Congenital muscular torticollis is a painless condition usually presenting during infancy with a tight sternocleidomastoid muscle causing the child's head to be tilted to the tightened side. Limited neck motion and a palpable tumor within the muscle are often present. A regimen of stretching exercises is the most common form of treatment with positive outcomes for over 90% of the identified cases. Rarely children require surgical intervention to release the tightened muscle. Botox injections to relax the tight muscle is a new form of treatment being used by some practitioners. Torticollis also presents as a symptom for a variety of muscular, bony, and neurologic conditions, which are briefly reviewed in this article.
Brenda L. Luther, MSN, RN, is the Director of Care Coordination Services at Shriners Hospitals for Children, Intermountain, in Salt Lake City, Utah.