ROTATOR CUFF IMPINGEMENT SYNDROME; SHIN SPLINTS;
SYNOVITIS.
torticollis Extended contraction of the muscles in
the neck, pulling the head down and to the side.
Torticollis, also called wryneck, may be present at
birth or acquired. Acquired torticollis may develop
after injury to the nerves or muscles of the neck
though sometimes the doctor is unable to deter-
mine the cause. Often the neck muscles are stiff. In
addition to the altered posture of the head and
neck, other symptoms of torticollis include
HEADACHEand restricted ability to move the head.
The diagnostic path includes a comprehensive
NEUROLOGIC EXAMINATIONto rule out other possible
causes for the symptoms, particularly in adults for
whom the symptoms are new. Treatment aims to
relax and lengthen the neck muscles on the
affected side through PHYSICAL THERAPYas well as
self-performed stretching and FLEXIBILITYexercises
(for adults). Rarely, surgery is necessary to release
the muscles. Baclofen, an anticholinergic medica-
tion that blocks neurotransmitters essential for
MUSCLEcontraction, provides relief for some peo-
ple. MASSAGE THERAPYand sometimes cervical trac-
tion help acquired torticollis that becomes chronic.
Early treatment usually corrects congenital torti-
collis.
See also CEREBRAL PALSY; NEUROTRANSMITTER;
SPASM; TALIPES EQUINOVARUS.360 The Musculoskeletal System