05 Mar 2020

Neck Sprain

Neck sprains are stretched ligaments or muscles in the neck. Sprains can occur without having any obvious injuries, but at times, they might be caused by a sudden impact with an object. Impacts can force the neck to extend beyond its normal range rather quickly. It then snaps back into position quite forcefully. This is quite common of a whiplash injury. A rear-end automobile accident, head jerking when riding on a ride at the amusement park or being kicked are the most common types of impact related to a neck sprain. You might have pain that grows worse with movements. At times, the pain might not appear until at least a day or two after the event that caused the injury. You will more than likely have stiffness in the neck that prohibits your ability to move the neck properly. The back of the head can end up hurting. Pain can also occur in the upper back and shoulders. Other common symptoms include dizziness, fatigue, ringing in the ears and patchy numbness in the arms or hands. Often the terms neck sprain and neck strain are interchangeable. But generally most medical professionals classify a neck sprain as a ligament injury in the neck, and a neck strain as a muscle injury in the neck.

Neck Sprain Anatomy Inside of the spinal column, there is a tube for the spinal cord. This thick bundle of nerves starts at the base of the brain. It relays information between the brain and the body. Nestled between the vertebrae are the discs. Each individual disc is attached to the bottom of the vertebra that lies above it and the top of the one below it. Muscles and strong ligaments keep the column together. All of the structures work together to surround, protect and support the spinal cord. There are many important muscles of the neck. The trapezius and levator scapulae both attach the neck to the shoulder blade. They are commonly painful in people with poor posture and easily get fatigued in computer users. The scalenes are muscles at the front of the neck and commonly get tight or painful in people with poor posture, or people with poor breathing mechanics. While they don’t tend to cause pain at the front of the neck, they contribute to pain at the back of the neck and can also aid the chronicity of the neck problem. At the top of the neck are the suboccipital muscles (sub = under, occipital = base of the skull).

How to Treat a Neck Sprain:

1. Ice Apply ice to the affected area for 5-10 minutes at a time three to five times per day. Make sure to wrap the ice in a thin towel to prevent an ice burn from occurring. Ice can help to reduce the inflammation and pain associated with the sprain. Ice is best used in the acute stage for the first 48 hours, but can be used at later stages if the inflammation has become chronic. You can also use contrast bathing, i.e. using a mix of ice and then heat. This can be done by wrapping a hot water bottle in a tea towel and straight after using the ice, place the heat over your neck. Heat can feel quite comforting and help with movement to the neck. Hot showers can also help and just standing with the water running over your neck for 5-10 minutes each morning can give some relief.

2. Anti-Inflammatory Medication Using an anti-inflammatory medication can help to lessen the inflammation and pain to the affected area. As the inflammation diminishes, the amount of pain associated with it will decrease as well. Try to limit anti-inflammatory use to only two weeks.

  1. Stretching Exercises Performing gentle movement exercises for the neck is encouraged. Movement exercises are often prescribed by a physical therapist. As you exercise the neck, it will help the neck to maintain flexibility and strength.

4. Therapy Chiropractic, osteopathy, physiotherapy, and sports massage therapy can all benefit neck sprains. Practitioners will establish what the diagnosis is before commencing a treatment program. Treatment will often consist of soft tissue massages to the muscles, and mobilization or manipulation techniques to the neck and upper back to improve mobility to your spine.

5. Soft Collar When the neck is very painful, sometimes a soft collar might be recommended. This will help limit movement and can provide support to the neck. Some patients find they help, and some do not. You can usually buy a soft collar from a pharmacist.

Tips: • Avoid slouching or slumping over in a head-forward posture. Sitting straight in a chair with the lower back supported, shoulders relaxed and feet firm on the floor is important. • Adjust computer monitors so that the top part of the screen is equal to your eye level. • If you are on the phone a lot, use a speaker phone or headset. Avoid cradling the phone on your shoulder. • Avoid long laptop or tablet use. Use a laptop stand to raise the screen. • Make sure to use proper lifting techniques. Lift with the knees and not the back. • Adjust your car seat into an upright position that will support the head and lower back. Don’t reach for the steering wheel when driving.

