- Massage therapy. A massage can loosen up and relax the muscles, as well as increase blood flow to the damaged tissues, which may provide some relief. Some medical professionals provide massage therapy in conjunction with manual manipulation.
A neck strain (pain) occurs when one or more fibers in a neck muscle or tendon stretch too far and tear. This injury, also called a pulled muscle, can vary in intensity depending on the tear’s size and location. While a neck strain typically heals on its own within a few days or weeks, the pain may range from mild and achy to sharp and debilitating.
Neck pain can occur from the top of your shoulders to the bottom of your head. Neck pain symptoms may be mild to severe and may limit your range of motion.
Neck Pain Causes:
As we age, neck bone and joint pain can be caused by the wear and tear of tissues and joints. Neck pain can have many causes, but most of these are not serious conditions. Neck muscles can be strained or pulled from poor posture or even from sleeping in an awkward position. Over time, normal wear and tear or arthritis can also lead to neck pain. Certain injuries can lead to bone and joint pain in the neck, as well as nerve compression in the area, causing one to seek neck pain treatment.
- Most cases of neck pain are caused by activities that cause straining of the neck such as slouching, painting a ceiling or sleeping with a twisted neck.
- Neck pain can also be caused by a fall from a ladder or whiplash from vehicular accidents.
- Holding the head in a forward or in an odd position for long periods of time during the working, reading, watching TV or talking to a telephone.
- Sleeping on a pillow that is too high or too flat that does not support the neck and sleeping on the stomach with the neck twisted.
- Spending long periods by resting the head on the upright fist or arm.
- Work or an exercise that uses the upper body and arms such as painting a ceiling and other overhead activities.
- Being stressed out and intensely immersed on a particular task can also instigate neck pain. Tension might develop in one of the muscles that are responsible for connecting the head, neck and shoulders. This will eventually lead to tightness and pain.
Treatment and home remedies for Neck Pain
- Use a heating pad that is set on low or medium setting for 15-20 minutes every 2-3 hours.
- Encourage the individual to take a warm shower and use single-use heat wraps that can last for 8 hours.
- Apply an ice pack 10-15 minutes every 2-3 hours in the affected area. Resume normal daily activities as soon as possible since movement will keep the muscles strong but avoid engaging in activities such as lifting and playing sports that will worsen the stiffness and pain.
- Perform stretching and strengthening exercises in order to keep the neck supple and strong as well as minimize stiffness.
- Avoid activities that may cause neck pain such as sitting for a long time in front of a computer and overhead work.
- Massage or rub the affected area in order to relieve pain and encourage circulation but avoid massage if there is pain.
- Provide the individual with acetaminophen to help minimize pain and inflammation.
- Avoid being stressed at home and work.
- Exercise regularly.
Neck Pain Risk Factors:
The weaker or more degenerated the tissue or joints in the neck become, the more susceptible the neck is to injury.
Age: As you age, you are more likely to have increased wear and tear on vertebrae, discs, muscles, and joints. This can often lead to neck pain and arthritis.
Occupation:If your job requires you to hold your head in the same position for prolonged periods (professional driver, computer work), you may increase your risk for neck pain. The good news is that simple stretching and strengthening exercises can help you reduce your risk for neck pain.
Sometimes the terms neck strain and neck sprain are used interchangeably. While a sprain is an injury to a ligament (not a muscle or tendon), the symptoms of pain and stiffness felt in both a strain and sprain are typically similar and resolve on their own before an official diagnosis is sought.Article continues below
Neck Pain Muscle Function and Strain
More than 20 muscles are connected in the neck. These muscles work together to help support the head’s upright position and facilitate movements of the head, neck, jaw, upper back, and shoulders.
A healthy muscle is comprised of numerous muscle fibers. Within each of these fibers are bundles of myofibrils that contain contractile proteins, which perform the actual contractions for muscle movements. When the muscle overexerts or stretches too far, small tears can form in the muscle, tendon, or connective tissue between the muscle and tendon, which is usually the weakest part.
More extensive neck strains involve more inflammation, which leads to more swelling, pain, and a longer recovery period. The strained muscle’s strength while the injury is healing largely depends on how many muscle fibers were torn.
