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.

    Medically reviewed: March 2026·Dott. 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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    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

    Congenital muscular torticollis resolves completely in almost all cases with early physiotherapy and guided home stretching exercises. The earlier you start, the better the results. Only a small percentage requires more invasive treatments, and always after attempting the conservative approach.

    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?▼
    Physiotherapy includes gentle stretching of the sternocleidomastoid muscle, strengthening exercises for contralateral muscles and positioning strategies (stimulation from the opposite side). Sleep always remains **supine, on a flat surface, without pillows or positioners**: the orientation of the head can be varied gently while keeping the baby supine. Tummy time and stimulation are done only while awake and supervised. Parents are instructed to continue exercises at home.
    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.

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