• Neck Sprain

    Definition

    A neck sprain is the stretching and/or tearing of neck ligaments. Ligaments are strong bands of tissue that connect bones to each other. In mild sprains, the ligaments are stretched too far. Severe sprains will have partial tears in the ligaments.

    Causes

    A neck sprain results from sudden movement. The movement causes the neck to go too far forward or back.
    Whiplash Injury
    Whiplash cervical
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    Risk Factors

    Incidents that increase your chance of neck sprain include:
    • Car accidents (known as whiplash)
    • Assaults with a blow to the head
    • Sporting events that include full contact
    • Strain of the upper back or shoulder
    • Falls

    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
    • 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. Your neck will be examined. Your doctor will check the stability of your neck and the severity of the injury. Other sources of neck pain may need to be ruled out before your doctor can confirm a neck sprain.
    Tests may be done to rule out other conditions that cause neck pain. These can include dislocations, spinal fractures, arthritis, and cervical disc disease. Your doctor may need pictures of your neck and spine. These pictures can be taken by:

    Treatment

    Treatment may include:

    Activity

    In most cases, you should continue to move your neck. Go about your normal activities as much as you can tolerate.

    Medication

    Your doctor may recommend:
    • Over-the-counter pain medicine (such as, ibuprofen, naproxen, acetaminophen, aspirin)
    • Medicated cream or patches that are placed on the skin
    • Prescription muscle relaxants to ease muscle spasms

    Ice and Heat

    To help reduce pain:
    • Apply ice or a cold pack to the neck for 15-20 minutes. Repeat four times a day for 2-3 days. Cold will help reduce 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. Wait for swelling to go away before using heat therapy.

    Therapy

    Physical therapy may be recommended. Therapy appointments may include:
    • Massage—to help increase blood flow and reduce tension.
    • Cervical traction—a special technique to stretch the neck and reduce muscle spasm.
    • Stretching and strengthening exercises

    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

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

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

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

    References

    Alleva JT, Franklin J, et al. Frontera: Essentials of Physical Medicine and Rehabilitation. Philadelphia, PA: Hanley and Belfus; 2002: chap 5.

    American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org. Accessed July 17, 2009.

    Cervical sprain. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated November 26, 2012. Accessed November 27, 2012.

    Conlin A, Bhogal S, et al. Treatment of whiplash-associated disorders—part II: Medical and surgical interventions. Pain Research & Management. 2005;10:33-40.

    Duane TM, Wilson SP, et al. Canadian cervical spine rule compared with computed tomography: a prospective analysis. J Trauma. 2011;71(2):352-357.

    Langevin P, Peloso PM, et al. Botulinum toxin for subacute/chronic neck pain. Cochrane Database Syst Rev. 2011;(7):CD008626.

    National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/. Accessed July 17, 2009.

    Neck sprain. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00410. Updated August 2007. Accessed July 17, 2009.

    Renstrom P. Sports Injuries: Basic Principles of Prevention and Care. Boston, MA: Blackwell Scientific Publications; 1993.

    Teasell RW, McClure JA, et al. A research synthesis of therapeutic interventions for whiplash-associated disorder (WAD): part 2 - interventions for acute WAD. Pain Res Manag. 2010;15(5):295-304.

    1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

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