Pediatric Torticollis

September 06, 2022 | Children, Chiropractic, Massage, Physiotherapy

Torticollis is when one side of the neck is much tighter than the other. This can occur in babies because of crowding while developing in utero or because of the birth process itself. When your child persistently tilts their head to one side, it is possible that they have torticollis.  The word “torticollis” is derived from two Latin words; tortus and collum which when together mean “twisted neck”.  This condition can also be referred to as wryneck. 

Congenital Torticollis

Congenital means present at birth and is the most common form of torticollis.  This form often responds well to chiropractic care and physiotherapy.  Alleviating muscle imbalance, joint restriction, and providing parents with at home exercises and repositioning advice typically lead to positive outcomes.  Clinical presentation includes limitations in neck ranges of motion, head tilt preference, and occasionally a small pea-sized lump in the sternocleidomastoid muscles (SCM).  

With congenital torticollis, plagiocephaly can also be a concern.  Plagiocephaly is an asymmetrical head shape due to consistently lying on one side of the head. This occurs as neck tension makes it difficult for the infant to change positions easily.  This results in uneven forces pulling on the baby’s head which then leads to a flat spot and/or facial asymmetry, and alterations to the infant’s head shape.  

Infants with congenital torticollis are slightly more likely to have other musculoskeletal problems such as hip dysplasia.  Firstborn children, males, and those born with the assistance of forceps and vacuum extraction are also at higher risk for developing plagiocephaly.

 The following can contribute to the development of congenital torticollis: 

  • baby position in utero
  • abnormal development of the SCM muscle
  • trauma/damage to the neck musculature during labour and delivery
  • multiple pregnancies with crowding in utero also increase the risk of one or both children developing torticollis

Acquired Torticollis

Acquired torticollis occurs later in infancy or childhood, typically after 4 months of age.  It can develop slowly or suddenly and is not typically associated with facial asymmetry or acquired plagiocephaly.  The causes for acquired torticollis can vary greatly and can run the spectrum of benign to more serious in nature and may also be related to other underlying health issues.  The treatment plan is dictated by what underlying cause is identified.


Treatment for congenital torticollis involves lengthening/stretching the SCM musculature while strengthening the opposite side of the neck which tends to become weaker.  Limiting container usage (ie stroller, car seats, bouncy seats etc.) may also be recommended to reduce the chances of developing head and facial asymmetries related to plagiocephaly.  Repositioning recommendations are also used. As a preventative approach to avoid constraints in utero, chiropractic, physiotherapy, and massage therapy techniques can be used during pregnancy

Your healthcare provider can develop a care plan and work towards the goals set for your child.  To book an appointment for an assessment, please call our clinics at 613-237-9000 (Glebe) or 613-860-8600 (Byward).  Or to learn more about our providers and how they can help, please visit our website at