Neck Sprain

Neck Sprain

Article by John Miller

Neck Sprain

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?

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.

Posture Fatigue

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.

Neurological signs:

  • 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.

Neck Brace

neck brace or soft collar may assist in severe neck pain, instability or neurological signs. They are certainly less commonly prescribed than ten years ago.

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 Machine

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.