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Cervical Dystonia Physiotherapy

by | Aug 19, 2026 | Uncategorized | 0 comments

Cervical Dystonia Physiotherapy

What is cervical dystonia?  

What is cervical dystonia?

Cervical dystonia (or spasmodic torticollis) is a painful neurological condition that causes involuntary contractions of muscles in the neck. This results in abnormal neck movements and postures (e.g., head tilting forward or backward). These movements or postures may come and go or last for a long time (chronic). Cervical dystonia is different for everyone. For a lot of people, it can be debilitating and severely affect their quality of life.

Symptoms of cervical dystonia

The symptoms of cervical dystonia vary in frequency and severity and usually develop gradually.
The most common symptoms are neck muscle contractions which cause the neck to move in and out of or stay in an abnormal posture.
Abnormal neck movements/postures include:
• Torticollis (most common): Head turns to the side
• Later Collis: Head tilts to the side
• Antero Collis: Head tilts forwards
• Retro Collis: Head tilts backward
Other symptoms include:
• Neck pain that radiates to the shoulder
• Headache
• Fatigue
• Insomnia
• Anxiety
• Depression

Dystonia causes

Scientists aren’t sure what causes cervical dystonia. In some cases, there is a family history of the condition (e.g., a close relative has cervical dystonia). Recently, researchers from the University of Tennessee have discovered several gene mutations that could be associated with cervical dystonia (LeDoux et al., 2016). In other cases, cervical dystonia could be the result of a prior head or neck injury (Samii et al., 2000).

Treatments
Until recently, spinal surgery had been the first-line treatment for symptomatic spinal stenosis (Weinstein et al., 2006). In the United States alone, more than 800,000 surgeries to decompress the spine have been performed between 2003 and 2012 (Poorman et al., 2018). Now, many people have shifted towards less invasive treatment options such as physiotherapy to manage their symptoms. Physiotherapy has been shown to be an effective treatment option for spinal stenosis (Hagen et al., 2016).
Who can get cervical dystonia?
Cervical dystonia can occur at any age. However, it usually begins at around 40 years old (Norris et al., 2016). Also, the condition is twice as common in women than in men and scientists do not know why (Defazui et al., 2013).
Can cervical dystonia be cured?
No. Presently, there is no cure for cervical dystonia. Treatment aims to reduce the symptoms and improve the quality of life of patients.
Cervical dystonia treatments
Fortunately, there are several safe and effective ways to manage the condition. Typically, the condition is treated with botulinum toxin (Botox) injections and physiotherapy. However, a recent study from the University of Groningen in Amsterdam found that physiotherapy alone is effective in treating cervical dystonia (Van den Dool et al., 2019).
The Study
The Amsterdam study was published in the Archives of physical medicine and rehabilitation and investigated the effectiveness of physiotherapy in the treatment of cervical dystonia (Van den Dool et al., 2019).
The study included 72 patients suffering from cervical dystonia. The patient’s symptoms included pain, muscle contractions, and abnormal neck movements and postures. Additionally, several patients were anxious and/or depressed.
All of the patients’ symptoms included muscle contractions and abnormal neck movements or postures.
All participants underwent weekly physiotherapy sessions for 12 weeks. Physiotherapy treatments included neck massage, stretching, and exercises.
Immediately after 12 weeks, 6 months later, and one year later, the researchers followed up with the patients. They found that there was a significant improvement in all symptoms at each follow-up appointment.
The results of this study suggest that physiotherapy by itself is an effective treatment for cervical dystonia.

References

Defazio, G., Jankovic, J., Giel, J. L., & Papapetropoulos, S. (2013). Descriptive epidemiology of cervical dystonia. Tremor and other hyperkinetic movements (New York, N.Y.), 3, tre-03-193-4374-2. https://doi.org/10.7916/D80C4TGJ

LeDoux, M. S., Vemula, S. R., Xiao, J., Thompson, M. M., Perlmutter, J. S., Wright, L. J., Jinnah, H. A., Rosen, A. R., Hedera, P., Comella, C. L., Weissbach, A., Junker, J., Jankovic, J., Barbano, R. L., Reich, S. G., Rodriguez, R. L., Berman, B. D., Chouinard, S., Severt, L., Agarwal, P., … Stover, N. P. (2016). Clinical and genetic features of cervical dystonia in a large multicenter cohort. Neurology. Genetics, 2(3), e69. https://doi.org/10.1212/NXG.0000000000000069

Norris, S. A., Jinnah, H. A., Espay, A. J., Klein, C., Brüggemann, N., Barbano, R. L., Malaty, I. A., Rodriguez, R. L., Vidailhet, M., Roze, E., Reich, S. G., Berman, B. D., LeDoux, M. S., Richardson, S. P., Agarwal, P., Mari, Z., Ondo, W. G., Shih, L. C., Fox, S. H., Berardelli, A., … Perlmutter, J. S. (2016). Clinical and demographic characteristics related to onset site and spread of cervical dystonia. Movement disorders : official journal of the Movement Disorder Society, 31(12), 1874–1882. https://doi.org/10.1002/mds.26817

Samii, A., Pal, P. K., Schulzer, M., Mak, E., & Tsui, J. K. (2000). Post-traumatic cervical dystonia: a distinct entity?. The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques, 27(1), 55–59. https://doi.org/10.1017/s0317167100051982

Van den Dool, J., Visser, B., Koelman, J. H., Engelbert, R. H., & Tijssen, M. A. (2019). Long-Term Specialized Physical Therapy in Cervical Dystonia: Outcomes of a Randomized Controlled Trial. Archives of physical medicine and rehabilitation, 100(8), 1417–1425. https://doi-org.ezproxy.library.yorku.ca/10.1016/j.apmr.2019.01.013