Torticollis is an abnormal twisting or tilting of the head and neck. It may be there at birth (congenital) or can happen later (acquired). It can occur at any age. Some forms develop suddenly, while others develop gradually.

Causes of torticollis include:

• Tight neck muscles that are present at birth or happen soon after birth.
• Injury or strain of the neck muscles, including from sleeping in an unusual position.
• Side effects of certain medicines.
• Problems with the bones, muscles, or joints in the neck, sometimes caused by an injury or infection.
• Conditions that cause the neck muscles to tighten or move without control, such as cervical dystonia.

All neck problems should be checked by a doctor within 24 hours. Get emergency care if you can't reach your doctor or if you have these symptoms:

• Trouble breathing or swallowing or in smaller children, continuous drooling
• Numbness or weakness in the arms and legs
• Trouble walking or speaking
• Fever or chills

The neck will be examined, and questions about any current or former health problems will be asked. Neck X-rays may be taken to check for broken bones.

The goal in treating torticollis is to relax the neck muscles. The best method will depend on the cause of the problem. In most cases, one or more of these may be given:

• Medicines. These help relax the muscles and ease pain.
• Hot and cold compresses. These may help ease muscle tightness.
• Physical therapy. This can help stretch and strengthen the neck muscles and improve movement.
• Botulinum toxin injections. These may help manage certain muscle spasms, such as cervical dystonia.
• Surgery. If nonsurgical treatment has not been successful, then surgery may be recommended to lengthen the muscle.

Depending on the cause, torticollis often goes away on its own. Follow the instructions from the ER and follow up with your doctor as instructed. Contact your doctor right away or return to the ER if any of these occur:

• More neck pain
• No relief with the medicines prescribed
• Symptoms get worse

Call 911 if any of these occur:

• Trouble swallowing or breathing
• Skin or lips that look blue or gray
• Increasing pain or severe pain that doesn't go away
• Sudden weakness, numbness, or tingling in the arms or legs
• Loss of control of bladder or bowels