Understanding and Managing Cervical Dystonia

At Horizon Spine & Pain of Utah, we are committed to helping patients find relief from complex movement disorders like Cervical Dystonia. This condition can significantly interfere with daily life, but with early diagnosis and advanced treatments, many patients experience meaningful improvement. Our team offers comprehensive, personalized care to help you regain control and live with less pain.

Cervical dystonia, also known as spasmodic torticollis, is a rare neurological disorder that causes involuntary muscle contractions in the neck. These spasms lead to abnormal head positions, twisting, tilting, or jerking movements that can be painful and disabling.

Cervical dystonia can affect individuals of any age, but most commonly develops in middle age and tends to worsen over time without treatment.

The exact cause of cervical dystonia is not fully understood, but contributing factors may include:

• Abnormalities in the brain's basal ganglia, the area responsible for controlling movement
• Genetic predisposition
• Physical trauma to the neck or head
• Repetitive strain or stress injuries
• Neurological diseases or other underlying conditions

Most cases are classified as idiopathic, meaning they occur without a clear identifiable cause.

Certain factors may increase the likelihood of developing cervical dystonia:

• Family history of dystonia or other movement disorders
• Age (commonly appears between ages 40 and 60)
• Female gender (women are more commonly affected)
• Neck or shoulder injuries
• Exposure to certain medications (e.g., antipsychotics)

Recognizing early symptoms and risk factors helps in achieving earlier intervention and better outcomes.

The hallmark symptoms of cervical dystonia include:

• Involuntary muscle contractions causing abnormal head or neck postures
• Neck pain and stiffness
• Tremors or jerking movements in the head or neck
• Head tilting forward, backward, or sideways (commonly known as torticollis)
• Muscle fatigue in the neck and shoulders
• Headaches originating from muscle tension

Symptoms may be intermittent at first but often become more persistent over time.

At Horizon Spine & Pain of Utah, we use a thorough diagnostic approach:

• Detailed medical history, focusing on symptom patterns and family history
• Physical and neurological examinations to assess muscle tone, reflexes, and movement patterns
• Imaging studies:
  • MRI or CT scans may be ordered to rule out structural abnormalities or other neurological conditions

Diagnosis is typically based on clinical evaluation, as there is no single definitive test for cervical dystonia.

Initial management of cervical dystonia often includes non-surgical therapies:

Medications:

• Muscle relaxants such as baclofen
• Anticholinergic medications, like trihexyphenidyl to reduce muscle contractions
• Dopamine-depleting agents in certain cases

Physical therapy:

• Stretching and strengthening exercises to improve posture and mobility
• Biofeedback therapy to retrain muscle control

Occupational therapy:

• Teaching adaptive strategies to manage daily tasks and minimize discomfort

These therapies are aimed at reducing symptoms, improving function, and slowing progression.

Botulinum toxin (Botox) injections are considered the gold standard treatment for cervical dystonia.

• Botox injections:
  • Administered directly into overactive muscles to block nerve signals causing contractions
  • Provide symptom relief for 3–4 months before needing repeat injections

Injections are highly effective in reducing pain, abnormal movements, and improving quality of life for most patients.

Surgery may be considered in severe, refractory cases where conservative treatments fail:

• Selective denervation surgery:
  • Cutting the nerves or muscles responsible for the abnormal contractions
• Deep brain stimulation (DBS):
  • Implanting a device to regulate abnormal brain activity causing dystonia

Surgical interventions are generally reserved for those with disabling symptoms who do not respond to injections or medication.

Patients trust Horizon Spine & Pain of Utah because we offer:

• Board-certified specialists experienced in diagnosing and treating movement disorders
• Advanced diagnostic tools for precise evaluation
• Non-surgical and minimally invasive therapies focused on maximizing recovery
• Personalized, comprehensive care plans tailored to each patient's unique condition

Our mission is to provide relief, improve your function, and restore your confidence in daily activities.