Neck Sprains and Strains | Joint, Ligament and Muscle Disorders

Neck Sprains and Strains

Anatomy

The spinal column is made up of small bones (vertebrae) stacked on top of one another, creating the natural curves of the back. Muscles and ligaments connect the vertebrae and allow motion while providing support and stability for the spine and upper body.

The spine contains three segments: lumbar, thoracic and cervical. The cervical spine includes the neck and consists of seven small vertebrae, beginning at the base of the skull and ending at the upper chest. The cervical spine supports the weight of the head and connects it to the shoulders and body. It is less protected than the rest of the spine, making it more vulnerable to injury and disorders that produce pain and restricted motion.

Muscles and ligaments connect the vertebrae and allow motion while providing support and stability for the spine and upper body. Tendons are fibrous cords of tissue that attach the muscles to bone. Ligaments are strong bands of connective tissue that connect one bone to another and support the joints of the body.

Description

Sprains and strains are injuries to ligaments, muscles or tendons. A sprain is the simple stretch or tear of a ligament. A strain may be a simple stretch of a muscle or tendon, or it may be a partial or complete tear in the muscle/tendon combination.

Symptoms

A person with a neck sprain or strain may experience one or more of a wide range of symptoms, including:

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

Nonsurgical Treatment

The recommended treatment for sprains and strains, wherever they are located in the body, is similar: rest, ice, compression and elevation, followed by simple exercises to relieve pain and restore mobility. Neck sprains and strains typically heal gradually over time, with appropriate treatment. Your doctor may prescribe a soft collar worn around the neck to help support the head and relieve pressure on ligaments, tendons and muscles while they heal. Other treatment options include massaging the tender area, ultrasound, cervical (neck) traction, and aerobic or isometric exercise. Your physician or physical therapist may prescribe specific exercises to help you improve strength and flexibility, restore movement, and provide relief from uncomfortable symptoms. Physical therapy is often a key factor in successfully recovering from a wide range of conditions and disorders.

Most symptoms of a neck sprain will go away within 4 to 6 weeks, however, it may take longer for more severe injuries to heal completely.

Surgery

For a serious tear, surgery may be needed to repair the soft tissues.

With any surgery there are some risks, and these vary from person to person. Complications are typically minor, treatable and unlikely to affect your final outcome. Your orthopaedic surgeon will speak to you prior to surgery to explain any potential risks and complications that may be associated with your procedure.

Causes, Symptoms, Diagnosis, and Treatment

A neck sprain refers to an overstretched or torn ligament in the neck. Neck sprains are commonly associated with a whiplash injury. If a ligament in your neck is torn, it can cause extreme pain and severely limit your ability to move your head and neck.

Whiplash can occur from a car accident, playing a contact sport, riding amusement park rides that snap your head around, or any sudden impact that forces your neck beyond its normal range of motion.

Causes

Neck sprains are typically caused by an impact or force that causes your neck to quickly extend beyond its normal range and then snap back forcefully.

While the terms “sprain” and “strain” are often used synonymously, they are not the same injury:

• A sprain specifically refers to ligaments (the fibrous tissues that connect joint bones together)
• A strain refers to muscles and tendons (the fibrous tissues that connect bones to muscles)

Whiplash can involve all of these neck structures, which are referred to individually as the cervical ligaments, cervical muscles, and cervical tendons.

Symptoms

Neck sprain symptoms don’t necessarily appear at the moment of an injury or impact. It may take one to two days for pain and stiffness to develop.

Common signs and symptoms of a neck sprain include:

• Headache (typically in the back of the head)
• Muscle spasms and pain in the upper back and/or shoulders
• Neck pain that worsens with movement
• Neck stiffness limits the range of motion
• Ringing in the ears (tinnitus)

Complications

If you sustain whiplash, look out for symptoms of a nerve injury or a pinched nerve, including numbness, tingling, the loss of coordination, dizziness, and weakness of the hands or arms.

Referred pain is a phenomenon in which an injury in one part of the body triggers nerve pain in a distant part of the body. It is another common sign of a nerve injury.

Loss of bladder control often occurs with a spinal cord injury. Neck stiffness that is accompanied by radiating pain to the lower back as well as having breathing problems and swallowing problems (dysphagia) are also signs of a more serious injury.

The symptoms of whiplash are usually delayed. Immediate neck or head pain following an extreme force or impact is a sign of a serious injury that is in need of emergency medical care.

If you have experienced a head or neck injury, you will also want to be on alert for concussion symptoms, including:

• Blurred or double vision
• Dizziness (vertigo)
• Fatigue
• Headache
• Nausea or vomiting
• Problems with balance and coordination
• Sensitivity to noise or light
• Weakness

Some people experience problems with cervical proprioception (knowing where your neck and head is in relation to space). If you experience this sensation, you need to be properly evaluated by a medical professional.

While they can also appear in the neck, swollen lymph nodes are not a sign of a neck injury (they are more often a sign of infection).

Diagnosis

A neck sprain is primarily diagnosed with a physical examination.  The aim of the physical exam is to assess the range of motion in your neck, evaluate your reflexes, and determine if you are experiencing any abnormal sensations.

Your doctor will also review your posture (specifically, how you hold your head) and might also check the blood vessels in your neck to see if there are signs of vascular injury. Imaging tests might be used to support a diagnosis or establish the severity of an injury.

Your doctor might order these tests to examine your bones and soft tissues (including tendons, ligaments, and spinal discs) or detect signs of bleeding. Imaging tests used to diagnose neck injuries include:

• Computed tomography (CT) scans: Captures multiples X-ray images to create cross-sectional views of your body
• Magnetic resonance imaging (MRI): Uses a magnetic field and radio waves to create radiographic images, particularly of soft tissues
• X-ray: Exposes you to low-level electromagnetic radiation

Treatment

The treatment for a neck sprain is the same as for sprains in other parts of the body. Rest and patience are key to helping you cope with the injury. Standard treatment recommendations for sprains include:

• Icing the injury. For the first two to three days, your doctor will likely ask that you ice the injury four to eight times per day, for 15 to 20 minutes at a time. To avoid frostbite, place a cloth barrier between the ice pack and your skin and keep the ice pack moving rather than holding it in one place.
• Wearing a cervical collar. To keep your neck stable and relieve pressure on the ligament, you might be given a soft cervical collar to wear for several days. It should be used for severe neck strains or if you feel like your head is going to “fall off.” Long-term use of a cervical collar is not recommended as it can cause your neck muscles to weaken and increase the odds of a neck strain injury.
• Taking a painkiller. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil/Mortin (ibuprofen), Aleve (naproxen), or Tylenol (acetaminophen) can relieve pain and reduce inflammation. 
• Using heat therapy. After you have iced the injury for two to three days, you can apply moist heat to the area. Heat will help increase blood flow, promote healing, and relieve stiffness.

You might want to explore other treatments once your injury starts to improve. Keep in mind that these options are best performed by or with the guidance of your doctor or a physical therapist:

• Cervical traction
• Gentle massage
• Isometric exercises
• Range of motion and mobility exercises
• Ultrasound therapy

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

If your symptoms are severe or do not improve after two months, you might want to have your vestibular system and upper neck checked by a physical therapist who has experience treating whiplash injuries. There could be underlying impairments that have not been addressed.

If the pain lingers despite other treatments, your doctor might prescribe a muscle relaxant or give you a local anesthetic injection to help manage the pain. Injections are typically reserved as a last effort after prior treatments fail to bring lasting relief.

