What is a Neck Sprain?
Neck sprain or its aliases: neck spasms, neck muscle strain or only neck muscle pain, is very common.
A neck sprain is probably the most common source of neck pain. The good news is that it is also one of the quickest neck problems to heal and rehabilitate.
What Causes Neck Sprain?
Most causes of neck sprain are muscle, ligament or joint-related. Common neck injury causes include muscular neck strains, ligament sprains or neck joint dysfunction, mainly when pain arises suddenly during or following physical loading of your neck. Muscle fatigue (poor posture sitting or sleeping, e.g. wry neck), excessive loads (lifting heavy items), or high-speed injuries (e.g. whiplash, concussions) are the most common causes.
The causes of neck pain are numerous but roughly fall into the following categories.
Neck Muscle Strain
Neck muscle pain is the most common source of neck pain. Muscle fatigue, excessive loads or poor lifting or sitting postures are the most common problems.
Inefficient, weak, or neck muscles that lack endurance can lead to vulnerable neck joint stabilisation and subsequent injury to your neck muscles, ligaments, joints or even spinal discs.
Poor posture when sitting, standing and lifting at work can place unnecessary stress upon your neck and spine. With muscle fatigue or overstretching, your ligaments and discs can stretch, and this puts spinal joint muscles and nerves under pain-causing pressure or strain that results in neck or back pain.
Neck Ligament Sprains
Ligaments are the durable, fibrous bands that limit the amount of movement available at each spinal level. Stretching ligaments too far or too quickly will tear them with subsequent bleeding into the surrounding tissues, causing swelling, muscular spasm and pain.
Awkward lifting, sports injuries (concussion or collisions) and motor vehicle accidents (whiplash) are prevalent causes. Just as in other regions of the body, physiotherapy hastens ligament healing and relieves pain so that you can enjoy life again as soon as possible.
What are the Symptoms of Neck Sprain?
Neck muscle pain symptoms may range from a mild ache, stiff neck, neck spasms, muscle knots to sudden debilitating neck pain or even shoulder and shoulder blade pain.
Typical neck sprain symptoms include:
- localised neck pain and stiffness.
- Neck muscle tenderness, tightness, knots or spasms.
You will usually feel better when resting or supporting your neck and may find that a change of neck position painful, e.g. looks down, up or sideways, rolling in bed, lift your head or quick neck movements.
Warning Signs of a More Serious Neck Injury?
In these instances, or you have constant and severe neck pain, you may have a more severe injury such as a disc bulge or pinched nerve in your neck. These can affect your upper limb and lower limb function. Very severe cases can even affect your bodily function, such as your bladder or bowel control. If this is the case, please urgently consult your nearest hospital, doctor or physiotherapist.
- pins and needles (paraesthesia) in your neck or arm
- numbness (anaesthesia) in your neck or arm,
- arm or leg muscle weakness,
- altered tendon reflexes (e.g. biceps to triceps jerk),
- difficulty lifting arms overhead or walking,
- loss of control of bladder or bowels.
How is Neck Sprain Diagnosed?
Differentiating a neck muscle strain from a ligament sprain can be difficult, as both injuries will show similar symptoms. However, an experienced healthcare practitioner such as your neck physiotherapist will accurately assess your muscles, ligaments, joints, discs and any potential nerve compromise. Please seek their professional opinion since neck treatments can vary considerably depending on your diagnosis.
What About Diagnostic Investigations?
X-rays do not identify muscle or ligament injury but will identify arthritic changes and bone injuries such as fractures. MRI scan is probably the thorough diagnostic test to precisely determine disc, bone, muscle or ligament structures are injured and to what extent. CT scans are also excellent. However, they are static images and do not identify locked joints or hypermobile joints without ligament rupture.
Please consult your neck physiotherapist or doctor for a professional opinion regarding your neck sprain.
What is Neck Sprain Treatment?
Seek a Professional Diagnosis!
A spinal health practitioner, such as your physiotherapist, should thoroughly examine your neck. Neck pain notifies you to protect your neck injury, and resolution of your pain may not restore you to regular neck joint range, muscle length and strength to prevent a future recurrence. Your physiotherapist has some nifty tricks for quickly relieving your neck sprain pain so that you can enjoy life again as soon as possible.
Neck Sprain Treatment Aims
PHASE I – Pain Relief & Protection
Managing your neck pain is the main reason that you seek treatment for the neck sprain. In truth, the pain was the final symptom that you developed and should be the first symptom to improve.
Your physiotherapist will use various treatment tools to protect your neck sprain and reduce your pain and inflammation. These may include ice, electrotherapy, e.g. tens, acupuncture, taping techniques, soft tissue massage, back braces, dry needling etc. Your doctor may also recommend a course of non-steroidal anti-inflammatory drugs such as ibuprofen.
PHASE II – Restoring Normal ROM, Strength
As your neck pain and inflammation settle, your physiotherapist will turn their attention to restoring your normal neck motion, muscle lengths and resting muscle tension, muscle strength and endurance, proprioception and joint position sense.
Your physiotherapist will commence you on a neck muscle stability program to facilitate your important muscles that dynamically control and stabilise your neck. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you, specific to your needs.
