Conditions We Treat

Cervical Dystonia

Cervical Dystonia - APSM

What is Cervical Dystonia?

Cervical dystonia, also called spasmodic torticollis, is a painful condition in which your neck muscles contract involuntarily, causing your head to twist or turn to one side. Cervical dystonia can also cause your head to uncontrollably tilt forward or backward.

Cervical Dystonia is a rare disorder that can occur at any age. It most often occurs in middle-aged people, women more than men. Generally, symptoms begin gradually. 

While there is no cure for cervical dystonia, the disorder sometimes resolves without treatment. While sustained remissions are uncommon, injecting botulinum toxin (Botox) into the affected muscles often reduces the signs and symptoms of cervical dystonia. Surgery may be appropriate in a few cases.

What causes Cervical Dystonia?

The cause of cervical dystonia is unknown in most people. Some people may have a family history of cervical dystonia. Researchers have found gene mutations associated with cervical dystonia. It is also sometimes linked to head, neck or shoulder injuries.

Risk factors for cervical dystonia include:

  • Age. It most commonly begins after age 30, but the disorder can occur in people of any age
  • Your sex. Women are more likely to develop cervical dystonia than are men.
  • Family history. You are at higher risk of developing cervical dystonia if a close family member has it or some other type of dystonia.

What are the Symptoms of Cervical Dystonia?

The muscle contractions involved in cervical dystonia can cause your head to twist in a variety of directions, including:

  • Chin toward shoulder
  • Ear toward shoulder
  • Chin straight up
  • Chin straight down

The most common type of twisting associated with cervical dystonia is when your chin is pulled toward your shoulder. Some people experience a combination of abnormal head postures. A jerking motion of the head also may occur.

Many people who have cervical dystonia also experience neck pain that can radiate into the shoulders. The disorder can also cause headaches. In some people, the pain from cervical dystonia can be exhausting and disabling.


The involuntary muscle contractions associated with cervical dystonia can spread to nearby areas of your body, in some people, such as the face, jaw, arms and trunk.

Bone spurs may develop in people who have cervical dystonia that may reduce the amount of space in the spinal canal, causing tingling, numbness and weakness in the arms, hands, legs or feet.

What are my treatment options for Cervical Dystonia?

There is no cure for cervical dystonia. In some people, signs and symptoms may disappear without treatment, but recurrence is common. Treatment focuses on relieving the signs and symptoms.


Botulinum toxin, a paralyzing agent often used to smooth facial wrinkles, can be injected directly into the neck muscles affected by cervical dystonia. 

Most people with cervical dystonia see an improvement with these injections, which usually must be repeated every three to four months.

To improve results or to help reduce the dosage and frequency of botulinum toxin injections, your doctor might also suggest oral medications that have a muscle-relaxing effect.


Sensory tricks, such as touching the opposite side of your face or the back of your head, may cause spasms to stop temporarily. Different sensory tricks work for different people, but they often lose effectiveness as the disease progresses.

Heat packs and massage can help relax your neck and shoulder muscles. Exercises that improve neck strength and flexibility also may be helpful.

The signs and symptoms of cervical dystonia tend to worsen when you’re stressed, so learning stress management techniques also is important.

Surgery and other procedures

If less invasive treatments don’t help, your doctor might suggest surgery. Procedures may include:

  • Deep brain stimulation. In this procedure, a thin wire is guided into the brain through a small hole cut into the skull. The tip of the wire is placed in the portion of the brain that controls movement. Electrical pulses are sent through the wire to interrupt the nerve signals making your head twist.
  • Cutting the nerves. Another option is to surgically sever the nerves carrying the contraction signals to the affected muscles.

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