Assistance with Cervical Dystonia / Torticollis

[SeaF]

I have a client who is experiencing Cervical Dystonia / Torticollis. Her condition rotates her neck left. She is currently receiving botox injections, which have provided relief. I seek help from those of you who have specifically worked on clients with this issue. What modalities/techniques have worked best? Have your client(s) had useful results?

 

[Kalaz]

Assistance with Cervical Dystonia / Torticollis

I actually have a long time client with this and is getting the same treatment. I would wait about 2 weeks after the botox before you work on the client. Because the botox needs time to grow and spread and that way you will know if they will have a bad reaction to the botox.

The injections are generally done in the same spots so there will be lots a scar tissue. And my client can only handle very light work on neck, shoulders and upper back. And I also make sure the back of her neck is supported.

 

[LuvYaMimi]

Assistance with Cervical Dystonia / Torticollis

I have a client with Cervical Dystonia. I have not seen her in a number of years (although I have been in phone contact with her). When she would come to me, it would be once a week, and I would use firm to deep work on her, depending on what she could handle and what was called for. I would spend a full hour on her neck, traps and upper back each session. The work did not stop the dystonia completely, but it did get her to a point where her head would not shake as much and she was eventually able to maintain the maximum benefit we gained coming in a a rate of approximately one a month. That was back around 2002 for approximately a year to two years of visits. Since that time, I have only seen her a few times a year.

Most recently when I spoke with her on the phone (approximately 4 months ago), she mentioned that she had been getting good results with botox, which had kept her at about the same level or a little better than where I had her in the early 2000's.

I hope that helps.

 

[Dee Cee]

Assistance with Cervical Dystonia / Torticollis

There are several conditions that produce similar signs and symptoms. Some are permanent, others are not. Based on what has been shared so far, I am assuming that this client has the permanent condition. At it's root, this problem arises from a central nervous system "disturbance".

Botox essentially deadens some of the nerves to block transmission of the signals for involuntary muscle contraction. At the moment, this may be the single most effective therapy, though it does not address the source of the problem. Without ongoing injections, the client's problem will return.

You can't "deep tissue" or ""trigger point" this problem away. With those methods, the best you can hope for is some measure of temporary relief. Do what you can.

I don't currenty have a client with this problem, but I would enjoy having the opportunity to work with it. Over the past few years, I have been studying the neurology of stuff like this, and neuro-based forms of manual therapy including dermoneuromodulation, positional release, and active methods like muscle energy technique and active isolated stretching. (Feldenkrais looks interesting, but haven't studied it yet.) My intention would be to use neuro-based work to disrupt the signals for involuntary contracture, and hopefully (over time) eliminate the source of the problem. I don't know if this is actually possible, but I haven't yet seen anything that tells me not to try.

If you are not familiar with neurological concepts and how to apply them in your work, the best thing you can do for this client is refer them to a physical therapist that works with neurological dysfunctions.