Torticollis: Causes, Symptoms, and Treatment

Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.

What kind of doctor treats Torticollis?

A pediatrician, a doctor who treats children, usually checks a baby who holds the head tilted. A physical therapist, an expert in movement and exercise, can teach stretching exercises. Adults can start with a primary care doctor, who can refer them to a specialist. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.

What is torticollis?

Torticollis is a condition in which the neck muscles make the head tilt, turn, or rotate to one side. It is also called wry neck or twisted neck.

Congenital muscular torticollis is present at birth or starts soon after. Torticollis can also start later in infancy, in childhood, or in adults. This later kind is called acquired torticollis.

Symptoms

Symptoms of torticollis can include:

  • Limited movement of the head.
  • Neck pain and stiff neck muscles.
  • One shoulder that sits higher than the other.
  • Swelling of the neck muscles, which may be present at birth.

In babies, the head tilts to one side and the chin points to the opposite shoulder. Limited neck movement makes it hard for the baby to turn the head from side to side. A soft lump may be felt in the neck muscle in the first weeks, and it is not painful. The lump gradually goes away before the baby reaches 6 months of age. One side of the face and head may flatten because the child always sleeps on one side.

Causes and who gets it

The cause of congenital muscular torticollis is unknown. It may be related to the baby's position in the womb, such as a breech position, or to crowding in the womb. This can injure the neck muscle, and the muscle scars as it heals.

Torticollis can also be due to problems in the nervous system, upper spine, or muscles. It can also be due to gene changes, often passed down in the family.

How doctors diagnose it

A health care provider will do a physical exam. The exam may show a head that is rotated, tilted, or leaning forward or backward.

Tests that may be done include:

  • An x-ray of the neck.
  • An MRI of the head and neck.
  • An electromyogram (EMG), a test to see which muscles are most affected.

For a baby, the doctor asks about the child's general health and the symptoms. X-rays and ultrasound scans of the neck or hips may be ordered. A pediatrician or another specialist can tell muscle torticollis apart from types caused by bone or vision changes.

Treatment

The standard treatment for congenital muscular torticollis is an exercise program that stretches the tight neck muscle. Stretching exercises include:

  • Turning the baby's neck side to side so the chin touches each shoulder.
  • Gently tilting the head to bring the ear on the unaffected side down to the shoulder.

These exercises are done several times a day. The child's doctor or a physical therapist teaches parents how to do them. Parents can also help at home by doing these things:

  • Carry the child so that they look away from the limited side.
  • Give brief periods of tummy time while the baby is awake to help strengthen the neck muscles.

About 10% of children with congenital muscular torticollis need surgery. Surgery is usually planned for the preschool years. It lengthens the short neck muscle, and the child may go home the same day.

Torticollis that comes from damage to the nerves, spine, or muscles is treated by finding the cause and treating it. Depending on the cause, treatment may include:

  • Physical therapy, such as heat, neck traction, and massage to ease pain.
  • Medicines to reduce neck muscle contractions.
  • Botulinum toxin injections into the affected muscles.

Torticollis may be easier to treat in infants and children. Early treatment may keep it from getting worse.

When to see a doctor

If you notice that your child holds the head tilted to one side, talk to your pediatrician. Contact your provider if symptoms do not improve with treatment or if new symptoms develop. Torticollis that starts after an injury or with an illness may be serious, so get medical help right away. Call 911 or go to the emergency room if there is trouble breathing, fainting, or a sudden change in mental state, such as confusion.

How a direct primary care or concierge doctor fits in

A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can examine the neck and order first tests. They can also refer you to a physical therapist or another specialist.

Common questions

What causes torticollis in babies?

The cause of torticollis in babies is unknown. It may be related to the baby's position or crowding in the womb. That can injure the neck muscle, which then scars as it heals.

Can torticollis be prevented?

There is no known way to prevent congenital muscular torticollis. For torticollis in general, early treatment may keep it from getting worse.

Does a baby with torticollis need surgery?

Only about 10% of children with congenital muscular torticollis need surgery. For most babies, stretching exercises and changes in how the baby is held or positioned gradually lengthen the muscle and correct the problem. Doctors may suggest surgery if these options do not correct the torticollis.

Can torticollis cause pain?

Yes, torticollis can cause neck pain and headache. The soft lump that some newborns have in the neck muscle is not painful.

Sources

  1. MedlinePlus - Torticollis
  2. American Academy of Orthopaedic Surgeons - OrthoInfo - Congenital Muscular Torticollis (Twisted Neck)

Medical Disclaimer

This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.