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Neck Sprain or Strain

A sudden force that causes turning or bending of the neck can cause a sprain or strain. An example would be the force from a car accident. This can stretch or tear muscles called a strain. It can also stretch or tear ligaments called a sprain. Either of these can cause neck pain. Sometimes neck pain occurs after a simple awkward movement. In either case, muscle spasm is commonly present and contributes to the pain. 

Unless you had a forceful physical injury (for instance, a car accident or fall), X-rays are often not ordered for the initial evaluation of neck pain. If pain continues and doesn't respond to medical treatment, X-rays and other tests may be done later.

Home care

  • You may feel more soreness and spasm the first few days after the injury. Rest until symptoms start to improve.

  • When lying down, use a comfortable pillow or a rolled towel that supports the head and keeps the spine in a neutral position. The position of the head should not be tilted forward or backward.

  • Apply an ice pack over the injured area for 15 to 20 minutes every 3 to 6 hours. Do this for the first 24 to 48 hours. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a thin towel or cloth before using it. Don’t put ice or an ice pack directly on the skin. After 48 hours, apply heat (warm shower or warm bath) for 15 to 20 minutes several times a day. Or alternate ice and heat.

  • You may use over-the-counter pain medicine to control pain, unless another pain medicine was prescribed. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen may work better than acetaminophen. If you have chronic liver or kidney disease, ever had a stomach ulcer or gastrointestinal bleeding, or take blood thinners, talk with your healthcare provider before using these medicines.

  • If a soft cervical collar was prescribed, only wear it for periods of increased pain. It should not be worn for more than 3 hours a day, or for longer than 1 to 2 weeks.

Follow-up care

Follow up with your healthcare provider, or as directed. Physical therapy may be needed.

Sometimes fractures don’t show up on the first X-ray. Bruises and sprains can sometimes hurt as much as a fracture. These injuries can take time to heal completely. If your symptoms don’t improve or they get worse, talk with your provider. You may need a repeat X-ray or other tests. If X-rays were taken, you will be told of any new findings that may affect your care.

Call 911

Call 911 if you have:

  • Neck swelling, difficulty or painful swallowing

  • Trouble breathing

  • Chest pain

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Pain gets worse or spreads into your arms or legs

  • Weakness or numbness in 1 or both arms or legs

Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Raymond Turley Jr PA-C
Online Medical Reviewer: Thomas N Joseph MD
Date Last Reviewed: 2/1/2022
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