When you start feeling better, you will still need to be careful about exercise. Avoid contact sports or any activity that compromises the stability of your neck until your doctor fully signs off on your condition.

Neck Sprains and Strains | Spine Care

Overview

A neck strain is an injury to the muscle or tendon in the neck that generally occurs when the neck muscle or tendon stretches too far and tears.

A neck sprain is an injury to the ligaments in the neck.

Symptoms of a neck sprain or strain are similar and can vary based on the size of the tear and location.

A neck strain can be classified from Grade I – Grade III.

• Grade I is a mild strain with partial tearing. Pain is typically mild.
• Grade II is a moderate neck strain where more muscle fibers are torn. You could experience some muscle weakness as well as mild to moderate pain.
• Grade III is the most severe type of neck strain. The muscle has completely torn in a Grade III tear. Pain is severe.

Your doctor will generally use the same protocol to treat sprains and strains.

Neck sprains and strains causes

Generally, neck strains or sprains are caused by an injury to the neck. Injuries to the neck can occur from a car accident, a direct blow that causes your head to be flung backward or forward or from when a force lands on the top of the head.

Other causes of neck sprains or strains include:

• Poor posture
• Lifting a heavy object
• Falling
• Performing a new activity
• Repetitive motions or activities that require repetitive motions
• Diseases such

Neck sprains and strains symptoms

The most common sign of a neck sprain or strain is a pain in combination with a decreased range of motion.

Other symptoms of neck sprains or strains include:

• Headache
• Muscle tightness or spasms
• Inability to perform daily activities
• Weakness, numbness or tingling potentially associated with nerve irritation or damage
• Stiffness in the neck
• Problems chewing, swallowing or breathing

Neck sprains and strains complications

If a Grade II or III neck strain is left untreated, you could experience:

• Chronic pain
• Headaches
• Depression
• Loss of cervical ROM
• Disability

Neck sprains and strains risk factors

There are a variety of factors that can increase your likelihood of developing a neck sprain or strain, including:

• Performing activities that require repetitive movements
• Having surgery on the neck
• Sleeping in an awkward position
• Maintaining a poor sitting or standing posture
• Suffering a bone fracture in the neck

Neck sprains and strains prevention

Although all neck sprains and strains cannot be prevented, you can prevent some cases by following these guidelines:

• Practice using good posture when standing and sitting.
• Take breaks if you are traveling long distances or sitting in the same position for an extended period.
• Quit smoking.
• Avoid carrying heavy objects or bags on your shoulders.

Neck sprains and strains diagnosis

Your doctor can diagnose a neck strain or neck sprain. During a clinic visit, your doctor will perform a physical exam, take a full medical history and order diagnostic testing.

Physical exam

Your doctor will evaluate your range of motion, examine your neck for abnormalities, and, when necessary, perform a Spurling’s test to see if symptoms associated with nerve compression can be reproduced.

In rare cases, your doctor will order an X-ray, MRI, or CT scan to confirm your diagnosis.

Neck sprains and strains treatment

Your doctor will develop a customized treatment plan for your case.

If the injury is a Grade I or Grade II neck strain, your doctor will typically start you with conservative treatments such as:

• Rest
• Local heat
• Medications such as ibuprofen or Aleve

If over-the-counter medications are not adequately treating your symptoms, your doctor may prescribe more potent pain relievers or corticosteroids.

In more severe cases, you may need physical therapy or cervical neck traction. Physical therapy will help strengthen the injured area. Your physical therapist may use massage, ultrasound, or weightlifting exercises. Cervical neck traction will help stabilize the neck during healing.

When to seek care

Most cases of neck sprain or strain heal on their own with in-home self-care. If your symptoms such as constant neck pain, persistent neck spasms, and inability to perform daily activities that do not go away within a few days or if they intensify, call your doctor to schedule an appointment.

If you experience any of these symptoms, go to the emergency room right away:

• Numbness or tingling in your upper extremities
• Weakness
• Trouble breathing
• Headache associated with dizziness, nausea or vomiting
• Difficulty swallowing

Next Steps

Symptoms of neck sprains or strains are similar to more severe neck issues. Patients are strongly encouraged to seek a diagnosis and treatment plan from their doctor.

Once diagnosed, your doctor will develop a treatment plan customized for your case. Carefully follow your doctor’s instructions and call if your symptoms change or intensify.

Neck Problems and Injuries | Michigan Medicine

Do you have a neck injury or other neck problem?

Yes

Neck problem or injury

How old are you?

Less than 5 years

Less than 5 years

5 years or older

5 years or older

Are you male or female?

Why do we ask this question?

• If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
• If your symptoms aren’t related to those organs, you can choose the gender you identify with.
• If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Have you had surgery on your neck in the past month?

Yes

Neck surgery in the past month

No

Neck surgery in the past month

Have you had a major trauma in the past 2 to 3 hours?

Yes

Major trauma in past 2 to 3 hours

No

Major trauma in past 2 to 3 hours

Do you have any numbness, tingling, or weakness or any moderate to severe pain that started after the trauma?

Yes

Symptoms after major trauma

No

Symptoms after major trauma

Have you had a neck injury in the past month?

Yes

Neck injury in the past month

No

Neck injury in the past month

Are you having trouble moving your neck or either arm normally?

Yes

Difficulty moving neck or arm

No

Difficulty moving neck or arm

Are you able to move your arm or hand?

Yes

Able to move arm or hand

No

Unable to move arm or hand

Have you had trouble moving your neck or arm for more than 2 days?

Yes

Difficulty moving neck or arm for more than 2 days

No

Difficulty moving neck or arm for more than 2 days

Do you have numbness, tingling, or weakness in your arms or hands?

Weakness is being unable to use the arm or hand normally no matter how hard you try. Pain or swelling may make it hard to move, but this is not the same as weakness.

Yes

Numbness, tingling, or weakness in arms or hands

No

Numbness, tingling, or weakness in arms or hands

Did the numbness and weakness start right after the injury?

Yes

Numbness and weakness began immediately after injury

No

Numbness and weakness began immediately after injury

Have the symptoms lasted for more than an hour?

Yes

Numbness, tingling, or weakness for more than 1 hour

No

Numbness, tingling, or weakness for more than 1 hour

Do you have a deep wound in your head or neck?

This is more than a minor cut. This type of injury usually is caused by an object going through all the layers of skin to the tissue beneath.

Yes

Deep wound to head or neck

No

Deep wound to head or neck

Has sudden, severe weakness or severe numbness affected the whole arm or the whole hand?

Weakness is being unable to use the arm or hand normally, no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness.

Yes

Severe or sudden numbness or weakness in the whole arm or hand

No

Severe or sudden numbness or weakness in the whole arm or hand

Do you have trouble moving your neck?

Yes

Difficulty moving neck

Is it very hard to move or somewhat hard to move?

“Very hard” means you can’t move it at all in any direction without causing severe pain. “Somewhat hard” means you can move it at least a little, though you may have some pain when you do it.

Very hard

Very hard to move

Somewhat hard

Somewhat hard to move

How long have you had trouble moving your neck?

Less than 2 days

Difficulty moving neck for less than 2 days

2 days to 2 weeks

Difficulty moving neck for 2 days to 2 weeks

More than 2 weeks

Difficulty moving neck for more than 2 week

Has the loss of movement been:

Getting worse?

Difficulty moving is getting worse

Staying about the same (not better or worse)?

