Neck (Cervical)
Acute Torticollis
사경증 (급성 목 돌아가기)
A condition in which the neck tilts or twists to one side
- How common
- Common
- Typical age
- All ages
What is it?
A sudden spasm of the sternocleidomastoid (SCM) or paracervical muscles locks the neck in a tilted position.
Commonly affected: Sternocleidomastoid (SCM), trapezius, splenius capitis.
How it develops
- Triggers of muscle spasmSleeping posture, cold drafts, sudden movement, or stress.
- SCM spasmA unilateral SCM contraction rotates the neck toward the opposite side.
- Pain–spasm cycleA vicious cycle of spasm → pain → worsening spasm.
Symptoms
- Abnormal neck postureNeck tilts to one side and rotates to the opposite side.
- Severe painSevere pain on any attempted neck movement.
- Muscle rigidityUnilateral cervical muscles palpably hard.
- HeadacheMay be accompanied by headache.
How it is examined
- SCM rigidityUnilateral SCM is firm and tender.
- Markedly restricted cervical motionRotation away from the affected side is nearly impossible.
- No neurologic deficitAcute torticollis has no neurologic symptoms.
Imaging
X-ray rules out subluxation, fracture, or structural abnormality.
- Usually normal
- May show mild cervical lateral curvature
MRI is not required for uncomplicated acute torticollis; obtained only if symptoms persist to identify a cause.
- Acute torticollis is usually normal on MRI
Non-surgical care
- Muscle relaxantsMethocarbamol or baclofen — the most effective option.
- NSAIDs + heatNSAIDs combined with warm compresses.
- StretchingOnce pain eases, gradually stretch in the opposite direction.
- Spontaneous recoveryMost cases resolve spontaneously within 1–2 weeks.
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Reserved for congenital torticollis or spasmodic torticollis (cervical dystonia).
Procedures that may be discussed
- Botulinum toxin injection (spasmodic torticollis)
- Surgical muscle release (congenital)
Outlook
Excellent prognosis for acute torticollis; most patients fully recover within 1–2 weeks.