Adult Torticollis: Treatment Options and Recovery Insights

Adult torticollis

Hello Dr.
Chen,
I would like to ask a question.
My son is 22 years old this year.
Since he was little, I made him sleep on his stomach on the same side (right side).
Foolishly, I only focused on the uneven curvature of the back of his head, wanting to correct it.
However, when he turned three months old, I noticed that his face had become asymmetrical.
At that time, my husband kept saying, "He is still young; it will get better as he grows." I watched him every day and saw no improvement, which made me very worried, but my husband insisted that he would get better with age.
Therefore, I never thought about taking him for a consultation.
In high school, he often complained of neck and shoulder pain, and his father always said it was just a stiff neck.
As a result, we never sought medical attention.
Now, he is experiencing severe neck pain and went to a nearby orthopedic doctor, who said that the cartilage between the 4th and 5th cervical vertebrae is ruptured (without an X-ray).
The doctor mentioned that he just needs to maintain correct posture moving forward.
My son went to see the doctor on his own and seemed to take it lightly, but I was terrified.
He said the doctor didn't say much, so why am I so anxious?
Now, I have researched information about torticollis online and feel devastated that we missed the critical period for rehabilitation.
What should I do now? Is the fact that he has ruptured cartilage an indication that his condition will worsen? He mentioned that he has exams and won't have time for rehabilitation for another six months.
Is that acceptable? Can torticollis be treated with acupuncture, cupping, or gua sha? Should he consult other specialists as well? Thank you!

Meihua, 50~59 year old female. Ask Date: 2015/08/17

Dr. Chen Wayda reply Rehabilitation

Visit the rehabilitation department at a major hospital.

Reply Date: 2015/08/17

More Info

Understanding Adult Torticollis: Treatment Options and Recovery Insights
Torticollis, commonly referred to as "wry neck," is a condition characterized by an abnormal, asymmetrical head or neck position. It can be congenital or acquired, with the latter often resulting from muscle spasms, injury, or prolonged postural habits. In your son's case, it seems that his condition may have developed due to the prolonged positioning during sleep, which can lead to muscle imbalances and structural changes in the cervical spine.

Given your son's age and the history of neck pain, it is crucial to address his condition proactively. The fact that he has been experiencing significant neck pain and has been diagnosed with a soft tissue injury (possibly a herniated disc or degenerative changes) indicates that he may require more than just posture correction. While the orthopedic doctor suggested that maintaining proper posture would suffice, it is essential to consider a comprehensive treatment plan that includes rehabilitation.

Rehabilitation is vital, especially since you mentioned that he has missed the "golden period" for treatment. Early intervention is often key in managing musculoskeletal issues effectively. Delaying rehabilitation for six months, especially when he is already experiencing pain, could lead to further deterioration of his condition. It is advisable to seek physical therapy sooner rather than later. A physical therapist can provide targeted exercises to strengthen the neck muscles, improve flexibility, and correct postural habits. They may also employ modalities such as ultrasound therapy, electrical stimulation, or manual therapy to alleviate pain and promote healing.

In addition to physical therapy, alternative treatments such as acupuncture, cupping, or gua sha may provide symptomatic relief. These modalities can help reduce muscle tension and improve blood circulation in the affected area. However, it is essential to consult with a healthcare professional before starting any alternative therapies to ensure they are appropriate for your son's specific condition.

As for the concern regarding the cervical spine's soft tissue injury, it is crucial to monitor his symptoms closely. If he experiences worsening pain, numbness, or weakness in the arms, it may indicate nerve involvement, necessitating further evaluation, possibly including imaging studies like an MRI. This will help rule out any serious underlying conditions that may require more aggressive treatment.

Regarding your emotional distress about your son's condition, it is understandable to feel anxious, especially when you believe you may have contributed to his current state. However, it is essential to focus on the present and the steps you can take to support his recovery. Encourage him to prioritize his health and consider starting rehabilitation as soon as possible, even if it means adjusting his study schedule.

In summary, your son should seek physical therapy to address his neck pain and torticollis. While posture correction is essential, it may not be sufficient alone, especially given the current severity of his symptoms. Alternative therapies can be considered as adjuncts to traditional rehabilitation. Lastly, maintaining open communication with healthcare providers and ensuring timely follow-up will be crucial in managing his condition effectively.

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