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Neck Sprain

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The seven bones of the spinal column in your neck (cervical vertebrae) are connected to each other by ligaments and musclesstrong bands of tissue that act like thick rubber bands. A sprain (stretch) or tear can occur in one or more of these soft tissues when a sudden movement, such as a motor vehicle collision or a hard fall, causes the neck to bend to an extreme position.

Symptoms

A person with a neck sprain may experience a wide range of possible symptoms, including:

  • Pain, especially in the back of the neck, that worsens with movement
  • Pain that peaks a day or so after the injury, instead of immediately
  • Muscle spasms and pain in the upper shoulder
  • Headache in the back of the head
  • Increased irritability, fatigue, difficulty sleeping, and difficulty concentrating
  • Numbness in the arm or hand
  • Neck stiffness or decreased range of motion (side to side, up and down, circular)
  • Tingling or weakness in the arms

Illustration shows the typical area of pain from a neck sprain.

Reproduced and adapted from AD Armstrong, MC Hubbard (eds.): Essentials of Musculoskeletal Care, ed. 5. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2016, p. 965.

Warning Signs

Some symptoms may indicate a more serious neck injury. You should seek immediate medical attention if you have neck pain that is:

  • Consistent and persistent
  • Severe
  • Accompanied by pain that radiates down the arms and legs
  • Accompanied by a headache and numbness, tingling, or weakness in the arms and legs

Doctor Examination

Physical Examination

To diagnose a neck sprain, your doctor will perform a comprehensive physical examination. During the examination, your doctor will ask you how the injury occurred, measure the range of motion of your neck, and check for any point tenderness.

Imaging Studies

X-rays. X-rays provide images of dense structures, such as bone. A neck sprain cannot be seen on x-ray since it involves soft tissues (muscles and ligaments), but your doctor may order one to help rule out other, more serious, sources of neck pain—such as a spinal fracture, dislocation, or arthritis.

Other imaging studies. In certain cases, a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan may be ordered to provide your doctor with more information about your injury.

Treatment

All sprains or strains, no matter where they are located in the body, are treated in a similar manner. Neck sprains, like other sprains, will usually heal gradually, given time and appropriate treatment. You may have to wear a soft collar around your neck to help support the head and relieve pressure on the ligaments so they have time to heal.

Pain relievers such as aspirin or ibuprofen can help reduce the pain and any swelling. Muscle relaxants can help ease spasms. You can apply an ice pack for 15 to 30 minutes at a time, several times a day for the first 2 or 3 days after the injury. This will help reduce inflammation and discomfort. Although heat, particularly moist heat, can help loosen cramped muscles, it should not be applied too quickly.

Other treatments may be helpful as your injury starts to improve. These treatments should not be started, however, without the supervision of your doctor. They include:

  • Massaging the tender area
  • Ultrasound therapy
  • Cervical (neck) traction
  • Aerobic and isometric exercise

Most symptoms of neck sprain will go away in 4 to 6 weeks. However, severe injuries may take longer to heal completely.

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Last Reviewed

June 2019

Contributed and/or Updated by

Daniel K. Park, MD

Peer-Reviewed by

Stuart J. Fischer, MD

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.