What Is Cervical Dystonia (Spasmodic Torticollis)?

Written by: Erin Pellot OMS-II

Involuntary neck turning and jerking accompanied by pain may be a sign of a condition called cervical dystonia. Primary cervical dystonia affects approximately 40,000 people in the United States.[2] 

Recognizing the symptoms of cervical dystonia and seeking appropriate treatment is the first step to finding relief from this painful condition. Contact our team of specialists at OrthoNeuro today to learn how we can help. We have many offices located throughout Columbus, Ohio for your convenience!

What Is Cervical Dystonia?

Dystonia is a condition that affects muscles by causing involuntary contraction, abnormal posture, and pain. Although dystonia can affect many different muscle groups in the body, cervical dystonia primarily affects the neck and shoulder region, causing twisting, shoulder elevation toward the ear, and shifting of the neck from the midline.[2]

Although the cause of cervical dystonia is not currently clear, in some cases, it is believed to be related to a genetic mutation. In others, trauma is thought to trigger dystonia.[5]

How Do I Know If I have Cervical Dystonia?

Cervical dystonia can cause symptoms such as:

  • Twisting of the neck or tilting to one side
  • Head tip forward or backward
  • Shoulder elevation toward the ear
  • Neck shift away from the midline of the body [2]

How Is Cervical Dystonia Diagnosed?

Physical exams, neuroimaging, and laboratory workups are all tools that a physician can use to find and diagnose cervical dystonia. Your physician will start with a thorough history of symptoms and focus on ruling out other orthopedic or neurological causes of neck pain.[6] This may include an X-ray or physical examination for muscle tightness.

What Is the Treatment for Cervical Dystonia?

Treatment for cervical dystonia is primarily conservative and focuses on relaxing the neck muscles that have become overly contracted. This usually includes Botulinum toxin (commonly known as Botox). This is an injected medication that can contribute to muscle relaxation.

Oral medications FDA-approved for other similar conditions may also be used. In rare cases that do not respond to non-surgical treatment, surgery can be used to improve symptoms.

The most common surgical treatment for cervical dystonia is deep brain stimulation—a procedure that involves the insertion of a thin wire into the portion of the brain that controls dystonic movement.[1] The wire can then be set to deliver small electrical impulses to disrupt the signals in the brain causing excessive contraction.[3]

Who Treats Cervical Dystonia?

Scheduling an appointment with a neurologist or other physician trained in botulinum toxin injection techniques specific for spasmodic conditions is the first step in finding relief for cervical dystonia.

Neurologists are specialist physicians that have completed a four-year residency in neurological conditions. This includes both the central nervous system (neurons such as those found in the brain and spinal cord) as well as the peripheral nervous system (nerves such as those found in the limbs).

A neurologist has the knowledge and expertise to help guide you to an accurate diagnosis and treatment plan. Our team of experts at Orthoneuro is ready to help. Contact one of our many locations in Columbus, OH today!


  1. Cervical dystonia – Diagnosis and treatment – Mayo Clinic. Published in 2019. https://www.mayoclinic.org/diseases-conditions/cervical-dystonia/diagnosis-treatment/drc-20354128
  2. Cervical dystonia. Dystonia Medical Research Foundation. Published 2018.  https://dystonia-foundation.org/what-is-dystonia/types-dystonia/cervical-dystonia/
  3. Dystonias Fact Sheet I National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/dystonias-fact-sheet
  4. How to Become A Neurologist. Published 2022.    https://www.aan.com/tools-resources/how-to-become-a-neurologist
  5. Jinnah HA, Factor SA. Diagnosis and Treatment of Dystonia. Neurologic Clinics. 2015;33(1):77-100.      doi:l0.1016/j.ncl.2014.09.002
  6. Queiroz MA, Chien HF, Sekeff-Sallem FA, Barbosa ER. Physical therapy program for cervical dystonia: a study of 20 cases. Functional Neurology. 2012;27(3):187-192.

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