Neck Sprain: Causes & Treatments

What is a neck sprain?

A neck sprain occurs when the ligaments—the tough, fibrous bands that connect the bones in your neck—have been overstretched or torn. A neck sprain can be caused by a sudden impact that creates a forceful back-and-forth movement of the head, most often from a car accident or sports injury. This is known as whiplash. But sometimes the cause can be minor, like sleeping in an unusual position.

Neck sprains are often confused with neck strains, but the symptoms and treatment are usually the same. The difference is that neck strains affect the neck muscles and tendons (the tissues that connect muscles to bone), not the ligaments. It’s possible to have both at once because nearby muscles and tendons may also be injured when you sprain your neck.

Symptoms

The most common symptom of neck sprain is pain in the back of the neck, which is where the ligaments connect to the bones of the neck. The pain gets worse with movement. You may have pain on the sides of the neck if your muscles are strained. If the pain is from an injury, symptoms may not show up until the day after the injury happened, when inflammation and stiffness develop.

Main symptoms

• Aching pain in the back of the neck. You may also have brief, sharp, and shooting pain if you turn your head suddenly.
• Neck stiffness or decreased range of motion. Your neck may feel stiff when turning your head side to side, nodding your head, or rolling your neck. It might be almost impossible to turn your head in one direction.
• Muscle tightness or spasm in the neck. You may feel a hard “knot” in the muscle.
• Pain in the upper back and shoulders
• Headache in the back of the head

Is whiplash a neck sprain?

Whiplash and neck sprain are two different issues, but whiplash often causes a neck strain or sprain. Whiplash occurs when the neck forcefully bends backward and then bends forward suddenly, like a whip cracking. It’s most commonly caused by a rear-end car accident. Whiplash can also cause spinal cord injury or fracture of the bones in the spine. The pain may be severe at first.

You should call 911 or go to the ER if you think you have whiplash so that you can be checked for more serious injuries. They may order imaging tests like X-ray, CT scan, and MRI. Neck sprain is usually diagnosed if other injuries are not found on these tests.

Causes

Sometimes a neck sprain comes on suddenly when the ligaments are overstressed, like during a car accident or from sports injury. But it can also develop more gradually after sleeping in an uncomfortable position or in a poor posture while sitting. Common causes include:

• Rear-end car accidents
• Contact sports like football, wrestling, and hockey
• Falls from a height, or minor falls at ground level in elderly people or people who are intoxicated
• Abuse or assault due to punching or shaking
• Amusement park rides
• Sleeping in an uncomfortable position or using a bad pillow
• Chronic poor posture while sitting, such as hunching

Next steps

If your neck pain started after a significant impact, like a car accident, sports injury, or fall, you should go to the ER to be checked for serious injuries like spine fracture in the neck or spinal cord injury. Any pain above the bones in the back of the neck must be checked right away in the ER. It’s also important to go to the ER if you had a head injury or loss of consciousness. Other signs you need to go to the ER include:

• Numbness or weakness in arms or legs
• Headache that is severe or becomes worse
• Difficulty talking
• Vision changes
• Confusion
• Extreme sleepiness
• Dizziness or loss of consciousness
• Fever
• Nausea or vomiting

If your neck pain developed gradually or you don’t have serious symptoms, you can treat the neck sprains and strains at home. But you should see your doctor if:

• The pain continues for more than 1–2 weeks.
• It becomes worse, instead of improving, after a few days.
• The pain is unbearable or prevents you from doing your normal activities.

Treatment

Most neck sprains will heal over time with at-home care. Home treatments for a neck sprain can include:

• Rest. Avoid strenuous exercise and contact sports, but try to do some light activity. Don’t just rest in bed, which can cause your neck muscles to stiffen.
• Apply ice to reduce inflammation. Ice your neck for about 24–48 hours after the injury. Apply it for 15 minutes at a time, 3–4 times a day. Always wrap the ice in a washcloth or towel instead of applying it to bare skin.
• Switch to a heating pad after a couple days. Again, limit use to about 15 minutes at a time.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve) can relieve pain and swelling. You can alternate with doses of acetaminophen (Tylenol).
• Gentle neck stretches are safe and can help prevent significant stiffness. Be careful not to force any movements that cause sharp pain.

Your doctor may recommend other treatments, such as:

• Prescription muscle relaxers or pain medications
• Wearing a soft neck brace for a short period of time (usually up to 3 days), which helps relieve stress on your neck ligaments. Be sure to follow your doctor’s instructions carefully, since wearing a neck brace for longer periods of time can weaken other structures in your neck.
• Physical therapy
• Ultrasound therapy
• Electrical stimulation
• Injections of numbing medication into the neck muscles

Stretches for sprained neck

It’s important to get your doctor’s approval before starting exercises for neck sprain. Stop doing the stretches if they cause severe, sharp pain, or if you develop new numbness or weakness in your hands or arms.

Do stretches slowly and without sudden jerky movements, and hold them for a few seconds. Repeat each one several times. Don’t have someone else grasp your head to force it beyond the point of comfort or apply any additional pressure yourself.

Here are some examples of stretches that a doctor or physical therapist might recommend:

1. Gently turn your head to look side to side.
2. Tilt your ear to your shoulder, return to center, and then repeat on the other side.
3. Tilt your chin toward your chest, then slowly look up.
4. Roll your shoulders forward and backward.