Cervical dystonia

This rare movement disorder causes neck muscles to contract on their own. This can make your head twist or turn into painful positions.

Update Date: 03.11.2026

Overview
Symptoms
When to see a doctor
Causes
Risk factors
Complications
Diagnosis
Treatment
Medications
Therapies
Surgery or other procedures
Coping and support
Preparing for your appointment
What you can do
Questions to ask your doctor
What to expect from your doctor

By Mayo Clinic Staff

Overview

Cervical dystonia is a painful condition that causes the neck muscles to tighten or spasm on their own. These involuntary muscle contractions make the head twist to one side or tilt forward or backward. The movements may be slow and repetitive, or they may feel like shaking or tremors. Cervical dystonia also is called spasmodic torticollis.

This rare condition can happen at any age, but it's most common in middle-aged people. Women get cervical dystonia more often than men. Symptoms typically start slowly and then reach a point where they don't get worse.

There is no cure for cervical dystonia. For some people, the symptoms go away for a while, but they often return. Without treatment, the condition may make daily activities more difficult.

Symptoms

The muscle contractions caused by cervical dystonia can make the head twist in different directions, such as:

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

The most common movement is when the chin is pulled toward the shoulder. Some people may have a mix of these head postures. In some people, a jerking motion of the head also may occur.

Many people who have cervical dystonia also experience neck pain that spreads into the shoulders. The condition also can cause headaches. In some people, the pain from cervical dystonia is serious enough to be exhausting and can interfere with daily life.

When to see a doctor

See a healthcare professional if you notice movements or twisting of your head or neck, especially if:

  • Your head turns, tilts or jerks on its own.
  • You have trouble holding your head in a natural position.
  • Your symptoms are getting worse or interfering with daily activities.

Early diagnosis and treatment can help manage symptoms and improve quality of life.

Causes

For most people with cervical dystonia, the cause is unknown. Some people have a family history of the condition, which suggests that genes may play a role. Researchers have found certain gene changes linked to cervical dystonia. Sometimes, cervical dystonia may develop after a head, neck or shoulder injury.

Risk factors

Risk factors for cervical dystonia include:

  • Age. While the condition can occur at any age, typically it begins after age 30.
  • Sex assigned at birth. Women are more likely to develop cervical dystonia than men.
  • Family history. If a close family member has cervical dystonia or some other type of dystonia, the risk of developing the condition is higher.

Complications

In some cases, the involuntary muscle contractions caused by cervical dystonia can spread to nearby areas of the body. Common locations include the face, jaw, arms and trunk.

The repetitive involuntary muscle contractions and head movements that happen with cervical dystonia can stress the cervical spine. Over time, this may lead to changes in the spine, including bone spurs in the neck. These extra bits of bone can narrow the space in the spinal canal, which can press on the spinal cord or nerves. This can cause tingling, numbness or weakness in the arms, hands, legs or feet.

Diagnosis

Cervical dystonia often is diagnosed with a physical exam alone. But your healthcare professional may order blood, urine or spinal fluid tests, or an MRI of the brain or spine, to help rule out other causes of your symptoms.

Treatment

There is no cure for cervical dystonia. For some people, symptoms may go away without treatment, but often they come back again. Treatment focuses on relieving the symptoms.

Medications

A common treatment involves injecting medicine into the affected muscles. The medicine contains botulinum toxin, which is used to treat muscle spasms and tightness in certain medical conditions. The medicine blocks nerve signals to the muscles, which lessens muscle spasms. These shots help most people with cervical dystonia. They usually must be repeated every 3 to 4 months.

To improve results or to help reduce the dosage and frequency of these injections, your healthcare professional also may suggest oral medicines that have a muscle-relaxing effect.

Therapies

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

Physical therapy, especially when combined with injections to lessen spasms and ease symptoms, may help relieve pain and improve quality of life. A physical therapist teaches you exercises to improve neck strength, flexibility and posture. Therapy may include gentle stretching, exercises to improve range of motion and strategies for reducing muscle tightness. These exercises can make daily activities easier and help relieve pain in the neck and shoulders.

Complementary therapies also may help manage symptoms. These therapies include:

  • Heat therapy. Warm compresses or heating pads can relax tight neck and shoulder muscles.
  • Massage. Gentle massage may help relieve muscle stiffness and pain.
  • Relaxation techniques and stress management. Breathing exercises, meditation and mindfulness exercises may help lower stress and ease muscle tension. The symptoms of cervical dystonia tend to worsen with stress, so learning stress management techniques is important.
  • Acupuncture. This practice involves placing thin needles into specific points on the body. Some people with cervical dystonia find that acupuncture helps lessen pain and improve comfort.
  • Yoga. Gentle yoga may improve posture, flexibility and body awareness.

Surgery or other procedures

If less invasive treatments don't help, your healthcare professional may suggest surgery. These 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 part of the brain that controls movement. Electrical pulses are sent through the wire to stop the nerve signals causing the head to twist.
  • Cutting the nerves. Another option is to surgically cut the nerves causing the involuntary neck muscle contractions.

Coping and support

Serous cases of cervical dystonia can cause discomfort in social situations. They also can limit the ability to do everyday tasks such as driving. Many people with cervical dystonia feel isolated and depressed.

Remember that you're not alone. A number of organizations and support groups are dedicated to providing information and support for you and your family — whether you have the condition or you have a friend or family member who does.

Ask your healthcare team to suggest support groups available in your area. Or do an internet search for information about local or online groups.

Preparing for your appointment

You’ll likely start by talking to your regular healthcare professional about your symptoms. Your healthcare professional may refer you to a doctor who specializes in treating conditions that affect the brain and nervous system, called a neurologist.

What you can do

  • Write down symptoms you have and when they began.
  • Write down key medical information, including other conditions you have.
  • Write down key personal information, including any major changes or stressors in your life.
  • Make a list of all medicines, vitamins and supplements you're taking.
  • Find out if anyone in your family has had a similar condition.
  • Ask a family member or friend to go with you to the appointment to help you remember what you learn.
  • Write down questions to ask during the appointment.

Questions to ask your doctor

  • What's the most likely cause of my symptoms?
  • What tests do I need?
  • What treatments are available?
  • I have other health conditions. How can I best manage them together?

Don't hesitate to ask other questions you may have.

What to expect from your doctor

Your healthcare professional may ask some of the following questions:

  • When did your symptoms start?
  • Have your symptoms worsened over time?
  • Does anything seem to help lessen your symptoms?
  • What medicines do you take?

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