Physical Therapy for Acute Cervical Sprain or Strain

Have you been in a car accident and now you have neck pain? Did you start working from home, sit in an uncomfortable chair for too long, and now your neck is stiff? Have you woken up with a “crick” in your neck?

Neck pain can make it uncomfortable to sit for long periods, drive (especially checking your blind spot), look up and down, turn your head, work overhead, lift, read or work at the computer, or even just rest comfortably. Sometimes, the pain starts to affect the shoulders but usually not the rest of the arms or hands.

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Causes of Acute Cervical Sprains and Strains

There are many things that can cause acute neck pain. Sometimes there is a specific cause like a car accident (including whiplash), a sporting injury, or a lifting injury. Other times, it is due to staying in one posture for a long time, like working at a computer for hours on end without changing positions or painting a ceiling over the weekend. Or, you may have acute neck pain due to no particular reason, and may even wake up with a crick in your neck thinking you must have “slept wrong.”

The onset of an acute cervical sprain or locking can have several underlying causes. Obviously any type of trauma such as sporting activity or a minor whiplash type injury can cause these joints to become swollen and inflamed. Often, the onset of this condition is unexplained which can suggest there is too much movement (hypermobility) in the specific joints in the neck called facet joints. Poor muscular control of the movement in the neck is called instability. When instability is the cause, patients will often have a frequent history of this same condition. Poor sitting postures can be an underlying cause to this condition due to the improper use of the neck and shoulder muscles.

  • Sport Injuries, Lifting Injuries, Whiplash, or Physical Trauma
  • Extended Periods of Time in One Position
  • Too Much Movement in the Facet Joints
  • Instability in Neck Muscles
  • Poor Sitting Postures
  • Other Medical Risk Factors

Symptoms of Acute Cervical Sprains and Strains

You may have difficulty finding a comfortable position when sitting or lying down, causing your productivity to decrease at work or make it difficult to get a good night’s sleep. Your pain is worse with head movement (looking up and down, turning your head, or tilting your head), and may be worsened with driving, lifting, or activities that cause you to look down for an extended period of time like reading.

You may describe the pain as a pinch, pressure, burning, stabbing, tightness or stiffness, or feel like your head is “too heavy.”

Acute neck pain is usually described as a sudden locking while turning the head or following sustained periods of looking up or down. Occasionally, patients awake with a "crick" or a "wry neck" for no particular reason. Both of these situations can cause very sharp, specific pain especially in one particular direction.

Very often turning the head to look over either shoulder is the most painful and is usually very limited. Frequently, there is a moderate amount muscle spasm associated with these specific movements. This can significantly limit the ability to perform normal activity such as driving, looking up, looking over your shoulder or raising your arms overhead. There are usually no symptoms in the arms or hands.

  • Discomfort When Sitting or Lying Down
  • Increased Pain with Head Movements
  • Increased Pain When Performing Certain Activities Like Driving, Reading, etc.
  • Pinch, Pressure, Burning, Stabbing, Tightness, or Stiffness Sensation in Head and Neck Area
  • Sudden Locking While Turning the Head
  • Sharp Pain When Looking in Certain Directions
  • Limited Head Movement

Diagnosis of Acute Cervical Sprains and Strains

A physical therapist can quickly and easily diagnose this condition, or you may be referred to physical therapy after first seeing a primary care physician or specialist like an orthopedist or neurologist. During your initial evaluation, your physical therapist will thoroughly review the history of your neck pain and then assess the ligaments, joints, muscles, tendons, and nerves or the neck, upper back, and shoulders.

Depending on the examination findings, treatment options will be discussed. After a plan is agreed upon, physical therapy treatment will begin.

Treatment of Acute Cervical Sprains and Strains with Physical Therapy

Manual therapy is found to provide a significant reduction in pain and increased ability to move in a very short time frame, usually no more than 1-2 visits.

Techniques of joint mobilization, deep tissue mobilization and muscular retraining are proven to be significantly effective treatments for this condition. Assessment and treatment of the underlying cause for this condition such as poor sleeping habits, neck weakness, postural stresses and associated areas of stiffness are the key to long term relief and reduction in re-injury. A key component for this condition is patient education. An individualized exercise program is developed for each patient’s specific problem often focusing on the deep neck muscles and the postural muscles of the shoulders and shoulder blades.

Modalities such as ice and electrical stimulation are utilized to reduce the acute inflammation and pain.

All Results PTs are trained to provide hands-on care for pain relief and to assist how well you are able to move your neck. This may include the physical therapist stretching the muscles and joints of the neck and upper back, performing soft tissue work to tender muscles or muscles in spasm, or assisting the range of motion of the neck with specific joint mobilizations for specific movements. Hands-on treatments are paired with exercises and may include stretching, neck, upper back, and arm strengthening, motor control or stabilization exercises, or aerobic exercise. All exercise programs will be custom made and tailored to your specific needs and goals.

Full recovery is generally possible and expected. Significant improvements in pain and function are usually made in the first 1-3 visits, and are definitely expected within two weeks of active physical therapy. Full recovery may take only a few weeks for neck pain not caused by a specific injury, while neck pain caused by higher speed car accidents or more severe injuries are often expected to heal within 1-2 months.

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Prevention Tips for Acute Cervical Sprains and Strains

Neck pain is best prevented with frequent exercise (aerobic, strengthening, and stretching) to keep the neck resilient. Also, prolonged postures should be avoided — avoid sitting at your desk or in front of the TV for hours at a time. Alternate between sitting and standing to work if you can, and briefly stretch throughout the day. Hands-free telephone devices can be helpful, and keep your neck in a comfortable, supported position at night when you sleep.

Lastly, drive safely and hope your fellow drivers do the same!

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