Neck Sprain
Definition
A neck sprain is stretching and/or tearing of the soft tissues of the neck. This including muscles, tendons, and ligaments. Ligaments are strong bands of tissue. They connect bones to each other. Mild sprains may involve only stretching of the ligaments. 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
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. This is done to assess its stability and the severity of the injury. Diagnosis depends on ruling out other sources of neck pain. They can include 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, to make sure that no bones are broken.
- MRI scan —a test that uses magnetic waves to make pictures of structures inside the body, 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. It takes pressure off the neck. These are worn only as long as recommended by your doctor. It is usually only a few days. Long term 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. It can decrease pain and reduce muscle spasm. It should be used as directed by a physical therapist.
- Trigger point and botulinum toxin injections may also be used.
For Conditions Associated with Cervical Strain
- Cervical facet injections
- Radiofrequency neurotomy
- Epidural steroid injections
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/
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 2009 by Robert E. Leach, 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.
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