The neck is a delicate construction of vertebrae, muscles, tendons, and ligaments, and 50–70 percent of US residents will experience neck pain at least once during their lives. The pain is usually a result of an acute trauma such as a car accident, although it may be caused by a repetitive neck injury or chronic strain.
Cervical collars are used to restrict movement of the neck during recovery and healing following an injury or surgery. They stabilize the injured area to a degree, although often the main benefit is to remind the patient that there is a neck issue and to therefore limit the range of motion. Cervical collars are also often used as a precautionary method following an accident until the patient’s condition can be assessed.
In general, collars should be worn for a limited time only, i.e., for a few hours or days, unless your doctor has ordered it worn for longer. Always follow your doctor’s advice. Avoiding movement of the neck can actually worsen a stiff neck, and may lead to atrophy of neck muscles, tendons, and ligaments.
Collars come in two forms: soft or rigid. The materials used are normally elastic cotton, foam, or molded plastic.
Soft collars come in wraparound form and are generally made from thick foam rubber, covered with cotton. They allow a close to normal range of motion and are often prescribed by physicians for mild to moderate neck pain. Many users experience a benefit from wearing a soft collar, but there is no evidence as to whether long term use is helpful.
Rigid collars (sometimes called semi-rigid) are made from hard plastic with removable, soft inner pads. They are in two pieces (front and back) attached by Velcro straps. Common types are the Aspen, Malibu, Philadelphia, and Miami J collars. Physicians prescribe rigid collars for moderate to severe neck pain and whiplash injuries. These restrict neck movement to a greater degree than a soft collar but can also support the chin, thereby allowing the neck muscles to relax. The collar is normally worn continuously for as long as advised by the medical practitioner, except when removed for daily washing.
There is some controversy over how long a rigid collar should be worn. The concern is that long-term use could lead to muscle, ligament, and tendon atrophy. Studies have shown that early mobilization after a whiplash injury, i.e., allowing the neck to move, resulted in lower pain and better neck mobility. It has been suggested that use of a rigid cervical collar should be limited to a maximum of ten days.
Rigid collars are most commonly used to stabilize the cervical spine following a trauma such as a fracture or dislocation, or after surgery. Wearing a hard collar can have side effects such as limiting the degree to which the mouth can open. They are an important part of medical care, but are not usually prescribed to manage neck pain.