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What's the best treatment for torticollis-like symptoms?

By July 22, 2009 - 8:59am
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I have had severe neck/upper back muscle spasms on one side of my body for over a year. I've tried chiropractic, massage, physical therapy and medication (cyclobenzaprine hydrochloride). Nothing has provided significant relief from the pain which continues to gradually worsen. I recently discovered (when applying for new health insurance) that my medical chart contains a diagnosis of torticollis, although I do not have the involuntary tilting of the head that usually accompanies this condition. How should I proceed?

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Expert HERWriter Guide Blogger

Hi Shubham - I can't diagnose you, but what you've described doesn't sound like scoliosis which is an abnormal curvature of the spine, or backbone. When you have scoliosis the spine has a C- or S- shape instead of being the normal vertical line.

Torticollis is a chronic condition in which the neck muscles contract involuntarily. This causes the head to turn and tilt to one side, and the chin to point to the opposite side. Sometimes one shoulder is lifted. The muscle contraction may be constant (fixed) or may come and go (intermittent). The abnormal posture caused by tilting the head may lead to neck pain. It may be present at birth (congenital) or develop later in life (acquired).

I wasn't sure where you were from. In the U.S. most patients are seen by a primary care doctor and have to get a referral that's approved by their insurance company in order to see a specialist. Are you able to see an orthopedic specialist? If so, the doctor would do a physical exam to see if there is a visible shortening of the neck muscles and whether your head tilts toward the affected side and your chin points to the opposite side. A electromyogram (EMG) may also be done to see which muscles are most affected. Depending on the findings, treatment may include application of heat, traction to the cervical spine and massage to help relieve pain. Stretching exercises and neck braces may also be prescribed to help with muscle spasms. While surgery is sometimes an option for children it is very rarely an option for adults.

Sometimes medications are used to treat this, including an anticholinergic drug called baclofen. In some cases injection of botulinum toxin (botox)) can temporarily relieve the torticollis, but repeat injections every three months are usually needed and in some areas botox is not approved for this type of use - you would need to check in your country.

If you worked with various types of therapies you might find some that would give you some short term relief but because this condition, long term, can impact your nervous system, you really should seek help beyond physical therapy.

I truly hope you can get the care you need and that you will feel better in the future. Hope that helps! Pat

November 12, 2010 - 6:55pm
Expert HERWriter Guide Blogger

Hi Shubh - It sounds like the physical therapy just relieved some of your symptoms and did not address the underlying cause. It's going to be impossible for anyone to know how to treat what you're dealing with until you have a proper diagnosis. You mentioned that your doctors have not been able to give you one. The next step would be to seek a referral to a specialist such as an orthopedic physician who specializes in neck pain or a physiatrist, a medical doctor with specialized training in physical medicine, rehabilitation and pain management. From what you've described this is a long term condition that is worsening. You may have to push to get the referrals but that really is the best course for you. Let us know how you do, and good luck.

November 12, 2010 - 4:40pm
EmpowHER Guest
Anonymous (reply to Pat Elliott)

Hi Pat, thanks a lot for your reply... I'm from Delhi, India and not familiar with the referral thing here, pls. help me know about it.
ps: with the xray tests taken 4-5 yrs back, scholiosis was confirmed and bend in the cervical to the right side was there... but at that time the bend was very less.. so doctor said that its minor and will cure with neck exercises itself but it just kept on worsening and now its quite a lot and my head/neck is twisted to the right.. is it torticollis? which specialist should i contact for it..

November 12, 2010 - 5:09pm
EmpowHER Guest

I've been suffering from neck pains since past 10 years.. n always had a feeling to twist my head/neck to adjust my posture and often had severe headaches... previously my family also felt its just somehting small as they cudnt see it... but after all these years it has increased so much that now even they can see it clearly tilted to one side.. and the development of my body is also affected .. less to the left side..tilted to the right, throughout the body(maybe an additional scholiosis as i saw thru the net)..
but doctors here havent been able to diagnose the problem correctly.. iwent to a physiotherapist.. he put me up for some neck exercises and some machines which project smaal amount of current to a region of muscles on my neck and shoulder... but its effect was temporary and problem came back as soon as i left it.
Pls. can u help me out to Treat it.


