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Cervical Neck Strain
Aka: Cervical Neck Strain, Cervical Neck Sprain, Whiplash
- Symptoms: Collison injury in Contact Sports
- Sensation of "jammed neck" for days to weeks
- Symptoms: Whiplash
- Neck Pain
- Headache
- Loss of concentration
- Arm Paresthesias (24%)
- Dizziness (24%)
- Fatigue (19%)
- Signs: Red flags suggestive of serious injury
- Asymmetry of rotation
- Decreased cervical range of motion
- Pain over single spinous process
- Unrelenting Neck Pain
- Weakness or paralysis
- Loss of movement or Bladder function
- Violent axial loading or rotation mechanism of injury
- Signs: Limited Cervical Sprain
- Limited Range of Motion
- No pain
- No Paresthesias
- No radiculopathy
- Normal Neurologic Exam
- Radiology: C-Spine XRay
- Loss of normal cervical lordosis with neck spasm
- Obtain flexion and extension views
- Rule-out instability
- Abnormal translatory displacement
- Posterior translation > 3.5 mm adjacent Vertebrae
- Radiology: C-Spine MRI
- Not indicated if neurologic changes absent
- References
- Ronnen (1996) Radiology 201:93-6
- Management
- Avoid home use of soft cervical collar for treatment
- Prolonged immobilization slows healing
- Early active range of motion of neck speeds healing
- Rotational Exercises 10 times per hour
- Start as soon as tolerated
- Continue for first 4 days
- Early high dose Corticosteroid (within first 8 hours)
- Initial study shows long-term benefit
- References
- Eck (2001) Am J Med 110:651-6