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Torticollis really is a pain in the neck

Updated: August 1, 2011 4:58PM

Dear Dr. Gott: I have been diagnosed with torticollis. I am 60 years old but was diagnosed with the condition 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 such 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? Thank you so much for any advice or suggestions you might have.

Dear Reader: Torticollis, otherwise known as a spasmodic torticollis or cervical dystonia, is essentially a painful, twisted neck in which the neck muscles involuntarily contract, causing the head to tip to the right or left instead of remaining upright and centered in the middle of the shoulders. 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 most 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. Because of the pull to one side, the muscles of the neck may be stiff and swelling may be present.

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. The latter will provide almost immediate — albeit temporary — improvement; however, the procedure will have to be repeated three to four times a year. Surgery for adults is an option when all else fails but is a common consideration for very young infants and young children.

Dear Dr. Gott:

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?

Dear Reader: 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.

If your quality of life is affected, speak with your doctor as to what he or she believes is the appropriate next step.

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