With the rapid and significant rise in birth intervention and birth trauma, we see more and more cases of torticollis (wryneck) in infants each year in our office.
Unfortunately, traditional medicine has not significantly updated its understanding of what causes torticollis or how to best care for it. This often leaves families with limited treatment options, such as physical therapy, which may not address the root cause of the problem.
What is Torticollis in Infants?
Torticollis in an infant causes a stiff, stuck, and twisted neck. The baby’s head remains continually bent to one side. This positioning makes it difficult for the child to turn and rotate their head and neck in both directions.
Parents and providers can easily identify more significant cases of infant torticollis. However, standard paediatric examinations often overlook mild to moderate cases. Parents are frequently told to “watch and wait” and reassured that their child will “grow out of it” over time.
Signs and Symptoms of Torticollis
While torticollis in older children or adult often presents with pain or headaches. In infants, the signs and symptoms of look different and may include:
- Frequent bouts of crying, irritability, or colic
- Difficulty latching, nursing, or breastfeeding
- Infant reflux or digestive problems
- Baby’s head tilted to one side, with the chin tilted to the other side
- Limited range of motion in the neck
- Repeated head positioning in the car seat or during sleep
- Difficulty settling or sleeping
- Swollen or tight neck muscles
- A small, pea-sized lump in one of the baby’s neck muscles
- Uneven or asymmetrical facial features
- Increased likelihood of plagiocephaly
- Gross motor delays
What Causes Torticollis in Infants?
Medical professionals diagnose torticollis as congenital when abnormal fetal positioning occurs in the womb. This presentation appears more often with breech positioning or reduced amniotic fluid. Some genetic conditions, such as Klippel-Feil syndrome, may also contribute to congenital torticollis.
The most common presentation of torticollis is acquired torticollis. Birth trauma represents the leading cause. Birth interventions such as forceps delivery, vacuum extraction, or caesarean section can place significant physical strain on a baby’s head and neck.
This strain can result in an upper cervical subluxation. That subluxation may then contribute to the development of torticollis.
Understanding Subluxation
A subluxation includes three main components:
- Misalignment and abnormal positioning of the spinal vertebrae
- Fixation and reduced range of motion in the segment and region of the subluxation
- Neurological interference and imbalance caused by reduced amounts of proprioception and increased amounts of nociception
In simple terms, more severe and visible torticollis often reflects more significant misalignment and fixation patterns.
Care Options for Torticollis
The first thing we encourage parents to do if they’re concerned their child may have torticollis is not to rely solely on their paediatrician’s or medical doctor’s exam findings. Of course, pediatricians are trained to perform physical exams in a way that allows them to spot neuromuscular challenges, such as torticollis. Still, they don’t have nearly the experience or detailed training in those systems as a Paediatric Chiropractor or Physical Therapist would.
If the paediatrician does spot torticollis for a child, they most likely will make a referral to a PT, who then will show the parents a few positioning and stretching exercises they can do at home to try and help alleviate the torticollis. However, most parents report to us that these stretches and exercises are extremely painful for the child and often tend to aggravate the condition, as they leave the child in a sustained state of fight-or-flight tension, a condition known as dysautonomia.
Upper Cervical Chiropractic and Torticollis
The Paediatric Upper Cervical Chiropractic approach to caring for torticollis is so often the one parents feel makes the most sense, and it can be summarised in these three (3) simple and safe steps:
- Find and locate the exact location and severity of the subluxation
- Make safe and gentle neuro-tonal adjustments to relieve the tension and remove the subluxation
- Encourage parents to watch closely for a recurrence of the torticollis around growth spurts, teething, colds, illnesses, or other stressful events the child may experience
Additionally, parents routinely report that when they put Paediatric Chiropractic as the foundation and first choice for their child’s torticollis, it then makes all the physical therapy stretches and positioning work easier and far more effective! At Top Chiropractic, we love nothing more than working in conjunction with your child’s therapy team for maximum results!
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