Neck Strain

Treatment At Home

If the pain is not severe and one does not have any new numbness, weakness, or other symptoms of nerve failure, mild neck strain can be safely treated at home.

  • If pain is moderate, bed rest may be necessary. A cervical collar may be beneficial.
  • It is helpful to place a small pillow under the nape of the neck to provide proper neutral positioning.
  • Dry or moist heat applied to the area often provides relief from pain caused by muscle spasm. However, it has not been shown to speed the healing process.
  • Pain control with a nonsteroidal anti-inflammatory drug (NSAIDs), such as ibuprofen (Advil or Motrin) or acetaminophen (Tylenol), is frequently helpful. An opioid, such as codeine, may be added if needed but will need to be prescribed by a doctor. Muscle relaxants are often used also. They are also available by prescription only.
  • One should guard against neck extension because this will make the pain worse. Stay active and perform one’s daily work as tolerated, unless this involves heavy physical labor. Contact a doctor for recommendations.

Medical Treatment

After the assessment of one’s condition by a doctor, a plan will be formulated, in conjunction with the patient and his/her family, to treat the injuries. Consideration will be given to the length of time that might be involved for recovery. The vast majority of neck strains heal themselves with appropriate supportive self-care alone. Many people do not need specific medical intervention.

Rest and apply local heat for symptomatic relief, and gradually resume one’s usual daily physical activity and work.

If pain lasts beyond two to three weeks, consideration should be given for further evaluation.

Osteopathic manipulative therapy (administered by a physician trained in manipulative medicine), chiropractic care, acupuncture, or an evaluation by a physical therapist should all be considered.

Several treatment plans are available for the person with persistent pain, including home cervical traction, under the direction of a doctor and physical therapist. Contact your doctor for a referral, as needed.



Neck strain is an injury to the muscles and tendons that support and move the head and neck. The neck is susceptible to injury because it is capable of extensive range of motion. It is, as a result, less stable that many other body areas. In addition, the neck muscles are affected by the motion of nearly all other areas of the body.

Overview

  • The neck contains many vital anatomic structures, the most critical being the airway (trachea, breathing tube), the spinal cord, and the blood vessels that supply the brain. Neck strain injuries do not typically involve serious injury to any of these vital structures. Neck strain is also not usually associated with fractures or dislocations of any of the bones of the cervical spine, but injury to all of these tissues can occur with the most severe trauma.
  • Injuries of tissues that contract and move, such as muscles and tendons, are termed strains. Similar injuries to nonmoving structures, such as ligaments, joint capsules, nerves, bursae, blood vessels, and cartilage, are termed sprains. Both strains and sprains of the neck may involve tears to ligaments covering the cervical vertebrae of the spine, the many muscles of the neck (which move the head), and many other associated structures. They may also result in injury to cervical nerves caused by stretching or compression.
  • The neck is an area where stability has been sacrificed for mobility, making it particularly vulnerable to injury. Because one can be injured in a number of different ways, a detailed medical and work history (including an analysis of work activity) is often needed to fully evaluate a neck injury. It also helps to predict how long one’s recovery will take and what the prognosis will be following an injury.
  • A thorough physical examination is necessary, particularly in instances where symptoms of nerve injury occur. Other studies using the latest imaging methods and other techniques may also be helpful.
  • Seeing a doctor is essential for all neck strains with serious injury or for severe, persistent, or unexplained symptoms or problems. Supportive self-care is often enough with the more common minor injuries for someone to have a complete recovery.

Causes for Neck Strain

Neck strains result from injury to the neck. Such injuries are caused most often by indirect trauma when the head is flung backward (hyperextension) or forward (hyperflexion), commonly known as whiplash. Injuries caused by rotation and compression (when the force of impact lands on the top of the head) can also result in neck strains and soft-tissue injury.

  • Automobile accidents are responsible for many whiplash injuries because of hyperextension or hyperflexion. A common scenario is when a seat-belted person’s head continues to move forward during a frontal impact and is then often thrown backward (the converse is also true). Side impacts typically result in bending of the head to that side, and rear impact tends to throw the head backward. Any or all of these movements usually result in whiplash.
  • People with occupations requiring repetitive or prolonged neck extension (microtrauma) may develop neck strain injury. Picture someone sitting at a computer keyboard, for example, straining to see a monitor that is not adjusted properly for the person’s posture. Also, the person may be trying to see the monitor through poorly adjusted bifocal lenses and must tip the chin upward to view the screen. Now tuck a telephone into the person’s shoulder for much of the day and that’s the formula for neck strain. With the increase use of computers at home, even the time away from one’s work can add to this injury.
  • Some people appear prone to neck strain injuries merely as the result of an abnormal posture while awake or from sleeping in an awkward position.