Two long neck muscles that are at an increased risk for strain are:
- Levator Scapulae. This muscle travels down the side of the neck, from the top of the cervical spine to the scapula (shoulder blade). The levator scapulae play a key role in bending and rotating the neck to the side, and these movements can be hindered if the muscle is strained.
- Trapezius. This kite-shaped (trapezoidal) muscle runs from the base of the skull and goes more than halfway down the back, as well as out to the shoulders. The upper trapezius muscle helps facilitate many movements, including head tilts and neck extension (looking up).
Other neck muscles can also become strained, and it is possible for more than one neck muscle to become painful at the same time.
Causes of Neck Strain or Pain
Some common causes of neck strain include:
- Poor posture or holding an awkward position. The neck’s muscles, tendons, and other soft tissues can become overstretched when the head is held too far forward or tilted at an angle for too long. Some examples include being hunched over a computer for several hours, holding the phone between the ear and shoulder, or sleeping in a position that does not support the cervical spine well. An increasingly common problem is text neck, which describes neck pain that is caused by looking down at a phone screen or other wireless device for too long or too frequently.
Lifting something too heavy. It is likely for the neck to become overexerted and strained when lifting something that requires too much work for the muscles. a
Collision or fall. A sudden impact can jar the head and cervical spine to move too quickly for the muscles, which may lead to whiplash or other types of neck strain injuries. Some examples include auto accidents, bike accidents, or sports injuries, such as in football.
- Performing a new activity. Putting any muscle through a new type of activity that is somewhat strenuous makes it more susceptible to strain, including in the neck. For instance, athletes are more susceptible to muscle strains at the beginning of a training season.1
- Repetitive motions. Even for motions and loads that neck muscles can handle, doing too many repetitions can eventually strain the muscles.
While most neck strains take a few weeks to completely heal, symptoms tend to mostly go away in less than a week. In general, severe muscle strains tend to take closer to 12 weeks to heal, but these rarely occur in the neck without the involvement of a more serious injury.
When to See a Doctor for Neck Strain or Pain
For most episodes of neck strain, self-care and avoiding any additional strain to the neck is enough to manage symptoms until the injury is healed. Medical attention should be sought if the initial injury was part of major trauma (such as a car crash or fall from height), has worsened or not improved within a few days, or is accompanied by troubling symptoms, such as numbness or tingling in the arm, weakness in the arms or legs, or difficulty with balance.
This is not a complete list of neck strain causes. Sometimes the exact cause of a neck strain is not known.
The Course of Neck Strain or Pain
A neck strain may be painful as soon as the injury occurs, or it may take many hours for the inflammation to increase and symptoms to appear. Sometimes the symptoms start so gradually that it is difficult to trace how or when the injury occurred. Typically, neck strain pain and stiffness continue to worsen during the first day or two after the injury.
Neck strains can range from being mildly annoying to severe and may limit head movements for basic tasks, such as getting dressed or going to work. Knowing the symptoms of neck strain can help identify the problem sooner and find treatments that work.
Common Symptoms of Neck Strain
Nearly all cases of muscle strain in the neck are either mild or moderate and will eventually heal, but even these cases can be troublesome and inconvenient. Common symptoms include one or more of the following:
- Pain localized to the neck region. Neck strains are usually felt in the back of the neck, or mostly in the neck and partially in a nearby region, such as the back of the head, upper back, and/or shoulder.
- Achy or throbbing pain. A dull, nagging pain may persist and potentially affect sleep at night and/or concentration during the day. This ache is likely to feel deep in the muscle.
- Sharp pain. A knife-like pain can sometimes be one of the more intense symptoms of neck strain.
- Pain that worsens with movement. The neck might have no or dull pain at rest, but then have a flare-up of sharp pain with certain movements or activities.
- Muscle spasm. Inflammation from the injury can trigger painful spasms in the injured muscle and possibly nearby muscles.
Stiff neck. Moving the neck in one or more directions may be difficult. Neck stiffness from a strain is due to swelling and/or muscles tightening to guard against further injury.
Sometimes a neck strain can accompany another injury or condition, which may cause additional symptoms.
