Neck Strains and Sprains

Neck sprains and strains are types of mechanical neck pain. The term mechanical implies a spinal structure(s) is the pain source. A common cause of a sprain or strain is excessive physical demand on the spine's ligaments or muscles. Although pain can be severe, and even temporarily disabling, most neck sprains and strains are easy to treat and do not require spine surgery.

• A sprain is a stretch or tear of a ligament
• A strain is a stretch or tear of a muscle

Ligaments and muscles help maintain spinal stability. Ligaments are sturdy fibrous bands of connective tissue that connect two or more bones together and help stabilize the spine's joints. Tendons attach muscle groups to bones. Tendons are more flexible than ligaments.

Whiplash is a common type of neck sprain often caused by being rear-ended in a car accident. It is a hyperflexion and hyperextension injury. This means the head is uncontrollably, suddenly and quickly moved forward and backward with great force. Ligaments, tendons and/or muscles become sprained and strained.

Other causes of neck sprain and strain

Many different movements and activities can stress the spine's soft structures. Some include:

• Falling down
• Not warming up before sports
• Poor posture
• Football tackling and blocking maneuvers, spearing
• Head trauma

Facts

• Your ligaments, tendons and muscles work together to keep your spine stable during activity and rest.
• Your neck is the most mobile part of your spine.
• The neck supports and moves your head in many different directions.

Symptoms

Symptoms usually begin suddenly and are provoked with movement. Sometimes, symptoms develop hours or days after the initial injury.

• Pain can be intense, throbbing, aching
• Localized swelling, feeling stiff
• Pain may be felt in the shoulders, upper back, arms
• Skin area tender to the touch
• Muscle spasms

Whiplash-related symptoms may include

• Headache
• Dizziness
• Jaw pain
• Ringing in the ears

A rare, but urgent medical situation is loss of bowel or bladder function.

Accurate diagnosis

Consult an expert, especially if neck pain develops suddenly, quickly worsens, or you have a pre-existing back disorder. An accurate diagnosis is essential to an effective and successful treatment plan.

Your medical history and physical and neurological examinations are very important. You and your doctor discuss your symptoms, when they developed, and treatments tried. The doctor tests your reflexes and evaluates you for muscle weakness, loss of feeling, and signs of neurological injury.

An x-ray or CT scan may be ordered to confirm the doctor's diagnosis and rule out a more serious condition such as spinal fracture. Sometimes, but rarely, electromyography (EMG) is performed to diagnose a muscle problem.

Treatment options

Non-operative therapies are used to treat neck sprain and strain. Your doctor may combine two or more therapies to maximize the success of your treatment.

• Activity modification; rest, avoid pain-causing movements
• First 24 to 72 hours: apply ice wrapped in a towel for 15 minutes every 3 to 4 hours. Moist heat can be applied thereafter
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Pain medication
• Muscle relaxing medication
• Short-term cervical bracing*
• Physical therapy
• Chiropractic
• Acupuncture

*A cervical collar, worn for a few weeks, can help support the neck, relieve muscle spasms and fatigue during healing.