Frugal Sports Medicine: Spastic Torticollis Syndrome

Submitted By Phillip Peters, Inventor of Shane's Neck Brace
Written by Dr. Emanuel Cane
This condition can occur at any age, but more frequently between the ages of 30 and 60. I have seen it in a girl 12 years of age. This particular case was a congenital condition that appeared at around age 3 or 4. The onset can be sudden or gradual in nature, it is usual gradual, unless it has been trauma induced, such as a whiplash due to an automobile accident, or a severe fall that impacts the head. A cure is not always possible and the condition can recur from time to time if it is aggravated in some way.
Two main muscles are generally involved in spastic torticollis. They are the sternocleidomastoid and trapezius. Other neck muscles can also be involved as well. When there is spasm of the sternocleidomastoid muscle the head is rotated to the opposite side and the neck is flexed to the same side. The reason that these are the two main muscles being the causative factors in spastic torticollis is that they are attached to the base of the skull and pass to the mastoid process, where at that point they split into different attachments along the clavicle. In whiplash injuries, it is usually the sternocleidomastoid muscle that is affected when the head is thrown backward and then snapped forward.

This is known as a hyperextension injury, or as previously mentioned, a whiplash injury of the neck. When an injury of this sort occurs, you should see your healthcare provider as soon as possible to evaluate the extent of the injury, even if you feel no pain at that time. A Chiropractor may be the best healthcare provider in this instance, as it may be necessary to adjust a subluxation of the cervical vertebrae in a hyperextension injury. A subluxation is the displacement of a vertebra or vertebrae from its normal position. Pain can occur after such an injury days or weeks after the initial injury. X-rays and possibly an MRI will be needed to get a definitive diagnosis, and to make sure that there is no minute fractures that might have occurred.

The individual should apply ice packs for 15-20 minutes several times a day for the first 48 hours, after which moist heat would be the therapy of choice. Your healthcare provider may also have provided you with a neck collar to keep your head movements at a minimum, so that the muscles will be able to rest more without the added movements. It is not advisable to wear the collar constantly so as not to have the muscles stiffen up, as that can cause a chronic stiffness of the neck. Wear it during the day when you are most active, and remove it at night when going to bed. With the application of the ice packs, followed by the moist heat packs as previously mentioned, you should apply a good analgesic gel 3 to 4 times daily. This will tend to relieve any residual pain and keep the muscles less spastic. Following a regimen as outlined above can be the best possible way to improve this condition and possibly prevent painful recurrences.

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