15 Causes of Cervical Dystonia You Need to Know About

Cervical dystonia—also called spasmodic torticollis—is more than a rare muscle condition. It’s a deeply disruptive neurological disorder that twists the neck into painful, uncontrollable positions, often leaving patients in daily discomfort and confusion. A tilted head, a raised shoulder, a chin that won’t stay still—these aren't just symptoms; they’re signs of a body fighting itself. But why does it happen? That’s the question we’re tackling head-on. In this expanded list of 15 Causes of Cervical Dystonia You Need to Know About, we break down the wide range of triggers—from genetics to injuries, medications to neurological disorders. Some causes are inherited. Others are triggered by trauma, medication, or even chronic misdiagnosis. And while not all are preventable, understanding the full landscape of possible causes can be the first step toward managing—and reclaiming—control. If you've been searching for clarity, start here. The causes are more layered than you think.

1. Family History And Genetics

Genetics and family history appear to play a role in some cases of cervical dystonia. Researchers estimate between ten and twenty-five percent of cervical dystonia patients also have a family history of the condition. The condition is estimated to affect around sixty thousand individuals in the United States, so up to fifteen thousand of those have a family history of it. Genetics may increase an individual's chances of developing cervical dystonia, but researchers believe genetics alone are not responsible. Instead, genetics are combined with a variety of environmental and physical factors to increase the risk of developing cervical dystonia. Researchers have discovered cervical dystonia tends to present in individuals who have mutations in one or more of several genes. Gene mutations linked to cervical dystonia have been identified in the ANO3, CIZ1, THAP1, and GNAL genes. With that said, not enough information is currently available about how the mutations affect an individual's chances of developing cervical dystonia. Because of this, there is no way to do a genetic test for diagnostic purposes with cervical dystonia, and the condition must be assessed through symptoms and family history alone.

2. Certain Injuries

Certain injuries may cause an individual to develop cervical dystonia. In cases where there's an underlying cause like an injury or neurological disorder, the condition is called secondary cervical dystonia. Injuries to the shoulders, neck, or head increase the likelihood of an individual developing cervical dystonia. This may be considered a kind of post-traumatic dystonia, which is dystonia that occurs after an injury or trauma to the affected body part. The most common injury leading to cervical dystonia is whiplash, which some individuals experience in car accidents or when suffering impacts at sporting events. Whiplash occurs when the head snaps quickly backward and forward in a way that causes muscle injury. If individuals suspect they have suffered a whiplash injury, they should have their neck evaluated to make sure no damage was done to their spine. It's important to be attentive during the rehabilitation process for an injury. If patients notice they're developing symptoms of abnormal tension or spasticity, they should talk to their doctor to see if there are ways to mitigate it.

3. Age And Gender

Age and gender don't appear to cause cervical dystonia by themselves. There have been cases where individuals of all genders and ages were affected, including children and the elderly. However, an individual's age and gender do appear to affect their risk of developing cervical dystonia. Around twice as many women develop cervical dystonia than men. In addition, most patients who develop the condition are between forty and sixty years old. One study indicated men with cervical dystonia tend to develop the condition at a significantly earlier age than women with cervical dystonia, which is interesting. If it's true that men are more likely to present with symptoms earlier, then they may be statistically more likely to develop the condition before turning forty years old. In addition to cervical dystonia, the study found men were likely to develop focal, primary segmental, laryngeal, and blepharospasm-related dystonia at earlier ages of onset than women. It's not well-known what sex-linked factors cause this discrepancy, nor is it known why women more commonly develop cervical dystonia than men.

4. Presence Of Neurological Disorders

The presence of neurological disorders can influence the development of cervical dystonia. In these cases, it's common for patients to have other types of dystonia as well. The neurological disorders might have other neurological symptoms. These are cases of secondary dystonia that should be treated by first treating the underlying neurological condition. One of the most common neurological disorders that can result in dystonia, including cervical dystonia, is Parkinson's disease. Parkinson's disease, which first causes movement issues, is progressive and terminal. Patients with Parkinson's disease have reduced dopamine levels because the part of the brain that creates dopamine begins to die. This leads to a lack of coordinated and smooth muscle movement. When anywhere from sixty to eighty percent of the cells of this part of the brain have died, Parkinson's disease symptoms will begin appearing. In addition to developing cervical dystonia, it's common for patients to develop a tremor, stiffness in the arms and legs, and trouble with walking. They might have a tendency to fall, experience issues with maintaining their balance, and their movements might be slow.