Whiplash and Whiplash Associated Disorder (WAD)

Whiplash is a common injury that occurs within the neck from a sudden acceleration and deceleration force causing unrestrained, rapid movements backward and forward to the head and the neck, which is often from a car accident. Whiplash injuries are those that damage the soft tissues and the bone structures, while a whiplash associated disorder describes a more chronic and severe condition. Thankfully, whiplash isn’t a life-threatening injury, but it can wind up leading to a prolonged period of disability. Even though the majority of individuals who are in a minor car accident will recover quickly without worrying about any chronic symptoms, there are some who will continue experiencing symptoms for years after the accident occurred. Whiplash is commonly caused by a car accident where the individual is in a car that isn’t moving and they are struck by another car from behind. The rear impact causes the neck and head to be forced into a hyperextended position as the seat pushes the individual forward and the head and neck end up falling backward. After a small amount of time, the neck and head will recover and be thrown into a forward position.

Whiplash is commonly known as whiplash associated disorder because often it is not just the neck affected, but other areas. Most commonly the shoulder and back are affected with a whiplash. A common shoulder problem is known as shoulder impingement syndrome and it is unclear why this can occur following road traffic incidents, but doctors are aware that it can cause difficulty sleeping on the affected side, difficulty lifting your arm above your head, and reaching behind your back.

Whiplash and Whiplash Associated Disorder (WAD) Anatomy

Inside of the spinal column, there is a tube for the spinal cord. This thick bundle of nerves starts at the base of the brain. It relays information between the brain and the body. Nestled between the vertebrae are the discs. Each individual disc is attached to the bottom of the vertebra that lies above it and the top of the one below it. Muscles and strong ligaments keep the column together. All of the structures work together to surround, protect and support the spinal cord.

How to Treat Whiplash and Whiplash Associated Disorders:

1. Range of Movement Exercises Patients who are involved in movement exercises early on have been shown to have a more reliable and quick improvement in their symptoms. Most of the time, this type of treatment involves rotational exercises done at a rate of 10 every hour. Don’t rush into the exercises, you want to wait until your symptoms allow you to do them. Often times, this is within the first four days after your accident occurred.

2. Physical Therapy Physical therapy is often beneficial in strengthening the muscles and helping to reduce any painful movements. Occupational therapy is great at helping you return to your normal work environment.

3. Ice and Heat Using ice and heat will help reduce inflammation. Your therapist will guide you on how long, and which to use, but in many cases 5-10 minutes of ice followed by 10-20 minutes of heat can help to reduce inflammation and reduce the pain. Make sure you wrap the modalities in a towel to prevent any burning, always be careful when using ice and heat as you may not realize you are causing a skin burn.

4. Rest and Recover Some people choose to do nothing. In mild whiplashes, getting about your normal day-to-day activities and getting on with it is a perfectly acceptable form of recovery. If you chose this approach but things do not improve, make sure you take medical advice.

5. Electrotherapy and Acupuncture

Ultrasound, interferential, TENS and acupuncture can all help reduce muscle spasm and pain.

6. Reduce Stress If your neck pain has become chronic, you need to look at other factors in your life that are affecting or contributing to your pain. Stress often goes to the neck. If you are having issues that are underlying this can prevent a full recovery and you need to address these issues. Often psychological therapy or cognitive behavioural therapy (CBT) can give significant improvements in symptoms. Do not ignore underlying stresses, distress, emotional problems, anger, depression or psychological traumas that might have happened in the past or the present.

7. Spinal Manipulation

If symptoms have extended beyond four weeks, you could consider spinal manipulation. An osteopath or chiropractor would typically perform an adjustment to the neck to improve spinal mobility. This form of treatment is stronger and can cause some tenderness for 2-3 days following the manipulation, but the results can give significant improvements.

Tips: • Don’t immobilize the injured site. This causes the muscles to stiffen and slow the healing process down. If you do need to wear a neck collar, use it only for short term (24-48 hours) and remove it when symptoms start to improve. Remember you need to regain mobility to the neck. • Get back to normal daily routine including your job as soon as you can. This has been shown to be beneficial in speeding up recovery.