Chronic Neck Strain from Poor Posture
While most neck strains go away on their own within a few days, healing cannot take place if the muscle strain is regularly reinjured. This situation is particularly common when the cause of the neck strain is undiagnosed.
For example, a person could go months or years with neck pain that worsens at the end of a long workday. If the pain is from poor posture or repetitive motions that cause the neck strain, it may be wise to give the neck a chance to rest and either avoid or modify previous activities that involved long periods of poor posture.
Serious Symptoms in Addition to Neck Strain
If a neck strain is the result of a sudden or major impact, such as a car accident, additional injuries in the cervical spine may occur or become exacerbated, such as a herniated disc or fracture. Symptoms that warrant a trip to the doctor for further evaluation include:
- Pain, tingling, numbness, and/or weakness that radiates down into the shoulder, arm, or hand
- Headache or dizziness
- Visual problems or sensitivity to bright lights
- Neck instability
- Difficulty with finger dexterity
- Gait disturbances such as feeling off balance
- Loss of bladder or bowel control
Other troublesome symptoms could also exist. If severe neck pain or neck instability follows a major accident, medical personnel may need to immobilize the neck before transporting to the hospital.
Most cases of neck strain are never officially diagnosed because the pain typically starts going away within a few days. However, if the neck pain occurs after a major impact or persists or worsens several days after the injury, it is important to see a doctor for an official diagnosis.
Reaching a Neck Strain Diagnosis
Collecting a medical history and performing a physical exam is typically enough to reach a neck strain diagnosis.
- A medical history includes any known medical conditions and family history, as well as how and when the current symptoms started and any accompanying symptoms. Information may also be collected about current lifestyle habits, such as work, hobbies, stress levels, exercise, nutrition, and sleep.
- A physical exam involves observing and palpating (feeling) the neck for any abnormalities, such as tenderness or muscle spasms. The Range of motion is also tested by moving the head up, down, and rotating side to side. If nerve root compression in the cervical spine is suspected of causing pain, tingling, and other symptoms to radiate into the arm, a Spurling’s test may be administered by gently pushing down on the head to see if symptoms can be reproduced.
Collecting a medical history and performing a physical exam is typically enough to reach a neck strain diagnosis.
If the medical history and/or physical exam suggest that something more serious than a muscle strain is causing any of the symptoms, more advanced diagnostic testing may be needed.
Advanced Diagnostics for Neck Pain
While rarely used to examine neck strains alone, some common imaging techniques to explore the possibility of other problems in the cervical spine include:
- X-ray. Also called a radiograph, an x-ray is good at showing the bones and possible fractures or spinal degeneration. An x-ray is typically the first imaging study used when neck pain occurs after a major accident, such as a car crash or fall from a ladder.
MRI. This imaging method creates a series of cross-sections of the soft tissues and bones by using radio waves and a strong magnet to view variations in the different types of tissues. When used to view the cervical spine, an MRI is typically the best option for assessing potential damage to soft tissues, such as muscles, tendons, ligaments, nerves, the spinal cord, and others.
CT scan. Using x-rays in conjunction with a computer, a CT scan creates a series of cross-sections for enhanced viewing of the bones. Especially if MRI is not an option, a CT scan may be combined with a myelogram (dye injected via spinal tap) to get a view of the soft tissues in addition to the bones.
Several other advanced diagnostic tests, such as electrodiagnostic testing or nerve conduction studies, may also be considered to help diagnose conditions that cause neck pain.
The severity of Neck Muscle Strain
In general, muscle strains are classified in the following categories:
- Grade I. A mild strain that only involves a relatively few muscle fibers partially tearing. There is some pain but no noticeable muscle weakness.
- Grade II. A moderate strain occurs when more muscle fibers have torn and some muscle weakness occurs in addition to pain.
- Grade III. A severe strain when the muscle has completely torn and the pain is usually severe and debilitating.
Most neck strains are either Grade I or II. If a Grade III neck strain occurs, it is likely in conjunction with a serious injury to the cervical spine and is not primarily referred to as a neck strain injury.