5. Certain Medications

Certain medications have been known to cause cervical dystonia and other types of dystonia as a side effect. This is most commonly reported with medications that block the brain's release of dopamine, which is required for the smooth and controlled movement of muscles. If individuals don't have enough dopamine, their muscles may spasm or become tense and rigid. When this is the case, they might develop cervical dystonia alongside other muscle problems. Many antipsychotics block dopamine in the brain, since psychotic symptoms have been linked to increased dopamine levels. Some medications that block dopamine and may cause dystonia include clozapine, quetiapine, risperidone, paliperidone, promethazine, metoclopramide, and chlorpromazine. If individuals are experiencing painful muscle symptoms as a side effect of their medication, they should talk to their doctor about lowering their dose or switching to a different type of medication. Sometimes changing medications or adjusting the dosage will be enough to stop the symptoms from continuing.

6. Chronic Stress and Emotional Trauma

While cervical dystonia is primarily neurological, the role of chronic emotional stress shouldn’t be underestimated. Prolonged psychological strain can manifest physically, especially in individuals already predisposed to movement disorders. Stress-induced muscle tension often starts subtly, but over time, it can retrain the nervous system into dysfunctional motor patterns. Trauma—especially from emotionally intense events—has also been linked to dystonic symptoms in some cases. The brain’s motor pathways and emotional centers are more connected than we realize. For some, addressing unresolved trauma may not reverse dystonia, but it could reduce flare-ups or severity. Mental health support isn’t just complementary—it can be foundational.

7. Repetitive Neck Strain and Poor Ergonomics

Spending hours hunched over screens, desks, or mobile devices can do more than just cause stiffness. Chronic poor posture—especially with repetitive neck strain—may alter muscular tension patterns and neural feedback loops, creating fertile ground for cervical dystonia to take hold. Think of it as the body’s overcompensation: your neck muscles start fighting to stabilize what posture has destabilized. Over time, that “compensation” becomes permanent dysfunction. In some cases, people in professions requiring repetitive head motion (e.g., violinists, machinists) have shown increased risk. Prevention begins with proper ergonomics, breaks, and body awareness. Your posture is your first line of defense.

8. Viral or Autoimmune Reactions

Certain viral infections or autoimmune conditions may act as a hidden trigger for cervical dystonia. Post-viral syndromes can provoke immune responses that mistakenly attack the nervous system, disrupting the delicate balance of motor control. Conditions like lupus, multiple sclerosis, or even post-COVID neurological syndromes have all been linked to new-onset movement disorders, including dystonia. In these cases, inflammation—not injury—is the culprit. These are often misdiagnosed at first, making early recognition essential. If muscle spasms begin after an infection or alongside other autoimmune symptoms, a deeper investigation into immune function could be a key diagnostic and therapeutic turning point.

9. Birth or Early Childhood Injuries

Injuries sustained during birth—particularly those involving the neck or nervous system—can predispose individuals to dystonic patterns later in life. In some cases, subtle birth trauma affecting cervical alignment or early brain development may lie dormant until adolescence or adulthood, when symptoms emerge unexpectedly. Similarly, childhood injuries like concussions or neck trauma can disturb the basal ganglia (the part of the brain involved in movement regulation). These incidents may seem minor at the time but compound over years. A full neurological history—starting from birth—can often reveal patterns that contemporary diagnoses overlook. Sometimes the roots go further back than we think.

10. Occupational Hazards and Physical Repetition

Certain professions carry a higher risk of triggering cervical dystonia due to repeated strain and lack of variation in movement. Assembly line workers, dental hygienists, surgeons, or even hairstylists—all perform precise, repeated actions with their upper body. When the same muscles are used for hours daily without adequate rest, the body can fall into maladaptive patterns. What begins as tension slowly becomes rigidity. Over time, the nervous system adapts to these distortions, making abnormal movement feel “normal.” If your job forces your neck into the same position day after day, take it seriously—it might be more than just a sore neck.

