Neck Sprain Causes, Symptoms, Diagnosis, and Treatment

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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 (from a therapist or a neck massager)
  • 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.

3 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Yadla S, Ratliff JK, Harrop JS. Whiplash: Diagnosis, treatment, and associated injuries. Curr Rev Musculoskelet Med. 2008;1(1):65-8. doi:10.1007/s12178-007-9008-x

  3. Vos C, Verhagen A, Passchier J, Koes B. Management of acute neck pain in general practice: A prospective study. Br J Gen Pract. 2007;57(534):23-8.

Additional Reading

By Elizabeth Quinn, MS
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.