There are basically two types of torticollis — acquired or congenital muscular torticollis. We believe that the most common cause of torticollis or wry neck is a rotatory subluxation of the atlanto-occipital joint, which is an acquired condition.
Congenital muscular torticollis, on the other hand, develops early in the life of a child. Patients with torticollis often have trauma to the cervical spine due to the high incidence of a breech birth.
The classic physical finding in torticollis is the tilting of the head to one side resulting in a limited range of motion. The head is typically rotated away from the neutral position.Some patients can feel on their neck a mass or lump that is often a contracted sternocleidomastoid (SCM) muscle. A common complaint is neck pain. Adult patients may also complain of occipital pain, vertigo, and dizziness.
Contracture of the sternocleidomastoid SCM muscle is another common cause of congenital muscular torticollis; the muscle may eventually become fibrotic .The most common bony abnormality is atlantoaxial rotatory subluxation – rotatory displacement of C1 on C2. Treatment of torticollis, as with any disorder, depends on accurately diagnosing the true cause of the condition first.