What is Neck strain?
A strain is an inflammation of the muscles and ligaments.
Whiplash is the common term for a cervical strain
A sore neck is usually due to a quick movement forward and backward during an accident.
Quickcare or ER?
Red Flags that will send you to the ER:
- Associated loss of consciousness from the injury
- Under the influence of drugs/alcohol
- Numbness or paralysis
- Severe pain
Once in the ER, a CT or MRI may be done.
What will your doctor ask?
Your doctor will want to know your whiplash symptoms. A symptom is your description of your condition. It is your story.
A doctor will want to know a story…
- Did you fall?
- Were you in a motor vehicle accident?
- Were you hit during a sports event?
Then a doctor will want to know more details of the pain…
- Where is it?
- What makes it better?
- What makes it worse?
Your doctor will want to know of associated symptoms….
- Do you have numbness or weakness with the pain? This indicates a pinched nerve in neck symptoms.
- Were you intoxicated or under the influence of drugs ?
What will your doctor look for?
Your doctor will look for signs. A sign is an objective finding that a doctor sees during the exam of your pain in the neck.
Your doctor will want to know if you are coherent enough to answer questions. If the patient is not coherent to answer the doctors questions, then the neck is presumed broken. Without a clear coherent answer, your doctor will keep your neck in a hard collar.
Your doctor will want touch the back of the neck and feel for pain. This is very important.
This is difficult when drunk persons come to the ER after a fall. Doing a thorough neck exam is very challenging thus leading to a CT scan which is great to look at the bones. MRI is best to look at the soft tissue such as a pinched nerve, and discs.
If the patient is alert, and coherent, a doctor will still want to touch along the back of the neck. If after a minor injury and there is no pain, and no neurological deficits, then the collar may be removed.
What is your doctor thinking?
Your doctor will create a list in his head of the reasons for neck pain. This list is called a differential diagnosis.
The pain could be from a pinched nerve in the neck. More importantly, your doctor will not want to miss a broken neck.
Your doctor will want to protect the spinal chord which runs within the neck bones (vertebrae)
An xray is very good first start to rule out a fracture. The advantage is that is effective and readily available.
Sometimes a neck can be severely injured without a broken bone. Scary! This is seen more so in children.
What is the treatment of Cervical strain?
Like any muscle, non steroidal medications such as Motrin, Alleve or Naproxen are helpful. Be careful if you have kidney disease. I like to add on muscle relaxer such as Flexeril or Soma which aid in neck pain relief.
The old soft collars are not helpful. It looks dramatic, but the reality is that they don’t help with recovery
After the neck has been cleared by physical exam, xray and/or CT, then physical therapy may begin.
Pinched nerve in neck treatment may need steroid injections or surgery.
How long will you have cervical strain?
Simple strain can last for weeks. Usually with medications such as Motrin and muscle relaxers (Soma or Flexeril), neck pain can greatly improve in 1-2 weeks.
Another step toward recovery is physical therapy. There, massages and therapeutic exercises can be very beneficial. Many patients succeed with acupuncture. Still others swear by chiropractic manipulation.
Key point: Clear the bones and spinal chord from injury
Then the soft tissue pain can be treated in a variety of ways such as massage, physical therapy, acupuncture or chiropractic treatments.
Let me tell You a Story
Every year in June, the rodeo comes to town. Our small community doubles in size as persons from all around the state come to see the cowboys compete. Just as the event was about to start, a couple named Darren and Sue arrived in my ER. They had been riding in the parade when their horse got spooked by a barking pit bull dog. They crashed down. Paramedics were called and the entire parade stopped.
As a precaution, hard neck collars were placed on them. Furthermore, they were placed on hard back boards.
Once in the ER, the scene was kinda funny. A cowboy and cowgirl strapped down. Their boots were pointing up. Little matching vests and Wrangler jeans.
I started with Sue. The questions are ones that I have done a million times:
” Does your neck hurt?”
“Have you been drinking?”
“Are you under the influence of drugs?”
“Did you get knocked out?”
She answered “no” to each question and recounted the story of her fall.
I touched the back of her neck and felt safe taking her out of the collar and backboard. She stood up. Aaaahh Freedom to walk around.
Her boyfriend Darren was up next. Same questions. Same answers.
When I touched his neck, however, he grimaced. Not good.
“Did that hurt?” I asked.
“Well, uh, yeah just a little.” said Darren
So he stayed in the collar and back board. Need to protect that neck.
Just at that time, the registration lady came to get his insurance card. Sue went into Darren’s back pocket to get his wallet. When she looked inside, she saw two condoms.
“What is this?!” she yelled. “We don’t use condoms!”
Darren could only lie there, immobilized from head-to-toe and take her barrage of threats. Sue got into his face and let him have it. Finally, Darren was able to squeak out, “Uh. I was only holding them for a friend.”
I finally cleared his neck and he cleared out of the ER.
I hope this helps