November 12, 2010 - 11:09am


How old are you now? I am guessing since you said this began during the end of puberty that you are in your early 20s now?

I am so sorry you have dealt with these issues for seven years. I know it has been a financial and emotional rollercoaster for you and you are probably really frustrated and angry over not being able to get help.

Do you have medical insurance now?

Can you tell us a little bit more about what doctors have tried?

Do you have any medication for the pain?

And what city and state do you live in?

February 25, 2010 - 9:02am

hi, I am also suffering from a spinal injury and because of the symptoms I believe i may be dealing with torticollis as well, my symptoms have matured over a 7 year process starting with aggravating mid back pain to now having symptoms of spasmodic distonia. I have been victim to multiple assaults as bad as auto injuries and have in the One of of the worst parts is that it has somehow warped the growth of my skull and ribcage, the ribcage bieng less noticable but still worrying. The one side of my head has been growing at a much higher rate of speed than the other, and it is always throbbing in pain. I read that developed asymetrical features are a symptom of the wry neck disfunction, its just my luck i developed them during the end of puberty and no one cares now. i have tried every alernative/homeopathic method in the book and still no results infact it seems to now slowly be getting worse with a noticed decrease in motor skills and concentration i cannot function in or out of society. Now the point of this post is that despite whats happened to me doctors have done nothing FOR 7 YEARS, my life is ruined and i cant even get a diagnoses. PLEASE CAN ANYONE HELP!
ps: i researched, and found that torticollis has been misdiagnosed as some kind of mental anxiety which is funny because when you're shaking uncontrollably, anxiety is a factor.

February 23, 2010 - 11:10pm

Hi, Pbunn, and welcome to EmpowHer! Thanks so much for your question, and I'm sorry you've been through so much in the last year without getting any relief.

I guess my first question to you is this: Are you satisfied with your doctor's diagnosis? Do you believe she or he has done/did everything to try to diagnose you correctly? Have you ever gotten a second opinion? I am astonished (aren't you?) that you never heard the diagnosis of torticollis until you came upon it in your medical chart. That's awful! No doctor ever spoke with you about it or told you why she/he thought that that was what is causing these symptoms?

Did it start after an injury? Does anyone else in your family have this condition?

Honestly, there are so many things that can cause neck or back spasms that I sure would like you to be able to see a specialist. One of the reasons I feel this way is that it seems like all the information I found about torticollis includes that head tilt -- and you say you don't have that. Which makes me wonder if you have something else entirely, like a pinched nerve, a herniated disc, etc. Were these things checked out in the beginning? Did your doctor do x-rays?

EmpowHer has a great encyclopedia page on torticollis, which includes causes, symptoms and treatment possibilities:


And here are the treatment possibilities it outlines:

Acquired Torticollis
◦Identifying the cause
◦Physical therapy to help relax the muscle and reduce pain
◦In some situations, surgery to cut the nerve to the muscle that is in spasm
◦Oral medications:
■ Anticholinergic drugs, such as trihexyphenidyl (Artane) , benztropine (Cogentin) , and ethopropazine (Parsitan)
■ Dopaminergic drugs that increase dopamine levels, such as levodopa (Sinemet or Madopar) or bromocriptine (Parlodel) , or conversely, drugs that decrease dopamine levels such as, clozapine (Clozaril) and tetrabenazine (Nitoman)
■ Benzodiazepines that block Gaba-A receptors, such as diazepam (Valium) or clonazepam (Klonopin)
■ Injection of botulinum toxin may weaken or partially paralyze the muscle. This may help improve neck posture, but only if begun soon after torticollis begins. The drug's effect wears off after several months and treatment must be repeated.
■ Another treatment involves injection of alcohol or phenol to deaden the nerve that causes the muscle contraction.

And here's a page on treatments from the National Spasmodic Torticollis Association. They also mention injections:


And here is a page on treatments from eMedicine:


In reading these pages, are you still certain that torticollis is indeed what you are dealing with? Are the medications they suggest some of the ones your doctor tried? And did anyone along the way speak with you about the possibility of injections to stop those spasms?

I hope this helps! You have been through a lot in the last year.

July 23, 2009 - 9:03am
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