Difficulty moving is unchanged

Getting better?

Difficulty moving is improving

Are you having trouble breathing (more than a stuffy nose)?

Yes

Difficulty breathing more than a stuffy nose

No

Difficulty breathing more than a stuffy nose

Is your ability to breathe quickly getting worse?

Yes

Breathing problems are quickly worsening

No

Breathing problems are quickly worsening

Do you have any swelling or a lump in your neck?

Yes

Swelling or lump in neck

No

Swelling or lump in neck

Is it quickly getting worse?

Yes

Lump or swelling in neck is rapidly increasing

No

Lump or swelling in neck is rapidly increasing

Are you hoarse or having trouble swallowing?

Yes

Difficulty swallowing or hoarseness

No

Difficulty swallowing or hoarseness

Has the pain:

Gotten worse?

Pain is increasing

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is improving

Do you have any neck pain?

How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?

8 to 10: Severe pain

Severe pain

5 to 7: Moderate pain

Moderate pain

1 to 4: Mild pain

Mild pain

How long has the pain lasted?

Less than 2 full days (48 hours)

Pain less than 2 days

2 days to 2 weeks

Pain 2 days to 2 weeks

More than 2 weeks

Pain more than 2 weeks

Has the pain:

Gotten worse?

Pain is getting worse

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is getting better

Do you think that the neck problem may have been caused by abuse?

Yes

Neck problem may have been caused by abuse

No

Neck problem may have been caused by abuse

Do you think you may have a fever?

How long have you had neck symptoms?

Less than 1 week

Symptoms for less than 1 week

1 to 2 weeks

Symptoms for 1 to 2 weeks

More than 2 weeks

Symptoms for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

• Your age. Babies and older adults tend to get sicker quicker.
• Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
• Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
• Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
• Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

• Try home treatment to relieve the symptoms.
• Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

• Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
• Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
• Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Pain in children 3 years and older

• Severe pain (8 to 10): The pain is so bad that the child can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
• Moderate pain (5 to 7): The pain is bad enough to disrupt the child’s normal activities and sleep, but the child can tolerate it for hours or days.
• Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.

Symptoms of difficulty breathing can range from mild to severe. For example:

• You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
• It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

• You cannot talk at all.
• You have to work very hard to breathe.
• You feel like you can’t get enough air.
• You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

• It’s hard to talk in full sentences.
• It’s hard to breathe with activity.

Mild trouble breathing means:

• You feel a little out of breath but can still talk.
• It’s becoming hard to breathe with activity.

Severe trouble breathing means:

• The child cannot eat or talk because he or she is breathing so hard.
• The child’s nostrils are flaring and the belly is moving in and out with every breath.
• The child seems to be tiring out.
• The child seems very sleepy or confused.

Moderate trouble breathing means:

• The child is breathing a lot faster than usual.
• The child has to take breaks from eating or talking to breathe.
• The nostrils flare or the belly moves in and out at times when the child breathes.

Mild trouble breathing means:

• The child is breathing a little faster than usual.
• The child seems a little out of breath but can still eat or talk.

Pain in adults and older children

• Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
• Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
• Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Major trauma is any event that can cause very serious injury, such as:

• A fall from more than 10 ft (3.1 m)[more than 5 ft (1.5 m) for children under 2 years and adults over 65].
• A car crash in which any vehicle involved was going more than 20 miles (32 km) per hour.
• Any event that causes severe bleeding that you cannot control.
• Any event forceful enough to badly break a large bone (like an arm bone or leg bone).

Symptoms of serious illness may include:

• A severe headache.
• A stiff neck.
• Mental changes, such as feeling confused or much less alert.
• Extreme fatigue (to the point where it’s hard for you to function).
• Shaking chills.

Symptoms of a heart attack may include:

• Chest pain or pressure, or a strange feeling in the chest.
• Sweating.
• Shortness of breath.
• Nausea or vomiting.
• Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
• Lightheadedness or sudden weakness.
• A fast or irregular heartbeat.

For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms, like shortness of breath, nausea, and back or jaw pain.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

• Call your doctor now to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don’t have one, seek care in the next hour.
• You do not need to call an ambulance unless:
  • You cannot travel safely either by driving yourself or by having someone else drive you.
  • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Do not move the person unless there is an immediate threat to the person’s life, such as a fire. If you have to move the person, keep the head and neck supported and in a straight line at all times. If the person has had a diving accident and is still in the water, float the person face up in the water.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

• Call your doctor today to discuss the symptoms and arrange for care.
• If you cannot reach your doctor or you don’t have one, seek care today.
• If it is evening, watch the symptoms and seek care in the morning.
• If the symptoms get worse, seek care sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

• Make an appointment to see your doctor in the next 1 to 2 weeks.
• If appropriate, try home treatment while you are waiting for the appointment.
• If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Postoperative Problems

Neck Sprain (Neck Pain & Stiff Neck): Symptoms & Treatment

Overview

What is a neck sprain?

A neck sprain is a stretched ligament or muscle in the neck. A neck sprain may occur without any obvious injury but sometimes it may be caused by a sudden impact with an object. An impact may force the neck to quickly extend beyond its normal range, and then snap back forcefully. This is commonly called a whiplash injury. Rear-end car accidents, head jerking during amusement park rides, or being kicked are the most common forms of impact that may cause a neck sprain.

Symptoms and Causes

What symptoms will I have with a neck sprain?

You will have neck pain that worsens with movement. Sometimes this pain will not appear until a full day or two after the event that caused it. You will most likely have neck stiffness that hinders your ability to move your neck. The back of your head might hurt. You may also have pain in the shoulders or upper back. Other symptoms that may happen with a neck sprain include:

• Dizziness
• Ringing in the ears
• Fatigue
• Patchy numbness in the hands or arms

If you notice these symptoms after a whiplash-type incident, see a doctor for an evaluation to rule out a more serious problem, such as damage to the spinal cord. Arm or leg weakness, difficulty walking, and an inability to control the bladder or bowels are signs of spinal cord injury. If you have immediate neck pain after the incident, go to an emergency room.

Diagnosis and Tests

How is a neck sprain diagnosed?

A physical examination will review your posture, ability to move, and the position of your head and chin. The doctor will inspect the blood vessels in your neck and may listen to them with a stethoscope. He or she also may check:

• The range of motion of your neck
• The muscle strength in your arms
• Your reflexes
• Whether or not you can detect sensations

Imaging tests such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) may be used, but most people with suspected neck sprain do not need these tests.

An MRI is a painless, noninvasive test that produces very clear pictures, or images of the human body without the use of X-rays. MRI uses a large magnet, radio waves, and a computer to produce these images.

A CT scan is an X-ray procedure that combines many X-ray images with the help of a computer to create cross-sectional views of the body.

Management and Treatment

How is neck sprain treated?

Pain, inflammation, and tension may be treated by:

• Analgesics and anti-inflammatory medications
• Ice for the first 24 hours followed by heat applied to the neck through a moist towel
• Muscle relaxants

Gentle movement of the neck is encouraged. Range of motion exercises may be prescribed by a physical therapist.

You may want to try sleeping with a rolled up towel under your neck for relief.

Outlook / Prognosis

What can I expect from treatment?

Your head and neck pain should get better within a couple of weeks. If not, local anesthetic injections may be tried. Full recovery may take as long as 3 months. If you are still having symptoms after this time further evaluation by a spine specialist is appropriate.

All About That “Pain in the Neck”

Interview with Dr. George Frey

Editor: Does Colorado Comprehensive Spine treat many patients with neck sprains and strains?

