Cervical Dystonia

Last Updated December 2020 | This article was created by familydoctor.org editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP


What is cervical dystonia?

Cervical dystonia is a neurological disorder that causes the muscles in your neck to contract involuntarily. That means without you making them move. This muscle contraction can make your head lean or twist to one side. Your chin may pull up, down, forward, or backward. Your shoulder also can contort up.

The disorder is more common in men than women. It’s more likely to develop during middle age, although it can happen at any age.

The disorder also is known as spasmodic torticollis (ST). It can cause severe pain and discomfort. It often begins slowly, gets worse, and then stabilizes.

Symptoms of cervical dystonia

The main symptom is involuntary muscle contractions in your neck. Other symptoms include:

  • Burning pain in your neck and shoulder
  • Severe headaches
  • Spasms and/or tremors

What causes cervical dystonia?

In many instances, doctors don’t know what causes cervical dystonia. In some cases, people who have a neck injury may develop it. When the cause isn’t known, it’s called primary dystonia.

Secondary dystonia can be caused by disease or injury, such as a stroke, traumatic brain injury, or Parkinson’s disease. You may develop it if there’s a problem with your basal ganglia. This is the part of your brain that sends messages to start muscle movement. Nerve damage from certain medicines is another possible cause.

Both primary and secondary cervical dystonia can be genetic, meaning it runs in families.

How is cervical dystonia diagnosed?

Your doctor will review your symptoms and perform a physical exam. They also will want to know about any health problems or disorders you may have. Your doctor may want to do some tests to see how your muscles work. These tests can detect the underlying cause of your muscle contractions. Cervical dystonia can resemble stiff neck, an acute pain, or spasm that goes away.

Can cervical dystonia be prevented or avoided?

Cervical dystonia can’t be prevented or avoided.

Cervical dystonia treatment

There are several treatment options for cervical dystonia. Medicines can help your neck muscles relax and reduce spasms. These include muscle relaxers and certain medicines used to treat Parkinson’s disease. Injections may also help.

Your doctor may recommend physical therapy. This includes exercises to stretch and strengthen your muscles. Physical therapy can reduce pain and improve neck posture and movement. Massage and practices to reduce stress also can help with pain and discomfort. Some people use neck or head braces for support.

Severe cases may require surgery. Selective denervation surgery cuts the nerves to the affected muscles. Deep brain stimulation surgery uses electrical pulses to correct your nerves.

Living with cervical dystonia

Cervical dystonia is a lifelong disorder. There is no cure. However, it doesn’t lower your expected life span. Some people may experience lengths of time without any symptoms. That means they’re in remission. If your cervical dystonia causes you pain, work with your doctor to help control it.

There is a small chance of getting dystonia in other parts of your body. It can affect muscles that you voluntarily control.

Try to minimize stress in your life. Even though stress doesn’t cause dystonia, your symptoms may be worse when you’re feeling stressed.

Questions to ask your doctor

  • My mother had cervical dystonia. Am I at risk of getting it? Can I pass it to my children?
  • Does cervical dystonia come on slowly or happen suddenly?
  • How can physical therapy help cervical dystonia?
  • What are the side effects of medicines that treat cervical dystonia?
  • Will I need surgery to treat this condition? If so, what are the side effects?