Cervical Neck Pain

Dr. Gott: Torticollis really is pain in the neck

Q) I have been diagnosed with torticollis. I am 60 years old but was diagnosed about 25 years ago. The doctor said it was a mild case and didn't feel it would get any worse. Well, it seems to be doing just that, especially if I have any stress in my life.

This has put limitations on the types of activities I participate in. Plus, I feel as if everyone is staring at me because of the turning of my head to the right.

What do you know about this condition, and could you please tell me what my options are for treatment?

A) Torticollis, otherwise known as a spasmodic torticollis or cervical dystonia, is a painful, twisted neck in which the neck muscles involuntarily contract, causing the head to tip to the right or left. The condition may be either inherited due to a gene modification or acquired as a result of injury or damage to the nervous system or muscles. It can develop any time from childhood to adulthood but commonly affects middle-aged adults, with women being more prone than men.

Symptoms include neck pain, head tremor, limited range of motion of the head and headache.

Diagnosis can often be made through visual examination only. When questions remain, MRI, EMG and laboratory testing may be appropriate.

Acquired torticollis is often treated with heat, cervical-spine traction, massage, stress-reduction techniques, sufficient rest, exercise and for some individuals, the judicious use of a neck brace to reduce muscle spasms. Medication may include muscle relaxants, pain medications, drugs commonly prescribed for Parkinson's disease, or Botox.

Surgery for adults is an option when all else fails but is a common consideration for young infants and children.

Q) I have a bunion on the edge of my right foot at the base of my little toe. It is sore and is about 4 years old.

The foot doctor has cut part of my shoe away at the edge so the bunion does not rub up against the edge of the shoe. Before I bandage it, I put antibiotic ointment or Neosporin Pain Relief ointment on it, but neither seems to help the pain. Do you have any suggestions I could follow to relieve the pain and not have to wear this funny-looking shoe?

A) Bunions form at the base of the big or little toe. The cause for yours to form may have been from wearing high-heeled, narrow-toed or poorly fitting shoes. Considering that you have had it for four years, we might consider options to include a modification of your footwear to sandals or something wider, supports, rest, bunion splint, an OTC pain reliever or bunionectomy to realign the toe.

Neck Pain caused by excessive computer work | Migraine Headaches ...

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Manage and Cure Neck Pain: Cervical Spondylosis

Problem-oriented medical diagnosis

Taylor's manual of physical evaluation and treatment, practitioner's guide to joint nerve and soft tissue management

Management of acute and chronic neck pain, an evidence-based approach

Clinical anatomy and management of cervical spine pain