Neck Sprain

Definition

A neck sprain is stretching and/or tearing of the soft tissues of the neck, including muscles, tendons, and ligaments. Ligaments are strong bands of tissue that connect bones to each other. Mild sprains may involve only stretching of the ligaments, whereas more severe sprains would involve partial tears.

Causes

A neck sprain results from a sudden movement that causes the neck to extend or flex too far.

Causes include:

Car accidents (rapid deceleration causes the head and neck to snap forward and then backward)
A blow to the head
Strain of the upper back or shoulder

Whiplash Injury

Risk Factors

A risk factor is something that increases your chances of getting a disease, condition, or injury.

Risk factors for a neck sprain include:

Playing contact sports
Reckless driving
Weak neck muscles and ligaments
Not wearing a seat/shoulder belt in the car

Symptoms

Symptoms may include:

Neck pain, especially in the back of the neck, that gets worse with movement
Shoulder pain and muscle spasms
Tingling sensations or weakness in the arms
Headache, especially in the back of the head
Difficulty sleeping
Fatigue
Trouble concentrating
Irritability
Sore throat
Stiffness and difficulty moving the head:
- Side to side
- Up and down
- In a circular motion

Diagnosis

The doctor will ask about your symptoms and how you injured your neck. The doctor will examine your neck to assess its stability and the severity of the injury. Diagnosis depends on ruling out other sources of neck pain such as dislocations, spinal fractures, arthritis , and cervical disc disease.

Tests may include:

X-rays—a test that uses radiation to take a picture of structures inside the body, especially bones. You may have x-rays done to make sure that no bones are broken.
MRI scan—a test that uses magnetic waves to make pictures of structures inside the body. You may have an MRI scan to see if a ligament has torn completely or if there is any damage to cervical discs (less common).

Treatment

Treatment may include:

Cervical Collar

Wearing this soft neck brace supports the head and takes pressure off the neck. These are worn only as long as recommended by your healthcare professional, usually only a few days, because prolonged use can weaken neck muscles.

Medication

Muscle relaxants may be prescribed to ease muscle spasms. In addition, a medication to relieve pain and inflammation may be recommended such as:

Ibuprofen (Motrin, Advil)
Naproxen (Aleve, Naprosyn)
Acetaminophen (Tylenol)
Aspirin

Ice and Heat

Apply ice or a cold pack to the neck for 15 to 20 minutes, four times a day for 2 to 3 days. This helps reduce pain and swelling. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
Moist heat helps loosen tight or injured muscles. Only apply a heat pack after any swelling has gone away.

Therapy

Massage helps increase circulation and reduce tension.
Cervical traction—May be used intermittently to decrease pain and reduce muscle spasm as directed by a physical therapist.
Trigger point and botulinum toxin injection

For Conditions Associated with Cervical Strain

Cervical facet injections
Radiofrequency neurotomy
Epidural steroid injections

Prevention

To reduce your risk of neck sprain:

Drive carefully to avoid car accidents; wear your seat/shoulder belt.
Avoid contact sports
Do exercises that strengthen the neck muscles

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org

The American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

CANADIAN RESOURCES:

Physical Therapy Canada
http://www.physicaltherapy.ca/

The University of British Columbia Department of Orthopaedics
http://www.orthosurgery.ubc.ca/index.html

References:

Alleva JT, Franklin J, Hudgins TH. Frontera: Essentials of Physical Medicine and Rehabilitation . 1st ed. Philadelphia; Hanley and Belfus; 2002. Ch. 5.

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org .

Conlin A. Bhogal S. Sequeira K. Teasell R. Treatment of whiplash-associated disorders--part II: Medical and surgical interventions. Pain Research & Management . 10(1):33-40, 2005.

National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health website. Available at: http://www.niams.nih.gov/ .

Sports Injuries: Basic Principles of Prevention and Care . Blackwell Scientific Publications; 1993.

Last reviewed January 2008 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.