Neck pain is one of the most common reasons for visiting a registered massage therapist. One cause of neck pain and disability requiring unique identification and treatment is called torticollis. Latin for “twisted neck”, torticollis involves involuntary painful contractions or intermittent spasms of neck muscles, which may lead to the head abnormally pulling to one side, difficulty turning the head, and headaches.
Whether torticollis is congenital, spasmodic, or acute/acquired, massage therapy is an effective treatment, but there are significant distinctions between the various forms and special considerations to be aware of to ensure a proper diagnosis and treatment plan. Here is how registered massage therapists may assess this condition and relieve the painful muscle contractions.
Torticollis is sometimes mistaken for muscular dystrophy, epilepsy or Parkinson’s disease. Massage therapists generally confirm that the patient has been diagnosed with torticollis by a medical professional prior to treatment.
Spasmodic torticollis, also called cervical dystonia, is an extremely painful, chronic neurological disorder with three variations, named according to neuromuscular dysfunction: tonic (a sustained contraction), clonic (head shaking), and mixed (both).
Congenital torticollis is present at birth or soon after in infants, possibly as a result of intrauterine crowding or muscle trauma during delivery. Afflicted infants often have an obvious head tilt, needing treatment to stop the head’s weight from deforming the skull base and cranium. Pediatric massage therapists may ask parents for symptoms such as difficulty breastfeeding in certain positions or a tendency to move the head in one direction, always proceeding only after a full evaluation and diagnosis from a medical professional. Massage therapists are also able to educate parents on appropriate stretches for the infant to help normalize head position.
Acute or acquired torticollis, sometimes called “wry neck”, is the most common form of the disorder encountered by graduates of registered massage therapist school. It most often involves shortening or hypertonicity of the sternocleidomastoid (SCM) muscle, which both turns the head and tilts it to the side. The SCM on the affected side will likely be more prominent and the head and neck are frequently held in a non-neutral position. Acquired torticollis may be manifested by any activity causing prolonged shortening of neck muscles, such as playing an instrument, sleeping in a bad position, holding a telephone between the head and shoulder, or even the cold Canadian winters. A neck injury such as whiplash may also cause the acute version. Massage Therapy students are trained through taking a thorough interview to inquire about various factors that could have contributed to the condition. Home care and prevention is then assigned to help patients keep themselves pain free.
Treating torticollis demands extra care, particularly with infants and highly sensitive tonic or clonic cases. Massage therapists will work to release contracted neck muscles using gentle massage, traction of the neck, and applying heat. Slow and gentle stretching and kneading movements learned in registered massage therapist training, will attempt to stretch and relax the neck tissues progressively from the superficial toward the deeper layers. Cranial-sacral therapy may gently enhance circulation around the musculature, allowing contracted tissues to slowly unwind.
Once the acute spasm has been relieved, myofascial release techniques can help improve the patient’s range of motion, stretching and holding the painful muscle and the same one on the opposite side of the neck until they are more relaxed and soft. The massage therapist will then search for tightened trigger points, pressing and holding to support relaxation.
Unique child-friendly approaches are required for treating congenital torticollis, applying gentle stroking techniques to help reduce spasms and engaging the infant to turn their own head once the tissues are softened. According to a 2011 study, primary massage of twining manipulation with one finger produced more obvious curative treatment than alternative techniques. Massage therapy both lengthens and strengthens the child’s neck muscles, generally resolving the condition within the first year.
Would you like to become a registered massage therapist?
Contact OVCMT to learn more about our massage therapy diploma training.