Dr. Frey:

Certainly, we see a steady stream of patients with neck pain; it is one of the most common complaints. Although neck pain may be caused by spinal stenosis, a herniated disc, or other more serious conditions, strains and sprains are the most frequent diagnosis. The pain can be severe and even temporarily disabling to the patient’s everyday activities.

The frequency of this condition is closely related to our lifestyles. For example, awkward positions such as cradling the phone between the ear and shoulder, sitting in a chair that offers no support, or working at an ill-designed computer station can contribute to neck strain. Another example is whiplash, which is a type of neck strain. It may develop after an automobile accident when the head is suddenly and quickly forced forward and backward (excessive flexion and extension) during a rear-end collision. Other causes of whiplash include injuries during sports or biking.

Although, the initial neck pain may be so severe that the patient fears they have “broken” their neck, the good news is that most neck strains and sprains are easily treated and do not require spine surgery.

Editor: Please help us understand what happens when a patient strains or sprains his neck.

Dr. Frey:

Well, first of all we need to briefly look at the anatomy of the neck (the cervical spine). Remarkably, only 7 small vertebrae and an intricate system of soft tissues (muscles, tendons and ligaments) support the head and enable it to move in a wide range. The cervical spine is the most mobile segment of the spine, but this mobility also makes it susceptible to strain and injury.

Cervical spine with muscles, tendons, and ligaments

Sprains and strains are soft tissue injuries. A strain affects muscles and tendons, while sprains affect ligaments. While these soft tissues provide reinforcement of the cervical vertebrae, they can be stressed and forced to the point of injury. Excessive flexion (bending forward) and extension (stretching out) activities, especially when combined with poor posture and movement mechanics,will lead to injury.

Editor: How would I know I might have strained or sprained my neck?

Dr. Frey:

The typical symptoms of cervical strain and sprain include sharp pain, stiffness and difficulty when moving, and swelling. Whiplash shares these symptoms and may include headache, dizziness, difficulty swallowing and chewing, burning sensations, and shoulder discomfort.

Although these symptoms might exist, it does not necessarily mean that the patient has a sprain or strain. To make a correct diagnosis, doctors at CCSI take several steps. First, we will take a detailed patient history, asking for information about when the pain started, what makes the pain worse, and so forth.

Following this step, we will conduct a physical and neurological examination. The physical exam will include palpation, during which the physician feels the patient’s spine to detect muscle spasm and areas of inflammation. The range of motion examination helps to measure the degree of injury. For example, can the patient turn his or her head from side to side comfortably or bend the neck forward and backward without pain? The neurological segment of the exam tests the patient’s reflexes and sensory responses. For example, are there areas of tingling or numbness in the shoulders, arms or hands?

Finally, it is possible that physician will order an x-ray to rule out fracture. Seldom is further diagnostic testing initially required.

Editor: OK, so after this diagnostic process, what are my treatment options?

Dr. Frey:

As I mentioned earlier, most sprains and strains do not require surgery. Treatment options thus focus on non-operative techniques.

The majority of patients will be prescribed medications to relieve pain and muscle spasm. Medications may include an anti-inflammatory, a muscle relaxant, and either narcotic or non-narcotic medications for pain. A narcotic is only prescribed when a non-narcotic medication is insufficient to relieve pain.

Some patients will be instructed to wear a soft cervical collar. This is a removable, padded, adjustable collar worn about the neck that serves to gently lift some of the head’s weight off tender and painful neck tissues. A cervical collar is a short-term treatment (two to three weeks) to help the patient manage muscle spasm, neck fatigue, and pain.

Finally, there is physical therapy. Therapeutic exercise programs begin slowly to acclimate the patient to stretching and strengthening routines. The patient is usually provided with a home exercise program to continue on a regular basis. A strong and agile spine is one step toward preventing future injury.

In addition, physical therapy incorporates “hands on therapies” such as ultrasound, massage, heat or ice packs, and electrical stimulation. These therapies work to increase neck mobility and decrease inflammation, muscle spasm and pain. Manual therapies of this type also increase circulation to the site of injury and facilitate healing. Chiropractic care can provide good results for patients with strains and sprains.

What pleases me most about the PT programs at CCSI is the attention we give to prevention of future injuries. All of the medical staff at CCSI is trained to give patients careful instruction regarding how to prevent future injury. Many of the sprains and strains we see could have been prevented if the patient had been better educated about such issues as correct posture, good body mechanics, diet and exercise.

Editor: Do you have any final thoughts about neck sprains and strains?

Dr. Frey:

Yes, don’t be a hero! By that I mean if you have some of the symptoms described in this article, do not try to diagnose yourself! Visit a doctor at CCSI who is an expert at diagnosing such conditions, and at identifying other more serious conditions with similar symptoms. We’ll help you on the road to a speedy recovery.

Editor: Thank you Dr. Frey for your time and insights.

Dr. Frey:

You’re welcome.

Neck Strain | Symptoms, treatment and rehab exercises

By Terry Zeigler, EdD, ATC 

A neck strain is a painful and debilitating injury because the pain and associated muscle spasm can inhibit any and all movements of the head/neck. For an athlete who needs to have full movement of his/her head, a neck strain can sideline an athlete until the injury has healed. Athletes who try to play through the pain of a neck strain may inadvertently prolong the healing process.

A strain is an injury to a muscle. A strain to a neck muscle can include any of a number of either deep or superficial muscles located around the neck. The muscles of the neck are responsible for the following movements including flexion (chin to chest), extension (eyes to ceiling), rotation, and lateral flexion (ear to shoulder).

When any one of these muscles becomes injured, the movements of the head can become severely limited because strained muscles often result in associated muscle spasms in the injured or surrounding muscles.

While a strain is a tear to the muscle fiber, a spasm is an involuntary contraction of the muscle that tightens the muscle to a point where movement is not possible. Muscle spasm is a mechanism of the body to protect injured or weakened muscles and often accompanies a muscle strain.

Classifications of neck strains 

Muscle strains are classified as mild (first degree), moderate (second degree), or severe (third degree) depending on their severity.

First degree neck strain:

Are the result of a stretching of the muscle tissue that results in pain, tightness, and discomfort with movement of the head/neck. Depending on the muscle that is affected, some or all movements of the head/neck may be painful for the athlete.

Moderate or second degree neck strain:

Muscle strains are caused by the actual tearing of some of the muscle fibers within the muscle. This can result in increased pain, muscle spasm, swelling discoloration, and increased limitations on head/neck movement.

Third degree or complete tear:

The most severe type of muscle strain is the result of a complete tear of the muscle usually at the place in the muscle where the muscle and tendon connect or at the insertion of the muscle into the bone.

This type of injury is a serious injury which may result in deformity of the muscle, intense pain, disability, muscle spasm, swelling, and discoloration. Any athlete suspected of a third degree muscle strain should be immobilized and immediately referred for medical evaluation and treatment.

Diagnosing neck strain 

A neck strain can be easily diagnosed by a medical professional with a thorough medical history and the administration of a clinical evaluation. If other injuries may be suspected, the physician may order an x-ray or MRI to rule-out bone, spinal cord, or disc injuries. 

Who gets neck strains? 

One of the most common mechanisms of injury for a neck strain is a “whiplash-type” of injury similar to that seen in individuals who have been rear-ended in car accidents. However, in sports, the whiplash occurs when the head is snapped forward and then backward either as a result of contact with an opponent or with the ground.

