Neck

Torticollis in Newborns: Diagnosis and Treatment

Head tilt in the newborn from muscular fibrosis: assessment is warranted if the tilt persists or is associated with facial asymmetry.

Updated: March 2026·Medically reviewed by Dr. Daniele Priano

Quick Answers

Does newborn torticollis resolve on its own?
With early physiotherapy (stretching, correct positioning), most cases of muscular torticollis resolve within the first 6-12 months of life. Early diagnosis and treatment are essential to obtain the best results. Only resistant cases require surgical intervention.
Can torticollis cause skull deformity?
Untreated torticollis is more often associated with positional plagiocephaly (flattening of one side of the skull), because the baby tends to keep the head on the same side. Physiotherapy and postural adjustments may reduce the risk or help it improve, without guaranteeing complete correction in every case.
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An awake infant lying on their back with their head turned to one side, observed by the mother and doctor.

A preference for one side

Head tilt or difficulty turning deserves assessment. Not every case of torticollis has a muscular cause: the paediatrician examines the baby and considers whether further assessment is needed.

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Congenital muscular torticollis is characterized by head tilting to one side with rotation to the opposite side and is caused by contracture of the sternocleidomastoid muscle: it is the most common form in newborns, but not every torticollis has this origin. Early diagnosis and treatment matter, and starting the pathway early may reduce the risk of facial and cranial asymmetry or help it improve. In atypical or painful presentations, with ocular or neurological signs, or without the expected improvement, a non-muscular cause (bony, ocular, neurological or inflammatory) must be ruled out.

Dott. Daniele Priano - Ortopedico Pediatrico

👶Early Physiotherapy, Excellent Results

Early treatment of congenital muscular torticollis is generally effective, but diagnosis, cervical motion and craniofacial asymmetry or associated conditions should first be assessed. Rehabilitation is tailored to the child; persistent or atypical cases require reassessment.

Assessment and treatment

When to seek evaluation

  • Head constantly tilted to one side
  • Difficulty turning head in one direction
  • Palpable lump on neck muscle
  • Facial asymmetry
  • Plagiocephaly (asymmetric head)

What is evaluated

  • Head and neck range of motion
  • Sternocleidomastoid muscle palpation
  • Facial and cranial asymmetry evaluation
  • Hip ultrasound (often associated dysplasia)
  • Exclusion of vertebral causes

Treatment options

  • Stretching exercises and positioning while awake and supervised, keeping sleep always supine on a flat surface
  • Specialized physical therapy
  • Cranial orthosis for plagiocephaly if needed
  • Surgical release in resistant cases

Frequently Asked Questions

Does newborn torticollis resolve on its own?▼
With early physiotherapy (stretching, correct positioning), most cases of muscular torticollis resolve within the first 6-12 months of life. Early diagnosis and treatment are essential to obtain the best results. Only resistant cases require surgical intervention.
Can torticollis cause skull deformity?▼
Untreated torticollis is more often associated with positional plagiocephaly (flattening of one side of the skull), because the baby tends to keep the head on the same side. Physiotherapy and postural adjustments may reduce the risk or help it improve, without guaranteeing complete correction in every case.
How is physiotherapy done for torticollis?▼
The physiotherapist demonstrates positions, movement directions and suitable stimulation on the child according to the restriction found. A generic instruction to use the “opposite side” is insufficient: rotation and side-bending are different movements. Tummy time is only while awake and supervised; sleep is on the back without pillows or positioners. Do not force painful movements.
When is torticollis not of muscular origin?▼
Late onset, pain, abnormal eye movements, squint, neurological signs, fever or lack of improvement with conservative management require ruling out non-muscular causes (bony, ocular, neurological or inflammatory) with a dedicated assessment.

Important Notice: The information on this page is for educational and informational purposes only and does not constitute medical advice. Each clinical case is unique: the appropriate treatment is determined during the specialist consultation, based on a thorough clinical examination and, where necessary, diagnostic imaging. For any doubts or concerns, please consult a specialist.