Doctor's Notes on Neck Strain
Neck strain refers to any injury to the muscles or tendons that support the head and neck. These injuries are often caused indirect trauma in which the head is flung backward (hyperextension) or forward (hyperflexion), commonly called whiplash. Most instances of neck strain injury do not involve fractures of bones or damage to the underlying structures of the neck like the trachea, spinal cord, or blood vessels.Symptoms of neck strain include pain that may be mild to severe and decreased range of motion of the neck. In a classic whiplash injury, the patient usually feels fine on the day of the injury but awakens the next morning with pain and decreased range of motion. Associated symptoms can include stiffness of the neck, pain that radiates to the low back, and the inability to perform daily work tasks or activities.
Neck Strain Symptoms
The cardinal symptom of neck strain is pain and often combined with decreased range of motion. Although one typically has pain after an injury, it is not uncommon for someone to be free of discomfort initially, because inflammatory changes may happen slowly. The presence of immediate pain at the time of injury should serve as a red flag that the injuries may be more severe than first thought. The classic events after a whiplash injury are that the patient feels fine the day of the injury but wakes up the next morning with pain and decreased range of motion.
Other symptoms include the inability to perform daily work or activities that one could do before. Be wary of symptoms suggesting nerve irritation or a pinched nerve, such as weakness, numbness, tingling, incoordination, and dizziness. Neck strain does not typically cause lymph node swelling.
Neck stiffness usually occurs and may radiate into the lower back when severe. Difficulty chewing, swallowing, and breathing occur rarely. Anyone with these symptoms should contact a doctor.
Neck Strain Causes
Neck strains result from injury to the neck. Such injuries are caused most often by indirect trauma when the head is flung backward (hyperextension) or forward (hyperflexion), commonly known as whiplash. Injuries caused by rotation and compression (when the force of impact lands on the top of the head) can also result in neck strains and soft-tissue injury.
- Automobile accidents are responsible for many whiplash injuries because of hyperextension or hyperflexion. A common scenario is when a seat-belted person's head continues to move forward during a frontal impact and is then often thrown backward (the converse is also true). Side impacts typically result in bending of the head to that side, and rear impact tends to throw the head backward. Any or all of these movements usually result in whiplash.
- People with occupations requiring repetitive or prolonged neck extension (microtrauma) may develop neck strain injury. Picture someone sitting at a computer keyboard, for example, straining to see a monitor that is not adjusted properly for the person's posture. Also, the person may be trying to see the monitor through poorly adjusted bifocal lenses and must tip the chin upward to view the screen. Now tuck a telephone into the person's shoulder for much of the day and that's the formula for neck strain. With the increase use of computers at home, even the time away from one's work can add to this injury.
- Some people appear prone to neck strain injuries merely as the result of an abnormal posture while awake or from sleeping in an awkward position.
You use your neck more than you think. Every time you drive, look over your shoulder, or talk to a group of people, your neck goes to work, bending your head anywhere you need to face. While you normally don’t notice your neck in action, when it is in pain, your neck becomes a very noticeable body part.
The question of why you experience neck pain can have a variety of answers. It could be the way you sit at work, how you sleep, or the natural degeneration of aging. We’ve gathered some of the most common causes of neck pain in the following article, along with treatments that can offer pain relief when you need it most.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.