This type of injury can be seen in athletes in a number of sports including soccer, basketball, wrestling, and football. Because the head is used as a sport implement in soccer, these athletes are more at risk for a neck strain.

Causes of neck strain 

Neck Strain

Besides a “whiplash” mechanism, a neck muscle can be strained anytime the force of resistance is stronger than the muscle itself. For example, a baseball or softball player can sustain a neck strain when sliding head first into a bag if his/her head is stopped by the opponent while the momentum of the athlete’s body continues to move forward thus straining the side muscles of the athlete’s neck.

A neck strain can also occur in a head-to-head contact in football if the players’ sizes are unequal. The smaller athlete’s head may be forced to one side resulting in a strained muscle on the opposite side of the neck.

Last, a fall from any height greater than that of the athlete can result in a neck strain secondary to other more severe neck injuries including fracture, cervical spinal cord injury or disc injury. In any serious neck injury, critical injuries must be ruled out first.

Preventing neck strain 

Athletes engaged in contact sports should regularly work on neck strengthening muscles. Muscles that are stronger are better able to withstand greater forces without being injured.

Resistance exercises should be performed to strengthen all of the motions of the neck including flexion, extension, rotation, and lateral flexion. This can be accomplished with manual resistance provided by the athlete (or a buddy) or by a custom designed piece of equipment.

Athletes on contact sports or in sports in which a lot of stress is placed on the head/neck (wrestling) should maintain a strength training program year round to ensure that the muscles are as strong as possible when the athlete needs to compete. This type of proactive strength training program can go a long way to preventing neck muscle strains in contact sports.

Attention to proper mechanics is another key to preventing neck muscle injuries. Ensuring that athletes are taught to not lead with their heads in contact sports is one way to reducing head and neck injuries.

Treatment for neck strain 

Acute neck muscle strains should be treated with the P.R.I.C.E. principles – Protection, Rest, Icing, Compression, Elevation – to reduce pain and swelling and reduce secondary injury.  Ice packs can be applied to the injured muscle for twenty minutes every two hours for the first two to three days.

Resting the neck muscles is the most important component of treatment in the early healing process. This can be accomplished through the use of a soft collar. The soft collar is designed so that the chin can rest on the front of the collar allowing the muscles surrounding the neck to relax.

The athlete needs to understand that the healing process will take longer if the neck muscles are continuously engaged and contracted (as in holding the head up). The neck muscles will still heal in time, but resting the muscles allows for much quicker healing.

The only other way to rest the muscles of the neck is bed rest. When the head is resting on a pillow, the neck muscles can be at rest. Anytime the athlete is sitting, standing, walking or active, the neck muscles are contracted to keep the head upright.

So if the athlete needs to be active during the day (i.e., attend classes, work, etc.), the athlete should wear a soft collar. The collar should be worn as long as the athlete has pain with any movement of the head (usually a couple of days).

After a couple of days of cryotherapy, the athlete can apply hot packs (moist or dry heat) to the injured area for 10 – 15 minutes at a time. This can be repeated throughout the day as needed.

The heat is effective at reducing muscle spasm and increasing circulation to enhance the body’s own healing process. The relaxation effect of heat can also help relax tight muscles so that the athlete can begin to move his/her head through increasing ranges of motion.

For moderate to severe injuries, a physician may recommend a prescription muscle relaxant or an over-the-counter NSAID to help reduce pain and discomfort.

Once the pain and stiffness begins to decrease, the athlete can begin to work on neck stretching exercises to gain his/her range of motion back. These exercises can be done by the athlete at home. Each can be performed for 20 to 30 seconds and repeated three times.

Increasing neck flexion can be accomplished by having the athlete move his/her chin to the chest until tightness is felt and then placing his/her hands on the back of his/her head. The athlete can then apply pressure pushing the head further into flexion.

Lateral flexion left and right can be increased by having the athlete tilt his/her head sideways trying to touch his/her ear to the shoulder. To enhance the stretch, the athlete can place one hand on the top of the head and place a light pressure on the head pulling the ear closer to the shoulder. This stretch should be repeated for both the right and left side.

Rotation left and right can be increased by turning the head towards the shoulder (opposite the side that is tight) and increasing the stretch by applying additional pressure (by the hand) in the direction of the shoulder at the chin. This stretch can be done for both sides of neck rotation.

After stretching exercises have been completed, the athlete can add strengthening exercises by applying resistance with his/her hands to the head. Because these exercises are done manually, the athlete can perform 3 sets of 10 repetitions for each exercise.

To increase strength of the muscles that extend the head/neck, the athlete needs to start with his/her chin on the chest, place his/her hands on the back of the head, add resistance by pulling, and then slowly extend the head until the eyes are facing the ceiling.

To increase the strength of the muscles that flex the head/neck, the athlete needs to start with the head fully extended (eyes to the ceiling), place his/her hands on the forehead, apply resistance by pushing against the forehead, and then slowly flex the head moving the head forward until the chin is on the chest.

Muscles for head/neck rotation can be strengthened by beginning with the head fully rotated (either right or left with chin over the shoulder) and applying pressure against the chin while the athlete rotates his/her head through the full range until the chin is directly over the opposite shoulder.

Treating neck strain with

KT Tape:

Last, the muscles that laterally flex the head/neck can be increased by relaxing the head/neck and placing the ear towards the shoulder until tight (either right or left), applying resistance with one hand at the side of the head, and slowly moving the head up and over towards the opposite shoulder. This exercise can be repeated for both sides.

Recovery – Getting back to Sport

The athlete can begin functional sports specific exercises when he/she has full range of motion and full strength in all directions of the head/neck without pain. Functional exercises should mimic the skills that the athlete will need to perform when he/she returns to sport.

Whatever the athlete’s sport, each component of the sport should be included in some type of functional exercise to ensure that the athlete can complete every skill without pain prior to returning to sport.

Good functional drills can begin with regular warm-up drills for the sport. They should include both lower and upper extremity work and should begin at a low intensity (50%) and gradually increase (to the athlete’s tolerance) to full intensity over time.

Once the athlete can complete full intensity functional drills without any pain, the athlete is ready to return to sport. If pain returns when the athlete is performing sport specific drills, then the athlete should stop the activity and apply ice. When the athlete is once again pain-free, he/she may begin functional exercises again.

When Can I Return to Play? 

The athlete can return to sport when he/she has been released by his/her physician and has full range of motion, full strength, and has completed full intensity functional training without pain.

References

• Bahr, R. & Maehlum S. (2004). Clinical Guide to Sports Injuries. Human Kinetics: Champaign, IL.
• Brukner, P. & Khan, K. (2002). Clinical Sports Medicine (2nd Ed.). McGraw Hill: Australia.
• Rouzier, P. (1999). The Sports Medicine Patient Advisor. SportsMed Press: Amherst, MA.

90,000 Whiplash neck injury – treatment, symptoms, causes, diagnosis

Whiplash neck injury is a non-medical term used to describe neck pain following injury to the soft tissues of the neck (particularly ligaments, tendons and muscles). This injury occurs as a result of excessive forceful overextension followed by sharp bending or sharp bending followed by extension.
Whiplash occurs in traffic accidents, sports, falls and fights.The term whiplash neck injury was first coined in 1928, and, it continues to be used to describe this soft tissue injury of the neck injury.

