are most prone to various infections.

The various viruses that may cause tonsillitis are:

1. Enterovirus
2. Herpes simplex virus
3. Epstein-Barr virus
4. Influenza virus
5. Adenovirus
6. Parainfluenza virus

Common Symptoms

The various symptoms of tonsillitis are -

1. Swallowing difficulties
2. A sore throat
3. The sore throat may result in bad breath
4. You may experience fever and chills
5. Pain in the head, ear and stomach
6. You may experience stiffness in the neck and the jaw
7. Swollen tonsils with possible redness
8. Changes in voice
9. Symptoms of cold


The treatment for tonsillitis is usually antibiotics and in some cases, tonsillectomy. The antibiotics help in getting rid of the bacterial infection. Surgery is only done in cases where tonsillitis is chronic in nature. It is important that you drink fluids and restrict smoking to prevent tonsillitis.

Physiotherapy Treatment for Torticollis

Physiotherapist, Noida
Physiotherapy Treatment for Torticollis


A development defect is one sternomastoid muscle or mal-position of the neck in the uterus can give rise to the deformity. The shortening of the sternomastoid is the principal causative factor. There may be an associated shortening of the scalenii, platysma, splenius or trapezius muscles. Incidence is more common in girls, and the side affected is usually left. Occasionally, it may bilateral. The affected sternomastoid may get atrophied and facial asymmetry may occur in untreated cases. 

Nature of the deformity: 

The head is fixed inside flexion to the same side (i.e, on the side of the affected muscle) while it is rotated to the opposite side. The shoulder on the affected side is raised. 

Scoliosis with convexity to the sound side may be present in the cervical region. Facial asymmetry with smaller eye and lowering of the corners of the mouth and eye with a deviation of the nose on the affected side may be present. In rare bilateral affections, both the sternomastoid are contracted. The head is protruded forward with associated kyphosis.


The basic objectives are: 

  • To correct the deformity by release of the contracted soft tissues and 
  • To maintain the correction by suitable exercise regime; avoiding recurrence. 

Early mild cases

Children with a mild degree of deformity reporting early for the treatment can be managed with physiotherapy

The physiotherapy procedures employed are:       

 I. Evaluation: Careful evaluation of ROM and the degree of deformity.      

II. Massage: Massage can relax the muscle preceding the stretching manoeuvres.  

III. Thermo Therapy Modality: Carefully administered thermo-therapy modality induces relaxation.  

IV. Passive movements: The child is placed in supine position with head beyond the edge of the table with the neck in extension by positioning a pillow under the thoracic region; Shoulders are stabilized by an assistant.

  • To attain relaxation, all the movements of the cervical spine are done in a form of slow relaxed passive movements.
  • This should be followed by sustained passive stretching to the affected sternomastoid. E.g. when the right sternomastoid is involved the head should be gradually bent inside flexion to the left, held there for a while and then rotated gradually to the right. Try to gain as much overcorrection as possible by applying gradual traction to gain further stretching.
  • Maintenance of Correction: Once the correction is achieved. It has to be maintained by passively holding or keeping a sandbag.
  • The same manoeuvre can be repeated during the subsequent visits.
  • Active correction: Active correction is best achieved by assisting the child head to follow an object moved in the proper arc of correction. The bright-coloured sound producing object is ideal to attract the child attention.
  • PNF: patients with neck extension can be used to an advantage with emphasis on stretch and traction
  • Home treatment programme: This assumes an important role as these manipulations needs to be repeated. The mother should be trained properly for this. The best method is to put the child in prone and the teach the mother to carefully move the head towards the affected side and the child is encouraged to look back over the right shoulder.
  • Positioning: Exact positioning of the head during sleep is important. The child should be made to sleep on the opposite side of the lesion and the position of head adjusted by pillow or sandbag in a maximally corrected posture during sleep. This positioning has two advantages:- First, there is natural relaxation of the muscle- Secondly, whatever correction is achieved, it is maintained for a longer period during sleep.However, the mother should intermittently check the correction.
  • Older children and adults: With advancing age the deformity gets organized and does not get corrected by conservative management.
  • Surgical: The sterna and the clavicular heads of sternomastoid are divided close to the origin along with the release of the tight fascia. The head is then immobilized in a plaster cast in over-corrected position for 2 to 4 weeks. Mobilization is begun as soon as the cast is removed.
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Popular Questions & Answers

I am suffering from neck pain /stiffness problem from last 6 months. Tried physiotherapy for 10 days but still the same. Guide what to do.

Tcmt ,svims, Tcmt,svims
Take more sitings .do cryotherapy for 7 min, do static neck exercises. Remove pillow while sleeping. Go for ict and ift machines.

I am a hard guy and use to do gym. 2 years back there was some pain in my neck because if a car accident and some popping sound use to came from my shoulder. I visit physiotherapist and took therapy for 2 weeks then I stop gaining and wait to heal my injury. Its almost 2 years now and my neck has almost no pain but shoulder popping sound is there whenever I lift something up. Also when I sleep and in morning my neck feels stiffness which reduces slowly during day. Please help me solving this issue.

Physiotherapist, Bangalore
It's due to non healing disc lesions at cervical level, due to which it causes radiculopathy, associated symptoms of pain, stiffness, muscle weakness, and the solution is start physiotherapy asap, use proper mattress and cervical pillow, if pain comes down start with cervical isometric exercises to strengthen the muscles.
1 person found this helpful

I am suffering from ankylosing spondylitis. My shoulders neck is totally stiff, can not pick items from ground as I can't bend.

Erasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPT
Physiotherapist, Chennai
Deep breathing for lung expansion and stretching exercises to improve spine and joint mobility. Are also advised to sleep on a firm mattress and avoid the use of a pillow in order to prevent spine curvature. Aerobic exercise is generally encouraged as it promotes full expansion of the breathing muscles and opens the airways of the lungs.

Table of Content

What is Spasmodic Torticollis?

What is the cause of spasmodic torticollis?

What are the symptoms of spasmodic torticollis?

What are the treatment of spasmodic torticollis?

What are the various types of Spasmodic Torticollis?

What are the neck stretching exercises for Spasmodic Torticollis?

Having issues? Consult a doctor for medical advice