Neck Strain: Symptoms, Causes, and Treatment

What is Neck Strain?

The neck’s muscles and ligaments act as a strong band that provides support and stability to the bones of the neck. More than twenty muscles in the neck are essential in holding the head in an upright position and producing movement in the head, neck, jaw, shoulders, and upper back.

Neck strain occurs when the muscles are stretched out or torn due to trauma, excessive motions, or poor posture over a long period.

Signs and Symptoms of Neck Strain

Neck strain can occur to almost anyone. Its symptoms vary from mild discomfort to serious complications such as sleep deprivation and extreme pain during movement, which may gravely impede one’s daily function and activities.

Some of the common symptoms of neck strain are as follows:

Dull, Nagging Pain on the Neck Area

Pain is usually felt at the back of the neck and the head’s base, but it can also be felt on the upper back or shoulders. In severe cases, pain may disrupt one’s sleep at night or make it difficult for one to concentrate and focus during the daytime.

Pain that Intensifies with Movement

Some individuals may not experience pain at rest; however, they may experience sharp or knife-like pain during specific neck movements. This is usually experienced by individuals who experienced sports-related accidents or motor vehicular accidents.

Muscle Spasms

Severe cases of neck strain are accompanied by inflammation which could cause painful muscle spasms.

Stiffness or Decreased Neck Motion

Neck movements may become difficult and limited, caused by the swelling or the tightening of the muscles to guard the area against further stress and injury.

Serious Symptoms to Watch Out For

Neck strain resulting from trauma such as a fall or an automobile accident may present with serious symptoms that need further evaluation by a trained physician. One must seek immediate medical attention if the following symptoms are present:

  • Headache, dizziness, incoordination, nausea, or fever
  • Numbness felt on the arm that may radiate up to the hand
  • Tingling sensation on the arm up to the hand
  • Severe pain that persists for long without relief

Common Causes of Neck Strain

Although the exact reason for the occurrence of neck strain is unknown, the following are some of the common causes:

Poor or Awkward Posture

  • The neck is slanted forward and is in front of the shoulders, also known as “forward head posture.”
  • The neck placed in extreme positions (such as when the head tilted to one side when using a mobile phone) that are maintained for a long time because of poor habits
  • Sleeping with large pillows under the neck results in a poor sleep position that may lead to an increase in muscle tension

Repetitive Neck Movements

Low-load neck movements that are done repetitively can also create small tears in the neck muscle, causing neck strain.

Rapid Movements such as in a Fall or Motor Vehicular Accidents

The sudden impact of car collisions or sports activities could cause quick back-and-forth movement of the head, causing overstretching or tear on the neck muscles.

Risk Factors for Neck Strain

The presence of one or more of the factors below may predispose an individual to have neck strain:

  • The elderly are commonly affected by neck strain due to the wear and tear of muscles and ligaments.
  • Poor workstation design, such as incorrect placement of computer monitor or keyboard, or wrong table and chair height could result in poor work posture.
  • Work that requires staying in one position for prolonged periods entails repetitive movements or needs precision movements.
  • As shown in several scientific studies, a previous neck injury is the main predisposing factor for neck strain.

Diagnosis

Comprehensive Medical History and Physical Examination

A trained physician will ask about how the injury occurred, the individual’s nature of work, activities that trigger the pain, hobbies, lifestyle, and sleep condition. A complete physical examination may include checking for local pain and tenderness, measuring the head, neck, shoulder range of movement, and assessing neck and shoulder muscles’ strength.

Severe neck strain or those that do not heal in a few days may require the following diagnostic imaging to assess the presence of an underlying cause:

X-ray Imaging

X-ray or radiograph gives an image of the bone. It will not confirm the presence of neck strain because of injuries to soft tissues such as muscles and ligaments. However, it may be needed to check for degeneration, fractures, dislocation, or arthritis that might be causing the neck strain.

MRI and CT Scan

An MRI (Magnetic Resonance Imaging) or a CT scan (Computed Tomography) together with an X-ray may be required to evaluate not only the bones but also the soft tissues, including the muscles, ligaments, and the spinal cord.

Electrodiagnostic and Nerve Conduction Testing

Severe cases of neck strain may require electrodiagnostic testing and a nerve conduction study to assess if specific nerves are affected because of impingement or compression.

Treatment for Acute and Chronic Neck Strain

Neck strain can resolve on its own, but obtaining the correct treatment could alleviate the pain faster during healing, allowing one to return to one’s daily activities sooner.

Treatment for Mild Neck Strain that can be Done at Home

Over-the-Counter Pain Medications

You can buy medicines for inflammation and pain relievers without prescription, such as Ibuprofen can help manage one’s pain.

Application of Cold and Warm Compress

  • Initial application of ice during the first 2 days to reduce inflammation followed by using a warm compress after 2 days to facilitate blood flow to the neck area bringing essential nutrients for the healing of injured tissues.
  • The warm compress should not be too hot to avoid burns and should only be done for 10 to 20 minutes.

Activity or Work Modification

  • Give rest to the neck. Continuing to work while there is pain may only result in further damage to the soft tissues
  • Incorporating frequent rest during work hours and simplifying work processes to limit excessive neck motions could help reduce undue stress and tension on the neck.

Workspace and Design Modification

Arranging one’s workstation, reducing clutter, fixing the height of one’s work table and chair, and correcting the position of one’s computer monitor, keyboard, etc., to facilitate correct body posture will help prevent and reduce the occurrence of neck strain.

Treatment for Neck Strain that Lingers

If neck strain is not resolved within a few days or when pain continues or worsens, there may be a more serious underlying cause; thus, another treatment is necessary to manage it.

Physical Therapy

A physical therapy program is formulated by a trained physical therapist or physiatrist based on a comprehensive physical examination.

  • It includes pain management, stretching and strengthening exercises, and advice on activity or workplace modification.
  • The program also teaches the individual some exercises to prevent neck strain or reduce the underlying cause’s progression.

Prescription Medication

Prescription medications are rarely given but may be recommended by a doctor to help manage extreme pain and inflammation. Such medications may include muscle relaxants to help manage muscle spasm. These are usually given on a short-term basis only.

Tips to Prevent Neck Tension

Ergonomically modifying the workplace, taking breaks & moving after a prolonged static posture, Regular exercise to strengthen muscles, Practice yoga & meditation to reduce stress, Maintaining a good posture while sitting & standing, and a good sleeping position with a small pillow under the neck are few ways to prevent neck tension.

Aarti Nehra, MD

Dr Aarti is an MBBS (Bachelor of Medicine and Surgery) from Baroda Medical College (The Maharaja Sayajirao University, Baroda). Dr. Aarti has also completed her Masters of Medical Science and Technology from the prestigious Indian Institute of Technology, Kharagpur.

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