The spine is a long column of bones, discs, ligaments and muscles that extends from the base of the skull to the tip of the coccyx. The cervical region supports the head, protects the nerves and spinal cord, and allows movement to the desired extent. The main supporting structure is the vertebrae. There is a disc between every two vertebrae. At the back of each vertebra there are two facet joints, one on each side.The joints are shaped to allow smooth back and forth motion and rotation, while limiting excess movement. Muscles and ligaments surround and support the spine. All of these structures are innervated, and damage to any structure can cause pain.

Cause of pain

It is usually impossible to pinpoint the exact cause of neck pain until days or weeks after a car accident. Muscles and ligaments are known to stretch and likely become inflamed after injury, but the condition usually heals spontaneously within six to ten weeks.Pain that lasts longer is usually the result of more serious problems, such as damage to the disc or facet joints.

• Facet joint pain is the most common cause of chronic neck pain after a car accident. The pain may be associated only with the facet joints or be associated with disc pain. Facet pain is usually located to the right or left of the center of the back of the neck. The area may be painful to the touch, and facet pain may be mistaken for muscle pain.Unfortunately, it is difficult to determine whether the facet joints are interested in x-rays or MRI. The only reliable way to confirm the role of facet joints in pain syndrome is to perform blockade of the medial branch.
• Injury to the disc from whiplash can also lead to chronic neck pain. The disc allows the neck to move, but at the same time keeps the neck from excessive movement. The outer part of the disc (called the annulus fibrosus) can be torn from a whiplash injury.This tear usually heals, but not in all patients. In this case, the disc becomes weaker and leads to pain during normal activities. The pain comes from nerve endings in the annulus fibrosus. Disc is the leading cause of chronic neck pain in 25% of patients, but pain can be associated with facet joint pain. Much less often, disc herniation and compression of nerve roots appear and, in such cases, pain in the hand prevails over pain in the neck.
• Sprains in the neck and upper back can cause severe pain.However, there is no conclusive evidence that neck muscles are the main cause of chronic neck pain. However, muscle damage can occur when the muscles have to withstand heavy loads in order to protect damaged discs, joints, nerves, or in cases where posture is impaired.
• Possible compression of the roots and spinal cord by disc herniation or osteophytes. This usually results in pain in the arm, but there can also be neck pain.

Whiplash symptoms

• Headaches caused by problems in the neck are called cervicogenic.These pains can be caused by damage to the upper cervical discs, facet joints, abnormalities in the atlantooccipital and atlantoaxial joints. Cervicogenic headache can also exacerbate migraines.
• Pain and heaviness in the arm can be caused by compression of the root by a herniated disc, which does not present diagnostic difficulties. More often, the pain in the arm has a “reflected” character from other parts of the neck. “Reflected pain” is pain that is felt in an area far from the injured area, but is not associated with nerve compression.Pain between the shoulder blades is usually a kind of reflected pain.
• Low back pain is common after a whiplash injury and can be caused by damage to the discs, facet joints, or sacroiliac joints.
• Disturbances in concentration and memory may be associated with pain or medication taken to relieve pain, depression, or mild concussion. Also, the patient may experience irritability and depression.
• Sleep disturbance may be associated with pain or depression. Other symptoms may include mild visual impairment, tinnitus, tingling in the face, and fatigue.

Whiplash diagnosis

The attending physician needs information about the symptoms, how the injury (accident) occurred, and a medical examination. This will allow the healthcare professional to find out if there is a need for diagnostic procedures or you can wait with this.Patients who persist symptoms for several weeks may require the following diagnosis:

• X-rays are taken immediately after injury if a fracture or spinal instability is suspected. X-rays can also show the height of the discs and the presence of osteophytes.
• X-rays are also indicated if symptoms persist several weeks after injury.
• Magnetic resonance imaging (MRI) is a necessary examination for suspected disc herniation, disc injury, root compression or spinal cord compression.
• Medial branch block is an injection of anesthetic to diagnose facet pain.
• Discography is the introduction of contrast into the disc and subsequent radiography, which is necessary only for severe pain.
• Computed tomography (CT), usually in combination with a myelogram (contrast injected into the spinal canal), can also be used to diagnose treatment-resistant neck pain.
• Electromyography and nerve conduction velocity measurements (EMG and ENG) may be used if a nerve is suspected to be blocked (eg, in carpal tunnel syndrome) or if there is nerve damage.

Treatment of whiplash injury

Treatment of whiplash injury consists of:

• Immobilization – wearing an orthopedic collar for several days, which allows in the acute period to reduce the load on the muscles and other structures of the neck.
• Drug treatment. Taking anti-inflammatory drugs both internally and externally for several weeks helps to reduce inflammation and relieve pain. In addition, with prolonged pain, it is possible to prescribe antidepressants and muscle relaxants.
• Physiotherapy (electrophoresis, cryotherapy, ultrasound) can accelerate regeneration and relieve inflammation.
• Exercise therapy is prescribed after minimizing the pain syndrome and allows you to restore the normal biomechanics of the spine.
• Manual therapy and massage can relieve muscle blockages and muscle spasms.
• Blockades can also be applied, but it must be borne in mind that they give a rather short effect in time. It is also possible to use minimally invasive procedures, such as radiofrequency neurotomy, if the pain syndrome is persistent.

Surgical treatment is prescribed only if there is a violation of the integrity of the structures of the cervical spine and persistent symptomatology resistant to treatment.

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Injury of the cervical spine: symptoms, consequences, rehabilitation

The method of treatment and subsequent rehabilitation depends on the cause, nature of the injury and the degree of damage. Consider the types of the most common neck injuries.

Ligament sprain

Ligaments are bands of connective tissue that hold bones together. Sprains can be triggered by a fall, a sharp twisting of the neck, or excessive stress on it.

Symptoms of a sprain: pain in the back of the neck, which worsens with movement; headache; spasms in the upper shoulder region; sore throat, numbness in the back of the head; tingling in the hands; general weakness. If you experience tingling symptoms in your hands, you should see a doctor as soon as possible.

“Whiplash”

Most often it happens in car accidents, during sports, unsuccessful diving into the water. A hard blow to the back of the neck leads to sudden extension and then flexion of the neck. In a head-on collision in a car accident, on the contrary, first flexion and then extension occurs. With such a blow, a person can lose consciousness.

As a result of this injury, joints or discs are damaged, which can irritate the roots of the spinal cord and cause neurological symptoms.These include: pain, weakness, numbness, tingling in the hands, or other sensations that resemble an electrical shock. Stiffness, dizziness, or sleep disturbances are also possible. Some patients need to call an ambulance immediately after a neck injury. If symptoms appear a few days after the injury, you should also see a doctor.

Displacement of the cervical vertebrae

Displacement usually occurs as a result of trauma or degenerative changes.Symptoms of the displacement of the vertebrae: headaches; drowsiness; general weakness; pain in the neck with the transition to the collarbone and shoulders; numbness in the hands.

In severe displacement, the bone is fully pushed forward and locked in this position, causing a rupture of the ligaments. Dislocation of the cervical vertebrae can damage the spinal cord and require surgery. In less serious injuries, the vertebrae can return to their place on their own, but in any case, you should consult a doctor.

Vertebral fracture

Fractures of the cervical spine account for 20-30% of all spinal fractures, of which 10-20% include spinal cord injury.A fracture requires immediate medical attention. Due to complications, most of the victims will not be able to return to their former life, some become disabled. One of the most common fractures is the fracture of the C5 and C6 vertebrae – they are the smallest and most fragile. The most common reason is a bad jump into the water.

