Massage therapy · Kitchener–WaterlooCervical Dystonia

Cervical dystonia is the most common of all focal dystonias (NINDS, 2026). Dystonia is caused by a problem in the part of the brain that controls movement (NHS, 2024). In cervical dystonia, the neck muscles that control head position tighten without you meaning them to, which causes the head to turn or twist to one side. The head can also be pulled backward or forward. It can start at any age, but it most often begins in middle age (Mills and Pagan, 2015). It usually begins slowly and then reaches a plateau (NINDS, 2026). About 10 percent of people have periods free of symptoms (remission), but these may not last, and for most people the condition is lifelong (NINDS, 2026; Mills and Pagan, 2015).

Cervical dystonia is sometimes known as torticollis, or spasmodic torticollis.

Cervical Dystonia Anatomy

The dystonias are a group of disorders that all share the same features of involuntary twisting movements or holding unusual postures. They are classified based on the part of the body they affect. Focal dystonias affect single body regions, like the neck (cervical dystonia), hand (writer's cramp), eyes (blepharospasm) and voice box (laryngeal dystonia). Involving two or more neighbouring regions is referred to as segmental dystonia. Generalised dystonia affects most of the body (NHS, 2024; NINDS, 2026).

How to Treat Cervical Dystonia

If you think you might have dystonia, see your family doctor or nurse practitioner, who can refer you to a neurologist (a specialist in the brain and nerves) (NHS, 2024).

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Things that can trigger dystonia symptoms include tiredness, stress, and drinking alcohol or caffeine (NHS, 2024). Noticing your own triggers may help you avoid them.
• Chairs with a high, firm back and armrests may be more comfortable, as they support the head and arms.
• I can advise you on comfortable positions for sitting, working and sleeping.

Cervical dystonia comes from the part of the brain that controls movement, so massage can't switch it off. Your neurologist and medical team lead your care, usually with botulinum toxin injections. My aim is to help you feel more comfortable alongside that treatment: easing overworked muscles, helping you relax and keeping your neck and shoulders moving.

I start by asking about your symptoms and treatment plan, then assess how your head, neck and shoulders move. I plan sessions around your injections and follow your medical team's advice about the injected muscles. If you've had deep brain stimulation surgery, I need your surgeon's okay before any hands-on treatment, and I never press over the device.

Hands-On Treatment

• Slow, rhythmical, full-body relaxation work, with your head and neck well supported
• Easing the shoulders, upper back and arms, which often work harder to make up for the pull on your head
• Gentle, direct work on the overactive neck muscles, never deep or forceful
• Warm applications in the clinic to help tight areas let go

Breathing and Relaxation

• Slow, fuller breathing during the session, and a short routine for home, especially for times of stress or tiredness

Movement and Strength

1. NHS (2024) Dystonia. Available at: https://www.nhs.uk/conditions/dystonia/ (Accessed: 7 October 2026).
2. National Institute of Neurological Disorders and Stroke (NINDS) (2026) Dystonia. Available at: https://www.ninds.nih.gov/health-information/disorders/dystonia (Accessed: 7 October 2026).
3. Mills, R.R. and Pagan, F.L. (2015) 'Patient considerations in the treatment of cervical dystonia: focus on botulinum toxin type A', Patient Preference and Adherence, 9, pp. 725–731. doi: 10.2147/PPA.S75459
4. Kassaye, S.G., De Hertogh, W., Crosiers, D., Gudina, E.K. and De Pauw, J. (2024) 'The effectiveness of physiotherapy for patients with isolated cervical dystonia: an updated systematic review and meta-analysis', BMC Neurology, 24, 53. doi: 10.1186/s12883-023-03473-3