Acute and Chronic Cervical (Neck) Sprain

Orthopaedic & Spine Center

Mark W. McFarland, DO

The neck area or cervical spine has many muscles, ligaments and tendons that help to support, stabilize, and provide movement for the neck and head as they sit on the spinal vertebrae.  When you think about it anatomically, it’s an architectural masterpiece that works together beautifully when healthy.  But then, life happens, and accidents, work, age, and other events occur than can traumatize the complex musculoskeletal system of the cervical spine.  In this article, I’m going to discuss Cervical Sprain, both acute and chronic varieties, how it is caused, what the symptoms are and how it is treated.

Pretty much everyone has heard of whiplash, which is an injury that happens to the neck of the person who happens to be in an automobile accident where they are rear-ended by another car.  However, an acute cervical sprain is quite a common injury and can simply be caused by playing sports, lifting something too heavy (moving furniture or lifting weights at the gym, for example) or doing repetitive over-the-head motions without proper conditioning first.

A sprain involves ligaments, which connect bone to bone, and there are six major ligaments in the neck to consider. Symptoms will include sharp pain, swelling, difficulty in movement of the head and neck and significant stiffness.  For traumatic accidents, there may also be dizziness, shoulder pain, headache, chewing and swallowing abnormalities and burning sensations in the neck and shoulders.

When I see a patient for a consultation, I order x-rays to rule out or confirm other mechanical issues, such as a cervical fracture, arthritis, or spinal stenosis, that can complicate treatment.  I do a thorough physical examination which will involve touching the neck, head, and shoulders of the patient, asking them to move certain ways, and asking them many questions about how the movement feels, if it hurts and if they feel certain sensations, which may indicate a neurologic issue.  I will look for inflammation, muscle spasms and swelling which also will help to indicate the severity of injury.

A cervical sprain is more serious than a strain and will take more time to heal.  In the first 24 hours after injury, intermittent icing is recommended (always with a protective barrier between the ice pack and the skin).  Anti-inflammatory medications will either be prescribed, or the patient can take OTC medications.  I will also prescribe muscle relaxants to help the muscle spasming decrease.  I typically do not prescribe narcotic pain medication for cervical sprains.  I may also prescribe a soft cervical collar to be worn for several weeks to help support the head and give the neck a chance to rest and heal. 

Physical Therapy will be most helpful, not only with the modalities they can employ to reduce inflammation swelling and pain, but also the exercises they will be able to teach the patient which will then help to reduce pain, strengthen the neck, increase range of motion, and restore function.  I usually will send the patient for therapy for a least three weeks to get the full benefit from the therapeutic modalities as well as the exercise regimen.  I will also ask the patient to continue to do the exercises at home after Physical Therapy is discontinued.

Unfortunately, even if this condition treated appropriately, it can become chronic.  Some patients will never fully recover and will continue to have symptoms for the rest of their lives. 

I will continue to care for these patients, help them to manage their symptoms, often with the help of my Pain Management colleagues, and ensure that they live the best quality of life possible, even with their chronic cervical sprain.


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