Friday, October 19, 2018

What is Wryneck and How is it Treated?

Wryneck occurs when the neck muscles twist beyond their usual capacity, causing the head to tilt. The condition is also known as torticollis or loxia.

Wryneck may develop over time. It can also occur after an injury to the area, or because of a reaction to medication. A person with wryneck may find it uncomfortable or painful to put their head up straight or bend their neck to the unaffected side. It is common in infants, with some sources reporting that it affects 3 in every 100 babies. In most infants, the condition is easily treatable.

Benign paroxysmal torticollis of infancy (BPTI) is a much rarer medical disorder in infants where the baby experiences recurrent episodes of the head tilting to on side.

Some of the [common] causes of wryneck are injury to the neck or spine causing muscle spasm, infection of the head or neck, abscess in the throat or upper airway, and infections in other parts of the body, such as ears, sinuses, jaw teeth or scalp. Less common causes include scar tissue, cervical arthritis, vascular abnormalities, certain medications, and tumors.

Temporary torticollis will usually only affect a person for 1-2 days before disappearing. Those affected may need to rest while keeping their neck as still as possible.

Fixed torticollis occurs because of an underlying problem with a person’s muscles or bone structure. It can also develop if a tumor is growing in the spinal cord, putting pressure on the nerves in the area. Muscular torticollis is the most common form of fixed torticollis. It happens when the muscles on one side of the neck are particularly tight.

The doctor may request X-rays of the neck or a CT scan to diagnose the cause of wryneck.

Treatment for wryneck includes ice packs, medication, a cervical collar, physical therapy, massage therapy, stretching exercises and/or surgery. A doctor may prescribe muscle relaxants and anti-inflammatory drugs for spasmodic torticollis caused by injury or as a side effect of medication. In cases of chronic neck muscle spasms, botulinum A toxin (Botox), may provide relief and prevent the condition from progressing.

Around 10% of children who have wryneck from birth will require surgery to lengthen the sternocleidomastoid muscle in the neck. This is typically done once the child reaches preschool age.

My Take:
Wow, no mention of spinal manipulation, the most effective treatment for torticollis. I have treated hundreds of cases over the years. Most cases occur during cooler weather. In South Florida, when we are off air conditioning, the house may get a little warm during the day. People often have a ceiling fan running in the bedroom and as they sleep and the night chill cools the room, cold air blowing on the neck creates spasm. Torticollis can also occur secondary to an URI or flu and flu season coincides with the colder weather. So, it can be a challenge to differentiate the cause. Typically, a structural torticollis will resolve with 1 or 2 adjustments of the cervical spine. If there is an underlying infection, recovery is often slower and the symptoms of infection also become apparent.

Pancoast tumor is a more common cause of torticollis than spinal tumors. Pancoast occurs in the upper portion of the lung and is always secondary to cigarette smoking. Fortunately, the incidence of Pancoast tumors has diminished as smoking has become less popular.

Bottom Line:
If you suffer from an episode of torticollis that lasts longer than two days or is recurrent in nature, see a chiropractor. They will be able to resolve most cases in just a few days. Please tell your chiropractor if you have had cold or flu symptoms in the past few weeks.

Source: October 12, 2018 NIH

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