PHASE III – Restoring Full Function
Depending on your chosen sport, work or activities of daily living, your physiotherapist will aim to restore your function to allow you to return to your desired activities safely. Everyone has different demands for their necks that will determine what specific treatment goals you need to achieve. Your physiotherapist will tailor your rehabilitation to help you achieve your own functional goals.
PHASE IV – Preventing a Neck Pain Recurrence
Recurrence of neck pain can and does regularly occur. The main reason f recur is due to insufficient rehabilitation. In particular, weak deep neck flexor muscle exercises have been shown to render your neck more vulnerable to instability and, therefore, re-injury.
To prevent a recurrence, you should continue a regular series of these exercises a few times per week. Think of your tasks as your anti-neck pain pill! Your physiotherapist will assist you in identifying the best exercises for you.
Neck Pain Treatment Options
There are many treatment options that your physiotherapist will discuss with you in the treatment of your pain. Treatment varies based on the source of your symptoms.
Acupuncture or Dry Needling
Acupuncture has been a useful source of pain relief for over 5000 years. While we do not fully understand how it works, acupuncture can assist your neck pain relief. Ask your physiotherapist for advice as most of our PhysioWorks physiotherapists have acupuncture training. More info: Acupuncture
Massage always feels lovely, plus it has terrific muscle relaxation benefits. Neck massage is beneficial when muscle spasm or chronic muscle tension is present. Regular remedial massage is also a convenient neck pain prevention strategy. More info: Neck massage
TENS machines are electronic pain-relieving devices that will reduce your neck pain and your need for pain-relieving drugs. More info: Tens Machine
What Recovery Can You Expect?
Neck pain has many causes, and EARLY diagnosis and treatment is the best way to recover quickly.
Pure neck muscle pain can usually improve within a week or two of injury if you manage your injury correctly. However, muscular pain or spasm lasting more than a few days often is a protective spasm overlying a more significant neck injury, which r professionally investigated. It may not be just a basic neck muscle strain!
Most sufferers of neck pain will recover within 4 to 6 weeks. However, this period can vary. It depends on both the nature of your injury and the treatment plan that you developed with your physiotherapist.
How Can You Prevent Recurring Neck Pain?
If you have suffered neck pain in the past, you are unfortunately more likely to suffer in the future and worsening bouts. The most common cause of recurrent neck pain is insufficient rehabilitation.
Follow the advice of your physiotherapist, who will establish a treatment plan to help you achieve your short-term goals and help prevent a recurrence.
While there are no guarantees, it is well known that active individuals who exercise and adopt safe lifting and postures at home and work are at a reduced risk of developing neck pain.
Discuss with your physiotherapist the specific postures and activities that you perform daily. They will help you understand how to position yourself and move with the lowest risk of injury based on your injury type and potential weaknesses.
Neck Pain Causes
Neck Joint Injuries
Nerve-related / Referred Pain
When Should You Be Concerned About Neck Pain?
There is one situation where there’s no need to wait several weeks before deciding if your neck pain is serious.
If you’ve had an accident with forces that may have been sufficient to fracture your spine or tear nerves, seek a medical assessment as soon as possible. This means to either call an ambulance or head to a hospital emergency department.
Red Flags for Neck Pain
Otherwise, the rule of thumb is that you should start a more thorough medical investigation only when all three of these conditions are met. The three general red flags for neck pain are:
- it’s been bothering you for more than about six weeks
- it’s severe and/or not improving, or getting worse
- there is at least one other “red flag” (see below)
Red flags are reasons to seek a professional opinion rather than to worry. Seek the advice of your physiotherapist or doctor if any of these red flags apply to you.
- Light tapping on the spine is painful.
- A torn artery may cause severe, throbbing or constrictive (novel pain), with a high risk of a stroke. Pain is the only symptom of some tears. Most but not all cases are sudden, on one side, and cause both neck and head pain (in the temple or back the skull), but the pain is usually strange. Any hint of other symptoms? Promptly attend a hospital emergency.
- There are many possible signs of spinal cord trouble in the neck, with or without neck pain, mainly affecting the limbs: e.g. poor hand coordination; weakness, “heavy” feelings, and atrophy; diffuse numbness; shooting pains in the limbs (especially when bending the head forward); gait awkwardness. Sometimes patients present with both neck pain and more remote symptoms and don't realise they are related.
- Unexplained episodes of dizziness or nausea, and vomiting may indicate a problem with the stability of the upper cervical spine.
- Weight loss without dieting (it's a potential sign of cancer).
- Mystery fevers or chills (especially in people with diabetes).
- A severe headache that comes on suddenly is a “thunderclap headache”! Most are harmless, but it is always wise to investigate thoroughly.
- A fierce headache, an inability to bend the head forward, fever, or altered mental state. These are all symptoms of meningitis (inflammation of the membranes covering the brain and spinal cord, caused by infection or drug side effects).
- The main signs that neck pain might be caused by autoimmune disease specifically include:
- a family history of autoimmune disease,
- gradual but progressive increase in symptoms before the age of 40,
- marked morning stiffness,
- pain in other joints as well as the low back,
- difficult digestion,
- irritated eyes, and
- discharge from the urethra (bladder).
- Steroid use, other drug abuse, and HIV are all risk factors for a serious cause of neck pain.
- If you feel pretty unwell in any other way, that could indicate that neck pain isn’t the only thing going on.
More info: Neck Pain