Neck Sprain Causes, Symptoms, Diagnosis, and Treatment

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A neck sprain refers to an overstretched or torn ligament in the neck. Neck sprains are commonly associated with a whiplash injury. Whiplash can occur as a result of a car accident, playing a contact sport, riding amusement park rides that snap your head around, or any sudden impact that forces your neck beyond its normal range of motion. If a ligament in your neck is torn, it can cause extreme pain and the severe limitation of your head and neck movement.


Neck sprains are typically caused by an impact or force that causes your neck to quickly extend beyond its normal range and then snap back forcefully.

While the terms "sprain" and "strain" are often used synonymously, a sprain specifically refers to ligaments (the fibrous tissues that connect joint bones together), while a strain refers to muscles and tendons (the fibrous tissues that connect bones to muscles).

Whiplash can involve all of these neck structures, referred to individually as the cervical ligaments, cervical muscles, and cervical tendons.


Neck sprain symptoms don't usually appear at the moment of an injury or impact. Sometimes it takes one to two days before the initial pain and stiffness develop.

Common signs and symptoms of a neck sprain include:

  • Neck pain that worsens with movement
  • Neck stiffness limits the range of motion
  • Muscle spasms and pain in the upper back and/or shoulders
  • Headache, typically in the back of the head
  • Ringing in the ears (tinnitus)


If you sustain whiplash, be wary of any symptom suggestive of a nerve injury or a pinched nerve, such as numbness, tingling, the loss of coordination, dizziness, and weakness of the hands or arms.

Referred pain, a phenomenon in which an injury in one part of the body triggers nerve pain in a distant part of the body, is another common sign of a nerve injury. Even more serious is the loss of bladder control which often occurs with a spinal cold injury.

Neck stiffness accompanied by radiating pain to the lower back is also indicative of a more serious injury. The same applies if you are having breathing problems and swallowing problems (dysphagia). By contrast, neck sprains are not associated with swollen lymph nodes (which are more a sign of infection).

Whiplash classically presents with a delayed appearance of symptoms. Immediate pain following an extreme force or impact is the sign of a serious injury in need of emergency medical care.

You should also be on alert for potential concussion symptoms, including headache, blurred or double vision, nausea or vomiting, dizziness (vertigo), sensitivity to noise or light, problems with balance and coordination, fatigue, and weakness.

In addition, some people experience problems with cervical proprioception or knowing where your neck and head is in relation to space. Be sure to tell your doctor about this symptom so it can be properly evaluated.


A neck sprain is primarily diagnosed with a physical examination. If needed, imaging tests will be used to support the diagnosis or establish the severity of the injury. The aim of the physical exam is to assess the range of motion of your neck alongside an evaluation of your reflexes and any abnormal sensations you may be experiencing.

The doctor will also review your posture, specifically how you hold your head and may check the blood vessels in your neck to see if there are any signs of vascular injury.

Imaging tests may be ordered to examine your bones and soft tissues (including tendons, ligaments, and spinal discs) or detect any sign of bleeding. Options include:

  • X-ray, which exposes you to low-level electromagnetic radiation
  • Computed tomography (CT) scans, which capture multiples X-ray images to create cross-sectional views of your body
  • Magnetic resonance imaging (MRI), which uses a magnetic field and radio waves to create radiographic images, particularly of soft tissues


The treatment of a neck sprain is the same as for sprains in other parts of the body. Rest and patience are key to helping you cope with an injury. Included among the standard treatment recommendations:

  • Ice the injury. For the first two to three days, your doctor will likely ask that you ice the injury for 15 to 20 minutes at a time, four to eight times per day.

To avoid frostbite, place a cloth barrier between the ice pack and your skin and keep the ice pack moving rather than holding it in one place.

  • Wear a cervical collar. To keep the neck stable and relieve pressure on the ligament, you may be given a soft cervical collar to wear for several days. It should be used for severe neck strains or if you feel like your head is going to "fall off."

Long-term use of a cervical collar is not recommended as it can cause your neck muscles to weaken and increase the odds of a neck strain injury.

  • Take a painkiller. Nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve or Motrin (acetaminophen) can help relieve pain while reducing inflammation.
  • Use heat therapy. After you have iced the injury for two to three days, you can apply moist heat to the injury to increase blood flow, promote healing, and relieve stiffness.

Other treatment options may be explored as your injury starts to improve. They are best performed by a doctor or physical therapist or under the guidance of a doctor or physical therapist. These include:

  • Gentle massage
  • Ultrasound therapy
  • Cervical traction
  • Isometric exercises
  • Range of motion and mobility exercises

Most symptoms of a neck sprain will go away within four to six weeks. Severe injuries may take longer to heal. If your symptoms are severe or do not improve after two months, it may also be worthwhile to have your vestibular system and upper neck checked by a physical therapist who has experience treating whiplash injuries. There may be underlying impairments that have not been addressed.

In addition, if the pain lingers despite other treatments, your doctor may prescribe a muscle relaxant or give you a local anesthetic injection to help manage the pain. Injections are typically reserved as a last effort after prior treatments fail to bring lasting relief.

Even if you start feeling better, it is best to exercise wisely. Avoid contact sports or any activity that compromises the stability of your neck until your doctor fully signs off on your condition.

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  2. Yadla S, Ratliff JK, Harrop JS. Whiplash: diagnosis, treatment, and associated injuries. Curr Rev Musculoskelet Med. 2008;1(1):65-8. doi:10.1007/s12178-007-9008-x

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