What Is Torticollis, and Why Is My Neck Stuck to One Side?
Torticollis, sometimes called wry neck, is a condition where the neck muscles tighten or go into spasm. This pulls your head into a tilted or turned position to one side. It can come on suddenly in adults, or a baby can be born with it. The cause can be anything from a simple muscle spasm to an underlying problem in the cervical spine that needs to be looked into.
- Torticollis means your head is tilted or twisted to one side because of muscle tightness or spasm in the neck.
- In adults it often comes on suddenly (acute wry neck) and usually settles within days, but cases that do not go away need investigation.
- In babies it is called congenital muscular torticollis and is usually caused by tightness in a muscle called the sternocleidomastoid.
- Standing imaging shows how a neck tilt affects the whole spine, revealing compensations that lying-down scans can miss.
- If you have numbness, weakness, or difficulty swallowing along with a twisted neck, get urgent medical help.
What does torticollis look and feel like?
Torticollis is usually easy to spot. Your head leans to one side. You may find it painful or impossible to straighten it. These are the common signs.
What causes torticollis?
Torticollis happens when the sternocleidomastoid muscle, or another neck muscle, shortens or goes into spasm. What sets it off depends on the type.
Why does acute wry neck happen in adults?
Acute wry neck usually comes on without warning, often after a night's sleep or a quick turn of the head. The muscles on one side of the neck go into spasm. They lock your head in a tilted or turned position.
Most episodes are self-limiting. They settle within a few days with gentle movement, warmth, and over-the-counter painkillers. But if the problem keeps coming back, or does not clear up within a week or two, it is worth looking into further.
A head tilt that does not go away changes the alignment of your whole spine. Your body is a connected chain from your skull to your feet. When the head sits off-centre, the shoulders, mid-back, and pelvis adjust to compensate. Over time, this can cause pain in places far from the original problem, including a cervical tilt that becomes a habit.
If your wry neck keeps coming back or your head tilt will not go away, a standing whole-body image can show the full picture. Book a free video consultation
What is congenital muscular torticollis in babies?
Congenital muscular torticollis is the most common form of torticollis in babies. It is caused by tightness or shortening of the sternocleidomastoid muscle on one side of the neck. This usually comes from the baby's position in the womb or during delivery.
Parents usually notice a head tilt in the first weeks of life. The baby may prefer to look one way and find it hard to turn the other way. Sometimes a small, firm lump can be felt in the affected muscle. If it is not dealt with, it can lead to a flattened area on the skull (plagiocephaly) and uneven development of the face.
Early stretching with a physiotherapist is the standard approach and works in most cases. Your doctor or paediatrician will guide you. If imaging is needed to check the cervical spine, paediatric imaging at ScanAlign uses an EOS system that delivers about 90% less radiation than a standard X-ray, around ten times less. This matters when the patient is a child.
How is torticollis assessed with standing imaging?
A standing, weight-bearing image captures your neck and spine in the position they actually work in. When you lie down for a normal X-ray or MRI, gravity is taken away. Your muscles relax, and a tilt or compensating curve may flatten out. This can make the image look more normal than the reality.
With ScanAlign, low dose standing imaging, the EOS system takes a full-length image of your skeleton while you stand naturally. This shows the true position of the cervical spine in relation to your shoulders, ribcage, pelvis, and legs. Your treating clinician can then see exactly how a lasting tilt is affecting the rest of your alignment.
The EOS system uses about 90% less radiation than a standard X-ray, around ten times less. This is especially important if repeat imaging is needed to track changes over time.
When MRI is the better choice: EOS is excellent at showing bones, joints, and alignment. If your treating clinician suspects a disc problem, nerve compression, or a soft-tissue cause for your torticollis, MRI is usually the better tool. The two work well together.
When should you see a doctor urgently for a twisted neck?
Most episodes of acute wry neck are uncomfortable but harmless. However, some symptoms along with a twisted neck need urgent medical attention. Contact your doctor or go to the nearest emergency department if you have any of the following:
- Numbness, tingling, or weakness spreading into your arms or legs.
- Difficulty swallowing or breathing.
- Loss of bladder or bowel control.
- A twisted neck after a fall, head injury, or accident.
- Fever, severe headache, or neck stiffness that could suggest infection or meningitis.
These signs do not necessarily mean something serious, but a medical professional needs to rule them out quickly.
Before you start treatment, or change the one you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in the pelvis, the legs or the spine changes what will actually help.
Frequently asked questions about torticollis
They mean the same thing. Torticollis is the medical term, from the Latin for "twisted neck." Wry neck is the everyday English name for the same condition.
Most episodes settle within a few days to two weeks with gentle movement, warmth, and simple painkillers. If it lasts longer than two weeks or keeps coming back, see your doctor for further assessment.
Yes. A head tilt that does not go away forces the rest of the spine to compensate. Over time, this can lead to shoulder pain, mid-back stiffness, or even lower back and hip discomfort.
Cervical dystonia, also called spasmodic torticollis, is a specific neurological form. It involves involuntary, sustained muscle contractions and is a long-term condition managed by a neurologist. Most cases of torticollis are muscular and much simpler.
No. ScanAlign accepts self-referrals. You can book an assessment directly without a letter from your doctor.
Yes. The EOS system uses about 90% less radiation than a standard X-ray, around ten times less. The scan takes only seconds while you stand still, so it is well tolerated even with a stiff neck.
Yes. The low radiation dose makes EOS well suited to younger patients when imaging is clinically needed. ScanAlign offers paediatric imaging for children referred by their treating clinician or a parent.
The sternocleidomastoid is a large muscle on each side of your neck. It runs from behind the ear down to the collarbone and breastbone. When one side tightens or shortens, it pulls the head into a tilt.
ScanAlign is a private, self-pay clinic. The price for patients travelling from abroad is confirmed during the free video consultation.
When you lie down, gravity is taken away. Your muscles relax and a tilt can flatten out, making the scan look more normal than the reality. Standing imaging captures your spine under real weight-bearing conditions. It shows the true position and any compensations happening further down the body.
Neck tilt that will not go away?
A free video consultation lets you talk through your symptoms with a specialist radiographer, with no obligation and no pressure.
Book a free video consultationWritten by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- NHS. "Neck pain and stiff neck." nhs.uk, 2023.
- American Academy of Orthopaedic Surgeons. "Congenital Muscular Torticollis (Twisted Neck)." orthoinfo.aaos.org.
- Deschênes S, et al. "EOS imaging for musculoskeletal conditions: a systematic review." European Radiology, 2010; 20(12): 2707-2714.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.