Symptoms of a fracture of the lower cervical vertebrae: dizziness, nausea, complete or partial paralysis of the limbs, weakness, muscle tremor, shortness of breath, pain at the fracture site, speech impairment is possible.To make an accurate diagnosis, you need to do an X-ray or MRI. Treatment will depend on the nature of the fracture and the presence of complications.

Spinal ligament injury. Diagnostics and treatment of spinal ligament injuries.

Ligaments of the spine are dense formations of connective tissue that connect the bony structures of the spine and limit the range of motion in the joint. Together with bones and muscles, ligaments control the movement of the spine. The ligamentous apparatus of the spine includes: the anterior longitudinal ligament, the posterior longitudinal ligament and a group of short ligaments (yellow ligaments, supraspinous ligaments, supraspinous ligaments, ligamentum nuchal, intertransverse ligaments).

The anterior longitudinal ligament serves to limit hyperextension of the spinal column. The posterior longitudinal ligament prevents excessive flexion of the spine. The short ligaments act as additional support, reducing stress on the muscles and preventing excessive lateral movement.

A sharp bend of the trunk may damage the ligaments of the spine. Since the ligaments are very strong in structure, the rupture of the ligament often occurs in places that have undergone a degenerative process, previously damaged or with congenital disorders of the development of connective tissue.There are three degrees of damage to the ligaments: detachment or rupture of individual ligament fibers, partial rupture of the ligament, complete separation of the ligament from the attachment site.

Symptoms of spinal ligament injury

The first symptom of spinal ligament injury is pain. It can be not intense, does not change a person’s activity during the day, or significant with a pronounced decrease in activity. Depending on the location, the pain may worsen when turning the head, neck, trunk, or when moving the pelvis.

The most common extensor injuries of the cervical spine with increasing pain, limited mobility in the neck with the impossibility of tilting the head to the side opposite to the affected one. With an injury to the thoracic region, patients note tension in the muscles of the back, stiffness. The pain does not appear immediately and is aggravated by coughing or sneezing. There may be a deviation of the spine to the right or left relative to its axis with a concavity towards the injury. In case of injury to the lumbar and lumbosacral spine ligamentous apparatus, the leading symptom will be lower back pain, aggravated by movement.In addition, there is stiffness and irradiation of pain in the thigh or buttocks on the healthy or affected side. In severe injuries, each movement will cause severe pain, and when trying to lift a leg or take a step, quite serious disorders can occur.

Injury of the ligaments of the cervical spine , often resulting from a sharp extension of the neck and is called “whiplash” injury. 90,074 such injuries can be obtained by diving, in a car accident, while practicing acrobatics, in a fight and for other reasons .Injury to the ligaments of the thoracic spine can occur with significant unusual physical activity, such as lifting heavy weights . Injury to the lumbar spine can occur when trying to catch a heavy object, professional sports and much more .

Applied methods of treatment of spinal ligament injury

If you suspect a spinal ligament injury, you should immediately contact orthopedic traumatologist , who will send the patient for an x-ray to exclude a spinal fracture, an ultrasound examination of the ligamentous apparatus or magnetic resonance imaging.

The classic treatment regimen includes maintaining rest with limited physical activity, applying pressure bandages, cooling compresses in the first hours after injury, non-steroidal anti-inflammatory drugs, physiotherapy and subsequent rehabilitation. Surgical treatment is indicated only in case of complete separation of the ligament.

An integrated approach to the treatment of spinal ligament injuries in the BiATi clinic

BiATi Clinic specializes in treatment and rehabilitation of the spine and musculoskeletal system .The clinic’s specialists will help you recover your health after an injury or surgical treatment. Special author’s techniques will allow you to get rid of pain at rest and in movement, create a powerful muscle corset that creates complete freedom of movement. Unique author’s simulators-constructors, which can be easily changed to perform certain tasks, will allow you to develop even deep muscles and return all skeletal functions. Classes in imperative corrective gymnastics under the supervision of an experienced instructor will greatly increase the effectiveness of the rehabilitation program.The combination of drug treatment, physiotherapy and physiotherapy exercises with the author’s method of rehabilitation allows you to achieve a positive effect in the shortest possible time in patients of any age with the most diverse injuries of the ligamentous apparatus of the spine . The specialists of the BiATi Rehabilitation Clinic are able to return the patient to a full-fledged active life, regardless of the complexity of the pathology, his age and psychological state.

Treatment of sprains and muscles in Yekaterinburg

Ligaments and muscle tissues do not allow the joint to deform, directing its movement, but they themselves suffer from strong tension.

As a result of increased physical exertion on unheated muscles, as a result of falls or blows, the integrity of the connective tissue fibers is disrupted.

Sprain of the ligaments and muscles of the joint is an injury that causes considerable discomfort and pain, makes it difficult and restricts movement in the joints.

Symptoms of sprain

• Sharp, pulling pain. Persists after trauma for a long time
• Swelling
• If the stretch is significant, some tissue may be torn.A hematoma appears at the impact site
• Inability to move the affected joint
• Sometimes a spasm appears in the injured muscles
• If a large muscle is ruptured, a ball is felt under the skin. These are torn fibers gathered in a ball.

Commentary of an orthopedic traumatologist

Sprains of ligaments and muscles have similar symptoms, but they can be distinguished by the time of onset of pain syndrome: with a sprain, pain appears immediately or within a short time after injury, and in the case of muscles, the interval can be up to days.

Butkevich Anton Andreevich

What to do when stretching

You can give yourself the first aid in case of injury. However, full treatment of muscle sprains is a challenge for a qualified physician.

Self-help with stretching is simple: you need to protect the affected area from stress and prevent severe swelling. To do this, apply ice to the affected area of ​​the limb, avoiding direct contact with the skin, and apply a bandage that will keep the joint from displacement.The arm or leg needs to be as calm as possible.

Treatment of sprains and muscles in Yekaterinburg

Secondary therapy using complex methods will be provided by a doctor. Sprains can be treated at the Evolife Prevention and Rehabilitation Center. The therapy is carried out by non-surgical methods and begins with an appointment with an experienced traumatologist.

STRETCH PAIN – Kyokushin Karate Portal

Ligaments are dense bands of connective tissue that connect bones together. By function, ligaments are distinguished that strengthen the joints of bones and ligaments, inhibiting or directing movements in the joints. Ligament damage leads to disruption of these functions, and joint instability develops. The most common damage to the ligaments is their sprain (trauma, performing a movement that exceeds the physiological capabilities of the joint).Ligaments contain a large number of nerve endings, so a sprain is always accompanied by severe pain. When the ligaments are stretched during the first three days, edema increases in the area of ​​the corresponding joint, there is a local increase in temperature, there may be hyperemia and hemorrhages in soft tissues.

Sprain of the ligaments is an injury resulting from the impact on the ligamentous apparatus of the joint of a load exceeding the elasticity of the tissues.

Sprains and tears of ligaments, muscles and tendons are common sources of pain in injuries of the musculoskeletal system.A sprain – the strong connective tissue band that binds one bone to another – occurs when a joint straightens or flexes too much outside of normal physiological motion.

Sometimes a sprain is combined with an abrasion or wound, which aggravates the severity of the injury, making it open to germs.

The name “stretching” is not entirely accurate. It explains the mechanism of damage, and not the nature of the changes obtained – with partial damage to the ligaments, their linear lengthening is not observed, but a partial violation of the integrity of individual fibers occurs.If the injury occurred with a complete break of the ligament, or if the ligament breaks off at the site of attachment to the bone, this is no longer a sprain of the ligaments, but a rupture.

