Definition

What is neck strain?

A muscle strain is a tear of some of the muscle fibres. This may be just a few, in which case it is a grade one strain, or may be up to 90% of the muscles fibres, which would get a grade 2 injury. A full muscle rupture is a grade 3 injury, this doesn’t often happen in the neck and isn’t generally described as a neck strain.

A neck strain is often the result of a sudden movement or force to the head or neck. This may happen from a fall or a car accident and is often referred to as whiplash. Similar pain in one or more of the neck muscles may also occur after holding an awkward position for a prolonged period, such as holding a phone between the ear and shoulder, or sleeping awkwardly (e.g. sitting upright).

How common is neck strain?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of neck strain?

The cardinal symptom of neck strain is pain and often combined with decreased range of motion. Although one typically has pain after an injury, it is not uncommon for someone to be free of discomfort initially, because inflammatory changes may happen slowly. The presence of immediate pain at the time of injury should serve as a red flag that the injuries may be more severe than first thought. The classic events after a whiplash injury are that the patient feels fine the day of the injury but wakes up the next morning with pain and decreased range of motion.

Other symptoms include the inability to perform daily work or activities that one could do before. Be wary of symptoms suggesting nerve irritation or a pinched nerve, such as weakness, numbness, tingling, incoordination, and dizziness. Neck strain does not typically cause lymph node swelling.

Neck stiffness usually occurs and may radiate into the lower back when severe. Difficulty chewing, swallowing, and breathing occur rarely. Anyone with these symptoms should contact a doctor.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes neck strain?

Neck strains result from injury to the neck. Such injuries are caused most often by indirect trauma when the head is flung backward (hyperextension) or forward (hyperflexion), commonly known as whiplash. Injuries caused by rotation and compression (when the force of impact lands on the top of the head) can also result in neck strains and soft-tissue injury.

Automobile accidents are responsible for many whiplash injuries because of hyperextension or hyperflexion. A common scenario is when a seat-belted person’s head continues to move forward during a frontal impact and is then often thrown backward (the converse is also true). Side impacts typically result in bending of the head to that side, and rear impact tends to throw the head backward. Any or all of these movements usually result in whiplash.

People with occupations requiring repetitive or prolonged neck extension (microtrauma) may develop neck strain injury. Picture someone sitting at a computer keyboard, for example, straining to see a monitor that is not adjusted properly for the person’s posture. Also, the person may be trying to see the monitor through poorly adjusted bifocal lenses and must tip the chin upward to view the screen. Now tuck a telephone into the person’s shoulder for much of the day and that’s the formula for neck strain. With the increase use of computers at home, even the time away from one’s work can add to this injury.

Some people appear prone to neck strain injuries merely as the result of an abnormal posture while awake or from sleeping in an awkward position.

Risk factors

What increases my risk for neck strain?

Please consult your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

 

How is neck strain diagnosed?

Pain

Pain perception varies from person to person and is hard to measure. The doctor will rely on one’s description of symptoms to better quantify the pain. Someone may be asked to rate pain on a scale from 0 to 10, with 0 representing no pain and 10 as the worst pain. Although difficult to generalize, the following types of symptoms usually predict the types of anatomic structures injured:

  • Cramping, dull, aching pain may indicate that muscles may be injured.
  • Sharp, shooting pain could be injury to a nerve root.
  • Sharp, lightning-like pain may indicate that a nerve is injured.
  • Burning, stinging pressure may indicate nerve injury.
  • Deep, nagging, dull pain could be injury to a bone.
  • Sharp, intolerable, severe pain could indicate a fracture.
  • Throbbing, diffuse pain may be injury to blood vessels.

History

As well as trying to determine the severity of someone’s pain, a doctor will focus on several other key areas as he/she makes a diagnosis:

  • The patient’s age
  • How the patient was injured
  • Previous injuries
  • One’s usual level of activities
  • The presence (or absence) of head impact and loss of consciousness
  • The way and the time frame the symptoms developed
  • Factors that make the patient feel better or worse
  • Radiation of the symptoms away from the neck and the presence of any symptoms that suggest nerve problems such as weakness, altered sensation, tingling, and (particularly ominous) any bowel or bladder dysfunction
  • Any treatments someone has already tried and their outcomes

Physical Examination

Physical evaluation for neck strain may be divided into the phases of observation, touching the muscles and other structures in the neck (palpation), examination of the blood vessels in the neck, nerve testing and, finally, an assessment of the ability to move. In most cases of trauma involving a significant mechanism of action, a complete examination is usually not completed until a set of preliminary X-rays has confirmed the lack of fractures (broken bones) and dislocations of the cervical spine.

