Congenital Torticollis: Management

Previous Post: Congenital torticollis- Diagnosis and Assessment

Management of Congenital Torticollis


  • Routine neck imaging is not recommended
  • If a mass is present but not characteristic of SCM, ultrasound (US) may be helpful
  • A cervical spine X-ray may detect vertebral anomalies in atypical torticollis
  • A hip US in infants with congenital muscular torticollis is recommended


  • Educate caregiver on infant positioning during feeding, sleeping and playing (including the importance of supervised prone positioning) and making environmental modifications to encourage head and neck movement
  • Passive stretching exercises 4-5 times a day
  • Follow up within 4 weeks for monitoring
  • Consider referral to physiotherapy in the following cases:
    • No improvement with home exercises by 4-6 weeks 
    • Severe torticollis: limited ROM at diagnosis (e.g. <30 degrees rotation)
    • Child older than 3 months at diagnosis with more than minimal torticollis
    • Associated moderate to severe plagiocephaly

A majority of cases will resolve after four to five months. If no significant improvement by 6 months of age, re-consider the diagnosis or refer to paediatric orthopaedic surgeon.

Previous Post: Congenital torticollis- Diagnosis and Assessment

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