wry neckWry neck or torticollis is a disorder that results in limited motion of the cervical spine, causing the head to remain in a tilted position. Torticollis is caused by muscular, skeletal, or neurologic abnormalities. Some common names for torticollis include skeletal wry neck, congenital wry neck, cock robin deformity, and Sandifer’s syndrome.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 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.