Patient's question:
My child is already 97 days old. His head and neck always habitually tilt to one side. He only turns back when something guides him. What could be the reason for this! What method should I use to correct him. Thank you!Doctor's answer:
Hello! It's important to consider whether your baby's condition could be due to torticollis. I recommend taking them to the hospital for a check-up.Torticollis generally falls into two categories: one is bony torticollis caused by developmental abnormalities of the cervical spine; the other is muscular torticollis, which results from the fibrosis and shortening of the sternocleidomastoid muscle after injury. The first type is rare, while the second is common. It is generally believed that there are two causes:
1. Prenatal Positional Factors: Poor posture of the fetus in the womb may compress or stretch one side of the sternocleidomastoid muscle, leading to ischemia, atrophy, and developmental abnormalities of the muscle. This can gradually cause muscle contracture, resulting in torticollis.
2. Delivery-Related Injuries: During childbirth, one side of the sternocleidomastoid muscle may be injured due to compression from the birth canal or forceps. Hematoma formation and subsequent fibrosis at the injury site can lead to torticollis.
Early treatment is crucial for torticollis, with better outcomes achieved the sooner it begins. Non-surgical treatments can be used in the early stages, including local massage, heat application, positional immobilization, and manual manipulation. The purpose of massage and heat application is to reduce swelling early and prevent muscle contracture.
For positional immobilization, the child should sleep in a supine position with the chin turned toward the affected side and the occiput toward the unaffected side. The head should be stabilized in this position using soft materials. Manual manipulation can be performed two weeks after birth. The method involves turning the chin toward the affected side while elevating it and tilting the head toward the unaffected side. This should be done 3–4 times daily, with massage or heat applied to the affected sternocleidomastoid muscle each time. Treatment typically needs to be maintained for 4–6 months.
If non-surgical therapy is ineffective, surgical intervention may be considered between the ages of 6 months and 12 years.