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Neck Sprain

A neck sprain is primarily an injury to the ligaments in the neck, but can also be used to describe damage to other soft tissues such as muscles and tendons. Ligaments are bands of strong, slightly elastic, connective tissue that join one bone to another. Ligament fibers can become stretched, frayed or broken by a trauma, leading to the painful symptoms of a neck sprain.

The neck, anatomically known as the cervical spine, is constructed of seven cylindrical stacked vertebrae, beginning at the base of the skull and ending at the beginning of the thoracic spine. These are named C1 through C7. The vertebral bones protect the spinal cord, support the head, and allow a great deal of flexibility and movement. Between each bone is an intervertebral disc that acts as a shock absorber and allows the neck to bend and rotate. Openings in the vertebrae allow the passage of nerve fibers and blood vessels.

Muscles, muscle tendons, and ligaments in the neck and shoulders are crucial to the stability of the neck. They function to support the neck structure and permit movement, but they also limit the extent of movement, thereby helping to prevent injury. Unfortunately, the high level of mobility in the neck, and the number of anatomical components, does leave it vulnerable to damage. Any injury to the neck can result in muscle spasm, where the muscle contracts and remains contracted in an effort to protect itself from further damage.

A neck sprain can occur when a force is applied to the body that causes the neck to extend beyond its normal range of motion, stretching or tearing ligament fibers. Examples of situations that might result in a neck sprain are motor vehicle accidents in which the head is violently thrust in one direction and then the other, as in a typical whiplash injury, or a fall from a height.

Symptoms will vary according to the individual injury, but commonly experienced symptoms of a neck sprain can include the following:
  • Pain, not necessarily felt at the time of injury, but typically worsening over the first 24 to 48 hours
  • Pain, felt particularly in the back of the neck, made worse with movement
  • Headache felt at the back of the head
  • Stiffness in the neck
  • Muscle spasms in upper back or shoulder
  • Decreased ability to rotate or bend the neck
  • Possible numbness, weakness or tingling in the arms
  • Cognitive impairment, such as difficulty concentrating
  • Irritability
  • Impaired sleep
Pain felt immediately after an accident, or any weakness, numbness or tingling in the arms, should be assessed by a medical professional as soon as possible in order to rule out a more serious injury.

After taking your medical history, your doctor will ask you about the circumstances of your current injury, and the type and severity of your symptoms. Your neck will then be physically examined to assess the range of motion and strength of your neck, and to check for areas of tenderness. Blood flow to the neck will be checked, as will nerve responses.

X-rays may be ordered to look for a possible fracture, dislocation, arthritis or other condition that may be causing your symptoms. CT (computerized tomography) or MRI (magnetic resonance imaging) scans may also be taken as these provide more detailed pictures of internal structures. MRI scans, in particular, are extremely good at detecting damage to ligaments and other soft tissues.

Most neck sprains heal with time and conservative (non-surgical) treatment. Recovery times vary with the individual, but can take anywhere from two weeks to three months. Symptoms lasting longer than three months should be investigated further.
Rest: Avoid movements that cause your symptoms to worsen, but try not to completely immobilize your neck as this can lead to increased stiffness and loss of muscle tone. It might be helpful to wear a soft cervical collar for a few days, to allow the damaged ligaments to rest, but do not wear it excessively.
Ice: Apply ice, crushed in a bag and wrapped in a towel, to your neck and shoulder for as long as is comfortable, several times a day during the first two or three days.
Heat: After the first three days, heat applied to the neck and shoulder will promote blood supply to the damaged tissues, stimulating healing. It will also relax muscles, relieving spasm.
Pain medication: Acetaminophen (Tylenol) can help with pain relief. NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil), naproxen (Aleve), or aspirin, taken according to directions, will relieve inflammation and associated pain. If necessary, your doctor may prescribe a muscle relaxant. These tend to cause drowsiness so should only be taken at bedtime.
Physical therapy: Gentle massage can help to relieve muscle spasms, and will promote blood supply to the painful area. Cervical traction can be used to gently stretch the neck, relieving pressure on damaged tissues. An exercise program designed to strengthen the neck muscles and increase flexibility will help to prevent future injury.

Before doing any exercises, obtain medical approval. While performing these exercises, do not move the neck.
1: Sitting, place the fingers of both hands on the forehead. Press the fingers against the head for a count of 5. Repeat 5-10 times.
2: Sitting, place both hands on the back of the head. Press the hands against the head for a count of 5. Repeat 5-10 times.
3: Sitting, place one hand against the side of the head, above the ear. Press the hand against the head for a count of 5. Repeat 5-10 times. Repeat exercise with the other hand.

Repeat the above exercises, but in this sequence bend the neck downwards during exercise 1, backwards during exercise 2, and to each side, moving the ear towards the shoulder, during exercise 3.
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