Acute spasmodic torticollis is a condition of painful muscle spasm in the neck. It's also called a wry neck. It usually occurs in children and causes the child to tilt their head to the side because it hurts too much to move from that position. This usually is a result of sleeping with the neck in a strained position. Having a common cold may also lead to this problem. Torticollis often goes away after a few days. In some children, however, torticollis occurs due to serious reasons such as neck injury or infection (a retropharyngeal abscess). Your child's health care provider can diagnose torticollis and provide follow-up care.
Home care
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Warm your child's neck muscles with a moist towel or a heating pad at its lowest temperature. Or, have your child take a warm bath or shower. This will help relax the muscles. Use the heat for 15 to 20 minutes every 3 to 6 hours for the first 24 to 48 hours. Gently massaging your child's muscles may also help.
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For children 1 year and older. Support your child's head and neck with small pillows or rolled-up towels when they are lying down. If a neck brace was given, your child should keep it on all the time until symptoms improve. You may remove it for bathing or applying heat or massage.
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For babies younger than 12 months. Talk with your child's health care provider about how to support your baby's head and neck. Don't use pillows or other soft items with a baby younger than 12 months.
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You may give your child over-the-counter medicine as directed based on your child's age and weight for fever, fussiness, or discomfort. Talk with the provider before using these medicines if your child has chronic liver or kidney disease or ever had a stomach ulcer or gut bleeding. Never give aspirin to anyone under 18 years of age who is ill with a fever. It may cause severe disease or death.
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Your child should stay home from school until symptoms are all better. They should also not play sports until symptoms are gone.
Follow-up care
Follow up with your child's health care provider as advised.
When to get medical advice
Contact your child's health care provider right away if your child has:
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Increasing neck pain.
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An inability to move the neck.
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Vision changes.
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Changes in behavior.
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No relief with the medicines prescribed.
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A fever (see "Fever and children" below).
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Chills.
Call 911
Call
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Trouble swallowing or breathing.
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Skin or lips that look blue or gray (discolored).
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Increasing pain or severe pain that doesn't go away.
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Sudden weakness, numbness, or tingling in the arms or legs.
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A loss of control of bladder or bowels.
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The health care provider may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the provider what type to use instead. When you talk with any provider about your child’s fever, tell them which type you used.
Below are guidelines to know if your young child has a fever. Your child’s provider may give you different numbers for your child. Follow your provider’s specific instructions.
Fever readings for a baby under 3 months old:
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First, ask your child’s provider how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher.
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Armpit: 99°F (37.2°C) or higher.
Fever readings for a child age 3 months to 36 months (3 years):
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Rectal, forehead, or ear: 102°F (38.9°C) or higher.
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Armpit: 101°F (38.3°C) or higher.
Call the health care provider in these cases:
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A repeated temperature of 104°F (40°C) or higher in a child of any age.
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A fever of 100.4° F (38° C) or higher in a baby younger than 3 months.
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A fever that lasts more than 24 hours in a child under age 2.
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A fever that lasts for 3 days in a child age 2 or older.
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