Observation

The doctor may wish to see the patient walk into and around the examination room.

Typically, the patient’s posture, gait, facial expression, willingness to move for examination, and ease of movement will be assessed.

The doctor will be interested to see whether the patient’s head is rotated to one side. This usually indicates muscle spasm of the neck (called torticollis).

The position of the patient’s chin and head will be noted as well as his/her habitual posture and the symmetry of the neck contour formed by the trapezius muscle.

The posture of the patient’s head and neck may also be checked while the patient sits and then stands. Any differences will be noted.

The patient’s shoulders will be checked to see if they are level when relaxed. Asymmetry often indicates muscle spasm.

Observation is often also sufficient to lead to a suspicion of a problem causing an inadequate blood supply (ischemia) in one of the upper limbs. A doctor will examine the blood vessels in the neck by feeling the pulses to assess for briskness of upstroke and fullness, and the presence of any abnormal sounds heard with a stethoscope placed over the blood vessel (auscultation). The doctor will also look for any evidence of any increased pressure in the neck veins (distended or bulging jugular veins). The doctor will check the patient’s trachea, particularly if there are any symptoms of hoarseness.

The doctor will also palpate the patient’s head, neck, shoulders, and possibly other areas. Palpation is useful in detecting differences in tissue tension, texture, and thickness, tenderness, and abnormal sensation. In addition, differences in temperature and dryness (or excessive moisture) become readily apparent. Tremor (shaking) and muscle twitches may also be checked in this manner.

The doctor will perform neuromuscular testing to determine whether the patient has any injuries to the nerves and joints in the neck. These tests typically involve moving the body both passively (with assistance) and actively, to assess for strength, range of motion, and any loss of sensation.

The combination of a detailed history, physical examination, and one or more imaging procedures should enable the doctor to exclude, or identify, any serious injury to the neck and thereby plan a course of treatment. Continue Reading

How is neck strain treated?

After the assessment of one’s condition by a doctor, a plan will be formulated, in conjunction with the patient and his/her family, to treat the injuries. Consideration will be given to the length of time that might be involved for recovery. The vast majority of neck strains heal themselves with appropriate supportive self-care alone. Many people do not need specific medical intervention.

Rest and apply local heat for symptomatic relief, and gradually resume one’s usual daily physical activity and work.

If pain lasts beyond two to three weeks, consideration should be given for further evaluation.

Osteopathic manipulative therapy (administered by a physician trained in manipulative medicine), chiropractic care, acupuncture, or an evaluation by a physical therapist should all be considered.

Several treatment plans are available for the person with persistent pain, including home cervical traction, under the direction of a doctor and physical therapist. Contact your doctor for a referral, as needed.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage neck strain?

If the pain is not severe and one does not have any new numbness, weakness, or other symptoms of nerve failure, mild neck strain can be safely treated at home.

If pain is moderate, bed rest may be necessary. A cervical collar may be beneficial.

It is helpful to place a small pillow under the nape of the neck to provide proper neutral positioning.

Dry or moist heat applied to the area often provides relief from pain caused by muscle spasm. However, it has not been shown to speed the healing process.

Pain control with a nonsteroidal anti-inflammatory drug (NSAIDs), such as ibuprofen (Advil or Motrin) or acetaminophen (Tylenol), is frequently helpful. An opioid, such as codeine, may be added if needed but will need to be prescribed by a doctor. Muscle relaxants are often used also. They are also available by prescription only.

One should guard against neck extension because this will make the pain worse. Stay active and perform one’s daily work as tolerated, unless this involves heavy physical labor. Contact a doctor for recommendations.

If you have any questions, please consult with your doctor to better understand the best solution for you.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: October 27, 2017 | Last Modified: October 27, 2017

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