As a rule, if the ligament is damaged, the blood vessels supplying it also break. As a result, hemorrhage is formed in the surrounding tissue. Stretching of the muscles or tendons that connect the muscle to the bone is usually observed when they are overloaded or when they are suddenly moved.

Symptoms of sprain

Symptoms of sprains and muscles are similar – as a rule, it is severe pain, especially when moving (some sprains hurt more than fractures), swelling at the site of injury, difficulty in movement, soreness when touching the damaged area, bluish spots under the skin or its redness …

Some signs can distinguish sprains or tears of ligaments and muscles. So, if the joint is in the wrong position and immediately gets sick, it is most likely a sprain (possibly even a fracture).

If the muscles hurt the day after exercise, this is most likely a muscle strain.

A characteristic sign of a rupture or stretching is a violation of movement in the joint, in the area of ​​which the ligament is damaged, or movement of the muscle if it itself or its tendon is damaged.

Pain and other symptoms of ligament injury usually appear immediately after injury, but they may not be very pronounced at first. Only after a few hours soreness sharply increases, edema appears in the area of ​​injury, and the function of the joint is significantly impaired.

Tendon ruptures are usually somewhat more severe. The victim often hears the cracking of a tearing tendon himself, then feels pain and dysfunction of the injured muscle.

Due to the contraction of the injured muscle at the site of the rupture, you can feel pain and a fossa – retraction.

In case of muscle rupture, in contrast to tendon rupture, hemorrhage is more pronounced; muscle retraction is located farther from the place of its attachment, it is more noticeable with muscle tension.

First aid

Rest for the injured limb. You cannot strain it strongly, as the pain intensifies and the torn ends diverge. The limbs are elevated, cold (a bag of ice or cold water) is applied to the damaged area, the damaged joint is immobilized with an improvised splint to prevent an increase in swelling of the periarticular tissues, and the victim is sent to the hospital.

Ice should be applied as soon as possible before swelling begins. During transport, it is desirable to create an elevated position and maximum rest for the injured area.

During further treatment, the joint is immobilized with a tight bandage – this limits swelling and bleeding. For tight bandaging, it is recommended to use an elastic bandage. The bandage should be worn for several days – this will reduce pain and swelling, and the victim will be more comfortable to move.

Bandage the injured limb in a spiral, overlapping loops, starting slightly below the injury site.In the place of injury, bandage is less tight than on healthy parts of the limb. A bag with ice or cold water is applied to the damaged area – for 15-20 minutes per hour (no more) – during the first 12-24 hours from the moment of injury. Do not put ice directly on your body – this can lead to frostbite.

By narrowing the blood vessels in the damaged area, cold reduces swelling, and this, in turn, dulls pain and relieves painful spasms. It is recommended to keep the injured limb above the level of the heart in the first 24-48 hours after the injury – this will reduce the blood flow to it.For severe pain, prescribe aspirin or ibuprofen, analgesics.

Remember: for about three days or until the pain and swelling have subsided, stress on the injured limb is undesirable.

In case of extensive ruptures, splints are applied, and sometimes even plaster casts. If the ligaments are torn completely, surgery may be required to restore their integrity.

Author of the text: B. H. Jepelei.

90,000 Why are sprains dangerous? And how to treat it correctly | Healthcare | Society

What medicine can offer today for the diagnosis of ligament damage, their treatment and restoration?

Our expert – Doctor of Medical Sciences, Professor of the Department of Restorative and Rehabilitation Medicine of the Moscow State Medical University Vitaly Epifanov .

Ligament sprains usually occur with injuries: falling, slipping, often during active sports, especially power types (different types of wrestling), as well as when playing tennis, football, basketball. When the ligaments are damaged, a person feels pain and limited mobility in the joint, sometimes it simply “does not work”. Inside it, the release of fluid begins, which is accompanied by edema, swelling in the area of ​​injury, pain when pressed or touched.

Only a doctor can finally confirm the signs of damage to the ligaments – with the help of special tests.An X-ray examination is also required, which is especially important in order to start the correct treatment.

Acute period

Lasts 8-14 days. At this time, the main method of treatment is immobilization (ensuring the immobility of the joint). A rigid bandage or orthopedic splint is applied to it – a small special prosthesis. At the same time, anesthesia of the injured area is carried out.

Depending on the stage of the disease, ice is applied or, conversely, thermal procedures are followed.The next task is to remove edema. For this, phonophoresis is used with anti-inflammatory and decongestant drugs. When inflammation and swelling are removed, it is useful to apply heat with the help of paraffin, ozokerite. At the same time, rhodon or pearl baths can be used. It improves the nutrition of muscles and joints, metabolism.

Before removing the bandage, begin massage and exercise therapy, and as soon as possible. The fact is that an injury to the ligamentous apparatus leads to the formation of pathological sources of pain in the adjacent muscles.And they cause a reflex response of the muscles, which turns into a spasm. This spasm is the body’s defense response to injury. Increasing the tone of the sympathetic nerves that cause muscles to contract is a general response of the body to pain stress. With massage and therapeutic movements, this problem can be successfully avoided.

In addition, it is also very important to maintain good microcirculation in and around damaged tissues. For this, special drugs are used that improve blood circulation, electrophoresis.

Then the second stage begins, when the preliminary preparation of muscles and ligaments for physical activity begins.

Recovery period

Here, muscle relaxation comes to the fore – relaxation of muscles, which allows you to break the wrong stereotype of movements that arose after an injury. It can be carried out with the help of electrical, thermal effects, massage. After muscle relaxation, myocorrection follows – the creation of a compensated stereotype of movements and myotonization – the consolidation of the correct attitudes.

A special simulator has been developed to solve the last two problems. This is a loop complex consisting of a system of lattices and suspensions, which allows you to remove the force of gravity and friction, so that the patient can easily repeat the necessary movements dozens and hundreds of times, increasing the strength of the muscles. In fact, the patient is engaged in a complex in zero gravity, like an astronaut.

Lessons in the pool are also very useful – they allow you to temporarily relieve the load of the force of gravity from the sore spine and accelerate the process of strengthening the muscle corset.The healing effect is enhanced in a pool filled with brine water. This is a special medicinal substance, which is the waste products of bacteria that live on the surface of the mud deposits of some lakes. In the dried form, brine is added to the pool water and has an anti-inflammatory, analgesic effect, improves metabolism in tissues, lymph and blood circulation. All this allows you to achieve better results and reduce the time of discharge from the hospital.

Classes with a psychotherapist are important almost all the time before discharge, especially in the first period after the injury.Patients are taught to create a dominant – the attitude to perform the correct movement in the affected joint. The main thing is to subordinate the dominant to your will, to control it in order to suppress pathological impulses in the affected spine. Muscle relaxation training is very important here, on the basis of which all the techniques of autogenous influence are implemented.

After discharge from the hospital

If a micro-rupture occurs, it takes several weeks to recover. If the ligament is ruptured – at least a month.But degenerative-dystrophic lesions, which may be associated with incorrect previous treatment, will require several years for rehabilitation. The younger the victim, the greater his ability to regenerate damaged ligaments.

Much also depends on how carefully a person subsequently treats his ligamentous apparatus, without straining it beyond measure. It is very important not only to spare the affected ligaments, but also to maintain good muscle tone while continuing to do gymnastics.

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