Pediatric Torticollis

Congenital Muscular Torticollis: A Review, Case Study, and Proposed Protocol for Chiropractic Management

From the abstract:   A case study of a 7-month-old infant who had been medically diagnosed with the disorder as birth-trauma related. Summary: Six sessions of chiropractic management involving low force adjusting and gentle myofascial release work were administered based on clinical mechanical findings derived from an apparent right hand and right leg dominance of the child. The child had not previously responded to several weeks of physical therapy. Following chiropractic care, the case completely resolved. The response was sustained at 1year follow-up.

Colin N.   Top Clin Chiro (1998); 5(3):27-33.

Reduction of Congenital Torticollis in a Four Month Old Child with Vertebral Subluxation: A Case Report & Review of Literature

Objective: To document clinical changes after a course of chiropractic care and physical therapy in a pediatric patient presenting with congenital muscular torticollis (CMT) and vertebral subluxation.

Clinical Features: A four month old female with congenital torticollis presents to a chiropractic office, having previously undergone physical therapy, Cranial-Sacral Therapy and myofascial release therapy with limited improvement. Chiropractic exam revealed a left head tilt with severely decreased left cervical rotation as well as resistance upon passive flexion of the left arm. Vertebral subluxations were found in the cervical spine and pelvis.

Intervention and Outcome: The patient received chiropractic adjustments, stretching and trigger point therapy. Palpation, range of motion and posture analysis were used to determine location of subluxation and needed correction. Through the course of care, postural as well as functional improvements were observed.

Conclusion: In this child, congenital muscular torticollis was markedly reduced with a combination of chiropractic care directed at reducing vertebral subluxation and physical therapy. Previous studies, pathophysiology and treatment pertaining to birth trauma, Congenital Muscular Torticollis and chiropractic are reviewed. Additional research is encouraged in order to further elucidate the best treatment strategy for these children.

Stone-McCoy, P , Grande , N, Roy, I [JVSR January 7, 2008 pp 1-8] 

Chiropractic Correction of Congenital Muscular Torticollis

Objective: To present a case of congenital muscular torticollis and discuss the clinical manifestations and chiropractic treatment.

Clinical Features: A 7-month-old male infant with significant head tilt since birth was brought to a chiropractic physician for evaluation. The infant’s history included ear infections, facial asymmetry and regurgitation. Significant spasm of the left sternocleidomastoid and trapezius muscles, a left lateral atlas and suboccipital joint dysfunctions were present upon examination. A diagnosis of congenital muscular torticollis was made.

Intervention and Outcome: Treatments included chiropractic manipulation, trigger point therapy, specific stretches, pillow positioning and exercises. Excellent results were obtained.

Conclusion: Suggests that chiropractic intervention is a viable treatment option for congenital muscular torticollis. Further studies should be performed to compare the effectiveness of other treatment options.

Toto BJ.   J Manipulative Physiol Ther. 1993 (Oct);16 (8):556-559

A Retrospective Analysis of Infants With Postural Torticollis Receiving Chiropractic Care

Abstract

Purpose: A retrospective analysis of infants under chiropractic care for postural torticollis.

Methods: Through descriptive statistics, we describe a cohort of infants that consecutively presented to one chiropractic clinic in Chur, Switzerland in a period of 6 months. The infants were cared for with contact-specific high velocity, low amplitude thrusts to sites of vertebral subluxations in the cervical spine.

Results: The cohort is comprised of 25 infants (15 males and 10 females) with complaints of postural torticollis. The average age of the infants at 4 ½ months (age range: 3 ½ weeks to 10 months).  With respect to the mode of referral, 15 were from a pediatrician, 6 were referred by a parent, and 3 were referred by a pediatric nurse and one from a midwife. Fifteen of the infants [8 females and 7 males] had a right rotation/left lateral flexion head malposition while 10 [8 males and 2 females] had a left rotation/right lateral flexion head malposition. Plagiocephaly was present in 10 of the infants [8 males and 2 females] on the left and 14 [7 males and 7 females] on the right side. Twenty three infants had microsomy on the left [n=15] and on the right [n=8].

All the infants suffered from postural torticollis from birth with 5 of the patients receiving medical care with no change in posture. According to the patient’s parent(s), associated complaints in a number of the patients included restlessness, excessive crying, colic, constipation and difficulty burping. One patient was diagnosed with Russell Silver Syndrome. With respect to treatment frequency, the care required an average of less than 2 visits to observe any postural improvement. At the time of analysis, one of the patients was still under chiropractic care. For the 24 other infants, less than 5 visits were required to attain complete resolution of symptoms within an average timeframe of 7 weeks. This amounted to approximately 3 visits per every 5 weeks.

Conclusion: The results indicate that infants with postural torticollis may benefit from chiropractic care via contact specific, high velocity, low amplitude thrusts to sites of vertebral subluxations.

Joel Alcantara 1, Rosemary E. Oman 2 and Gian Joerger 3

  1. Research Director, International Chiropractic Pediatric Association, Media, PA, USA and Private Practice of Chiropractic, San Jose, CA, USA.
  2. Private Practice of Chiropractic, Chur, Switzerland
  3. Private Practice of Chiropractic, Chur, Switzerland

This study was funded by International Chiropractic Pediatric Association, Media, PA, USA

Presented at Canadian Consortium for Chiropractic Research. Montreal, Canada, July 9-12, 2004