Most neck strains heal on their own, but finding the right treatment can help alleviate the pain while the injury is healing. In cases where neck pain lingers for more than a few days or initial treatments do not provide enough relief, trial-and-error may be needed to find the combination of treatments that work best.
Initial Treatments for Neck Strain
When pain from a neck strain first develops, one or more of the following treatments are typically tried:
- Activity modification. Resting the neck and/or refraining from strenuous activities for a couple of days can give the muscle or tendon time to start healing and feeling better. Trying to push through the pain without reducing activity levels could worsen the injury and prolong the pain.
- Ice and/or heat therapy. It is recommended to apply ice within the first 48 hours of an injury to help reduce swelling. After 48 hours, heat or ice may be applied, depending on the patient’s preference. Heat can help facilitate blood circulation and bring healing nutrients to the damaged tissues. A layer should be kept between the skin and hot/cold source to avoid skin damage, and applications should be kept to 10 to 20 minutes with rest periods in between.
Over-the-counter pain medication. Taking anti-inflammatory medicines, such as ibuprofen (e.g. Advil) or naproxen (e.g. Aleve), reduces inflammation, which in turn can reduce pain. Pain relievers, such as acetaminophen (e.g. Tylenol), may also be an option.
It should be noted that even if a neck muscle strain is painful with most movements, total bed rest and/or a neck brace are not typically recommended because that could lead to weaker neck muscles and a longer recovery period.
Treatments for Neck Strains That Linger
If a neck strain lasts longer than a few days or perhaps another underlying problem in the cervical spine continues and causes muscle spasms and chronic pain, other treatments may need be needed for adequate relief. Some examples include:
- Physical therapy. A physical therapist, physiatrist, or other trained medical professional may design a physical therapy program that targets muscles in the neck and elsewhere that need to become stronger and more flexible. Typically, a physical therapy program begins with instruction on how to do the exercises and stretches. After gradually making the process over a period of a few weeks or months, the patient continues the program on his or her own at home.
Manual manipulation. A trained medical professional may make manual adjustments to the cervical spine (as well as lower in the spine) with the goal of realigning joints, improving the neck’s range of motion, and reducing pain.
Massage therapy. A massage can loosen up and relax the muscles, as well as increase blood flow to the damaged tissues, which may provide some relief. Some medical professionals provide massage therapy in conjunction with manual manipulation.
Acupuncture. This treatment is based on the theory that unbalanced energy flows (or blockages) within the body may contribute to pain, and therefore strategic placements of thin needles in the body may restore balanced energy flows and reduce pain. While this theory has not been scientifically proven, some people report experiencing pain relief from acupuncture treatments.
Prescription medications. While rare, sometimes a neck strain may require a prescription medication to provide relief. For example, a muscle relaxant may be prescribed on a short-term basis to alleviate the pain from a, particularly bad muscle spasm.
Reducing the Risk for Neck Strain
While not all neck strains can be prevented, some basic steps can reduce the risks
- Stay active. A physically active lifestyle keeps the whole body relatively strong and flexible, including the neck. In addition, regularly performing exercises and stretches that target the neck and core muscles can help improve posture as well. Many neck strains result from poor posture due to deconditioned neck muscles.
Start slowly. When starting a new activity or sport, begin at a manageable pace or workload, then gradually build up over time. It is common to strain a muscle when performing a new or unfamiliar activity.
Take breaks. Repetitive motions can lead to muscle strain, including in the neck. Taking breaks or alternating activities enables muscles to rest and recover to avoid injury.
Sleep well. Finding the right pillow, mattress, and sleep position can reduce the risk for waking up with neck pain. However, everyone is different, and it could take trial-and-error before settling on what works best. For example, sleeping on the stomach causes the most stress on the cervical spine, but not everyone agrees as to whether sleeping on the side or on the back is better. Also, some people prefer a cervical pillow, but others may find more comfort with other pillows.
Focus on posture. Sitting and standing up straight with shoulders back helps keep the spine in neutral alignment. Remembering to use good posture throughout the day helps minimize the forces acting on the intervertebral discs and ligaments.
Having a strained neck increases the risk for it to happen again in the future. Also, trying to return too quickly from a neck strain injury before it heals can worsen the injury and prolong the recovery period.
*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
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