In this episode, we review torticollis, a condition characterized by abnormal head and neck positioning caused by involuntary contraction or dysfunction of cervical muscles—most commonly the sternocleidomastoid. We discuss the various forms of torticollis, including congenital torticollis, cervical dystonia (spasmodic torticollis), ocular torticollis, and trauma-related cases, along with the neuromuscular mechanisms that lead to abnormal neck rotation and tilt. The episode highlights common clinical presentations, risk factors such as birth trauma, stress, or sudden neck movement, and key physical exam findings including lateral head tilt with contralateral rotation. We also review the role of imaging when structural or neurologic causes are suspected and discuss management strategies ranging from physical therapy and muscle relaxants to botulinum toxin injections and surgical intervention in select cases. Key clinical pearls help clinicians recognize the different types and underlying causes of this distinctive neck disorder.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Raucci U, Roversi M, Ferretti A, et al. Pediatric torticollis: clinical report and predictors of urgency of 1409 cases Ital J Pediatr. 2024; 50(1).
3. Cunha B, Tadi P, Bragg BN. Torticollis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539857/
4. Gundrathi J, Cunha B, Tiwari V, et al. Congenital Torticollis. [Updated 2024 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549778/