11. Sensory Processing Disorders

For some, the issue isn’t just in the muscles or the brain—but in how sensory information is processed. Sensory processing dysfunctions can create confusion in the brain about where the head or body is in space, prompting overcorrection through muscle contraction. This is especially relevant in cervical dystonia, where the body’s “sense” of its posture might be miscalibrated. In some cases, interventions like sensory tricks (gently touching the cheek or chin) can temporarily relieve symptoms, offering clues into the disorder’s sensory roots. Understanding these sensory-motor links opens new doors for therapy and symptom relief, particularly in early-onset cases.

12. Hormonal Imbalances

Fluctuations in hormone levels—especially involving estrogen, dopamine, and thyroid hormones—can influence muscle tone and neurological signaling. Some studies suggest that cervical dystonia symptoms worsen during menopause or hormonal changes, pointing to a possible endocrine connection. Since hormones regulate neurotransmitter production and muscular responsiveness, disruptions in this system may trigger or aggravate dystonic patterns. Thyroid dysfunction, in particular, is known to alter nerve excitability and muscle control. If you’re experiencing cervical dystonia alongside symptoms like fatigue, hair loss, or weight changes, a full hormonal panel might reveal an underlying imbalance that’s been amplifying the condition’s grip.

13. Toxin Exposure

Certain environmental toxins—like heavy metals, pesticides, or industrial chemicals—have neurotoxic effects that can damage or disrupt the motor control centers of the brain. Chronic exposure, even at low levels, may slowly degrade neurological function over time. Cases have been documented where individuals exposed to manganese or lead developed symptoms mimicking Parkinsonian or dystonic syndromes. These toxins can interfere with dopamine pathways, which are essential for smooth muscle control. If you’ve worked in industrial settings or lived near chemical exposure zones, this could be a factor worth investigating. Environmental health is an underexplored but critical piece of the dystonia puzzle.

14. Sleep Disorders and Chronic Fatigue

Poor sleep doesn’t just leave you groggy—it disrupts your entire nervous system. Chronic sleep deprivation affects dopamine regulation and muscular recovery, two crucial factors in managing motor control. Some patients report worsened dystonia symptoms after nights of fragmented or insufficient rest. In rare cases, sleep disorders like REM behavior disorder or periodic limb movement disorder may also co-occur with dystonia. Because cervical dystonia involves involuntary muscle movement, any condition that destabilizes muscle tone during sleep can worsen symptoms. Sleep hygiene, quality, and underlying sleep disorders should all be examined as part of a holistic dystonia care plan.

15. Structural Brain Changes or Lesions

While many cases of cervical dystonia are idiopathic (meaning no clear cause), some are rooted in visible structural changes in the brain. Lesions in the basal ganglia, thalamus, or brainstem—caused by stroke, tumor, or trauma—can directly disrupt the neural circuitry responsible for controlling muscle movement. Even small changes in these motor regions can have outsized impacts. MRI or CT imaging may reveal subtle damage that explains otherwise mysterious dystonia cases. For patients with sudden onset symptoms, or those that don’t fit the standard profile, brain imaging is an essential next step—not just for diagnosis, but for targeted treatment.

Cervical dystonia isn’t just a condition of twisted muscles—it’s a complex neurological puzzle shaped by genes, injuries, stress, medication, and sometimes, mysteries we’re only beginning to understand. For those living with it, the pain is real, the movements are exhausting, and the search for answers can feel endless. But knowledge is power. By expanding the list to 15 causes, we’ve gone beyond the obvious to spotlight the lesser-known triggers that deserve just as much attention. Whether your symptoms emerged gradually or overnight, whether the cause is clear or elusive, understanding the “why” is a powerful step toward healing. Because cervical dystonia isn’t just about what your neck is doing—it’s about what your body is trying to say. Listen closely. Your story might begin with a symptom, but it doesn’t have to end there. With awareness, advocacy, and the right support, you can move forward—on your own terms.