By Dr. Joseph Will

Yet another Pain in the Neck; a chiropractic approach to torticollis.

Jessica is a new patient who presented this week with an acute case of myogenic torticollis (simple wryneck) which brings our grand total this summer to 11 cases! She claims there was no trauma to her neck during the past few days and that this was the first episode that she had ever experienced. She just “woke up with it” in the morning and was terrified because she couldn’t move her head in rotation or lateral flexion to the right and was suffering extreme pain in the neck and upper back localized to the right side.

Simple acute idiopathic (without a known cause) torticollis will affect about 10% of the population during their lives and can be very scary for most. It is defined as “a form of dystonia (prolonged muscle contractions) in which the neck muscles, particularly the sternocleidomastoid and levator scapula muscle, contract involuntarily causing the head to turn. Torticollis may occur without known cause (idiopathic), be genetic (inherited), or be acquired secondary to damage to the nervous system or muscles.

Although a prolonged search of the literature will give you loads of data about virus induced, neurogenic (caused by a lesion in the brain), and congenital (born with it) types of torticollis there is very little to be found about what causes a simple, acute case in a relatively healthy individual. It is often cited that an “incorrect sleeping posture” is the principle factor and, although we agree with this, the preponderance of cases that appear suddenly as we head into the hot, humid, sticky months of summer in Mexico leads many therapists to believe that there may be something to the local “wives tale” beliefs that a constant breeze upon sweaty muscles can aggravate the situation.

In 8 years of private practice in the Riviera Maya I can confidently state that I see many more cases of torticollis in the summer months than winter. I too have suffered this condition and, although I know it is not serious and that eventually it will resolve without complication, it is at once scary, debilitating, and a terrible nuisance for at least three days. You can be sure that every masseuse, PT, chiro, and acupuncturist that owes me a favor will be getting a call from yours truly when I wake up with a “tweaked” neck.

Although I was hard pressed to find specific scientific studies as to exactly HOW a constant air flow hitting sweaty skin and underlying muscle tissue causes the muscle to go into uncontrollable spasm I did find several references to this precipitating factor.

So what can you do to AVOID it?

1. Most of our patients (neck pain or no) have OVERLY TIGHT AND CHRONICALLY CONTRACTED MUSCLES IN THE UPPER BACK AND NECK. Specifically the upper trapezius, splenius capitus, levator scapula, and suboccipital muscles. Many also have tightened and shortened Sternocleidomastoid muscles (located in the FRONT of the neck, running from the clavicles up to the bony prominence behind the ear.) This is due in large part to the typical “shoulders rounded, head forward” posture of people who are working at computer stations, driving all day, or who just generally have a lazy posture. The farther forward the head is, the more extra work we give to these small muscles of the posterior neck. Making a conscious effort to hold your shoulders back and keep your chest “open” dramatically reduces the chronic tight bands and “knots” that we find in many patients. This, in turn, reduces the risk that the muscle will spontaneously go into spasm just because you sleep a little crooked. Obviously, learning how to STRETCH these tight muscles is one of your best defenses. EVERYBODY has bad posture and stress now and then. A good therapeutic stretch performed by the patient regularly is, in the opinion of many therapists, essential MAINTENANCE for the spine just as brushing and flossing is for the teeth!
2. Sleeping face down every night DEFINITELY puts you more at risk. This doesn´t need much explication. The natural curves of the spine are best preserved by sleeping in fetal, side lying position with the head supported by a small pillow keeping the neck in a straight line and even a pillow between the knees to keep the low back free of rotation. Alternately face UP with a pillow under the THIGHS to keep the low back flat and a small cervical roll under the neck. Face DOWN sleeping necessitates that the cervical spine is FORCED in rotation all night and also may aggravate low back pain in patients who already suffer from excess low back curvature (lordosis.)
3. Having a ceiling or pedestal fan on full power blowing on your sweaty skin all night is many times the “last straw” for these tight and tired muscles. I have found that I can protect my neck from torticollis by draping a very light “sarong” or “pareo” type material over my neck and upper body and I cannot recommend this practice enough if you just absolutely have to have your fan in “full-on-helicopter mode” to be able to sleep! If you are fortunate enough to have a good “mini-split” airconditioner try to just use that WITHOUT the fan and you may get through the summer without incident. Weak and “dying” airconditioners sometimes compound the problem because instead of helping to dry the air in your room they end up just re-circulating the humidity and putting a chill to it..a sure recipe for disaster.

If all of this does NOT work and you wake up one morning with a severe “kink” in your neck; don´t despair!! Between physical therapy, gentle chiropractic vertebral adjustments, therapeutic stretching and acupuncture we can get you feeling much better in no time! Most patients report 40-60 percent relief after the very first treatment and those who apply the therapeutic stretches that we teach plus using hot moist packs and some mild analgesic medicine at home tend to recover 100% after just 2-5 treatments. The key then is to PREVENT a recurrence which basically boils down to educating the patient and keeping their spine and muscular system in a balanced, relaxed and healthy state.

Author: Dr. Joseph Will, 1997 Graduate of New York Chiropractic University and has been working 6 years in a multi-doctor clinic in Cancun (phone 998-887-0028). He is also available to patients of Playa del Carmen in the Sanar clinic located on 16th Street between 40th and 45th Avenues. Ask about their program for combined chiropractic and acupuncture care 5 session of each for only $2,500.00 pesos. You save a $1,000.00 pesos! Call the clinic for further information or to make an appointment at: 984-803-2039 or email:

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