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Neck Strain

A neck strain is the term used to describe an injury, which can range from mild to severe, to the muscles of the neck. Muscle fibers become stretched or torn, resulting in inflammation and pain. An injured muscle often goes into spasm, which means that it contracts and stays contracted, as a way of protecting itself from further injury. Both a strain and a spasm can severely restrict movement of the head, shoulder, and neck, and cause considerable pain.

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 flexibility in the neck, and the number of anatomical components, does leave it vulnerable to damage.

Neck strain is caused when force applied to the neck is stronger than the muscle is capable of resisting.

There are several common causes of neck strain. One of the most common is an extended period of time spent with the body in a poor posture. Examples of this might include sitting slumped in a car seat while driving, seated in a unsatisfactory chair while working at a computer with the screen improperly positioned, cradling a telephone between the ear and shoulder, carrying a heavy load on one side of the body, or sleeping with a pillow that is an incorrect height or firmness for the way you sleep.

Trauma can very easily cause neck strain. A whiplash injury is a well-known example of such trauma, but any fall or awkward movement of the head or neck might lead to neck strain.

Symptoms of a neck strain will vary according to the severity of the injury, but the most commonly experienced symptoms are:
  • Pain, usually felt in a shoulder muscle
  • Stiffness of the neck
  • Pain when trying to rotate the head or bend the neck
If the strain is severe enough to have completely ruptured the muscle (usually where the muscle tendon inserts into the bone) the symptoms will be:
  • Intense pain
  • Bruising
  • Muscle spasm
  • Swelling
  • Disability
For many cases of mild neck strain it is not necessary to visit the doctor. You should make an appointment if your symptoms last for more than two or three days, or if you are experiencing pain, numbness, or tingling in your arm, as this may indicate nerve damage that could have serious consequences.

If your neck strain is the result of a car accident or other trauma, you should see a doctor who would carefully examine you and perhaps order diagnostic tests such as X-rays, CT (computerized tomography) or MRI (magnetic resonance imaging) in order to rule out other injuries.

If your symptoms indicate that you may have ruptured a muscle, see your doctor as soon as possible.

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 day or two, to allow the damaged muscle 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 day, 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.
Massage: Gentle massage can help to relieve muscle spasm, and will promote blood supply.

Probably the most important thing you can do to prevent neck strain is to practice good posture, particularly when sitting for long periods. Make sure your chair or car seat is at the correct height so that you do not have to bend your neck to view the screen, book or road.

If you are prone to neck injuries, strengthen your neck muscles by performing exercises such as those listed below. You should always check with a medical professional before starting any exercise program.

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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