What is Cervical Strain?
Cervical Strain is nothing but neck strain where the patient experiences injury to the tendons or muscles of the cervical spine or the neck. These injuries can occur as a result of wear and tear from daily activities or sudden injury or trauma to the cervical spine or an injury incurred while playing sports. The cervical tendons and muscles are affected in a cervical strain where these bands of fibrous tissue which connect the muscles to bones are overstretched or get torn.
Our neck and the cervical spine possess a wide range of motion in all directions and are supported by a complex structure consisting of ligaments, muscles and tendons. Sternocleidomastoid and trapezius muscles are the large muscles of neck and assist with the gross motor movements of the neck. The trapezius muscle is a triangle-shaped muscle, which joins the back of the neck and the shoulders.
The symptoms of a cervical strain are tenderness, pain and difficulty in moving the neck. The pain in the neck can also radiate into the shoulders, upper back and over the shoulder blades. This indicates involvement of the trapezius muscle.
Cervical strain is not actually a serious condition; however, the dysfunction and the pain which the patient feels can be quite significant. There are can be inflammation in the surrounding injured tissue along with spasms in the neck muscles which can be quite painful.
Many times, a mild cervical strain will resolve on its own in a few days; however, patient can have periodic flare-ups of aching pain which can persist for many weeks to months after the patient has sustained the initial injury.
Causes of Cervical Strain
- The cause of a Cervical Strain could be as simple as daily activities of living such as working at a computer or driving with bad posture or cradling a phone in the crook of the neck in a hunched up position. Any activity which causes stiffening or tightening of the neck muscles for prolonged periods of time can cause cervical strain.
- Having a poor posture for a long time can also lead to cervical strain.
- Sudden injury to the neck where there is abrupt jolting of the body forward and the head being thrown backwards and forwards in a rapid manner can also result in a cervical strain.
- Carrying heavy objects such as a suitcase on one side of the body can also cause cervical strain.
- Sleeping in a position where the pillow is too firm high or too firm can also put strain on the neck and cause cervical strain.
Symptoms of Cervical Strain
Common Symptoms of Cervical Strain: Pain and tenderness is the main symptom of Cervical Strain. However, the locations and the intensity of the pain vary and depend on the cause of the Cervical Strain. Pain can also radiate to the shoulders, upper back and shoulder blades. Pain can worsen with movement. Other symptoms of cervical strain which the patient can experience include tiredness, difficulty in concentrating, irritability and neck stiffness. Patient can also have headaches with cervical strain.
Serious Symptoms of Cervical Strain which need prompt medical attention includes weakness, tingling, burning sensation or numbness in the neck and radiating to the shoulder and arm. These symptoms of cervical strain indicate a problem with the spinal nerves or the spinal cord and warrants immediate medical attention.
Diagnosis of Cervical Strain
Medical history and physical exam of the patient is conducted. Other than this, imaging tests such as x-rays, CT scan, myelography, discography, MRI scan, radionuclide scan are done to rule out more serious causes of cervical strain.
Treatment of Cervical Strain
Rest: If the Cervical Strain is mild, then it tends to heal quickly on its own in a few days. Patient should rest till the cervical strain symptoms subside and can use home remedies for alleviating the neck pain and stiffness.
Ice Application: Ice application can be done in the initial stages of the injury causing cervical strain after which heat applications can be started. Application of ice or cold packs helps in reducing the inflammation and boosts the healing process of cervical stain. Ice application should be done for twenty-minutes every couple of hours.
Heat Application: This should be started after the initial stage of the injury has passed. Heat application helps in stimulating blood flow to the injured cervical region and in turn boosts the healing process of cervical strain. Some patients like to use moist heat which can be taken from a hot shower or a hot bath. Some patients find relief with the application of continuous low level heat with a heat wrap.
Medications: Over-the-counter medications, such as paracetamol or NSAIDs can help in relieving the neck pain. Muscle relaxants can also be taken to relieve muscle spasms in the neck accompanying the cervical strain.
Massage Therapy: Gentle massage can also help with mild cases of cervical strain. A gentle massage helps in stimulating the blood circulation to the cervical region and helps it to heal faster. However, massage should not be done if the patient has severe pain and stiffness with difficulty in neck movement, as this indicates an acute injury.
Cervical Collar & Pillow: Patient can also use a soft cervical collar during the day and a cervical pillow when sleeping to relieve pain and increase comfort.
Chiropractic or Osteopathic Manipulations: If conservative treatment is not effective for relieving cervical strain then there are various treatments which can be done including chiropractic or osteopathic manipulations. These treatments involve manipulations of the spine and helps in treating less severe injuries.
Physical Therapy can also be done for treating a cervical strain after the acute phase has passed. Physical therapy helps in strengthening the neck muscles, increasing the range of motion of neck and helps in relaxing the muscle spasms in the neck. Physical therapy also consists of electrophoresis, ultrasound, and using TENS units (transcutaneous electrical nerve stimulation).
If the cause of cervical strain is inflammation in the neck muscle, the strain will get resolved in a few days; however, there can be recurrence of neck pain.
In some patients, the pain felt with cervical strain can be due to some complex underlying medical problem such as disc degeneration or facet joint syndrome or other such inflammatory processes within the spine. A herniated disc, degenerated disc or a bulging disc can also cause cervical strain. In such cases, patient needs to consult the appropriate physician and follow the treatment plan chalked out for him/her.
The facet joints are the small joints present in the posterior part of the spine and they facilitate the neck movements. The facet joints can also suffer from wear and tear and arthritis, causing neck pain radiating to the neck and shoulder muscles. In such cases, corticosteroid injections can be given to reduce the facet joint inflammation and the inflammation in the spinal canal. This can relieve the symptoms of cervical strain.
If the neck pain is getting worse and is hindering with daily activities of living then it is important to seek medical attention. Other symptoms for which immediate medical attention is needed includes weakness, tingling, numbness or burning sensation, which starts from the neck and radiates through the shoulder and arms. This indicates a serious condition which involves damage to the spinal nerves or spinal cord and needs immediate medical attention.
Prognosis & Recovery from Cervical Strain
The prognosis is excellent if the cervical strain is diagnosed and treated at the right time and the patient can have complete recovery from cervical strain. With the right management of cervical strain, almost all the patients can recover completely and rapidly without any complications. However, if there are any complications, such as nerve damage or nerve problems, then recovery will take time and the recovery period depends on the extent of the cervical strain and nerve injury. In some patients, cervical strain can also lead to chronic pain syndrome.