Cervical Strains and Sprains

Cervical strains and sprains are characterized by pain in the neck because of irritation and spasm of muscles at the back of the neck. Common related factors are poor posture (e.g., while working or studying), carrying heavy bags on one shoulder, emotional or physical stress, and trauma. The patient has a history of pain in the lower neck and upper back; stiffness in the neck, back, and shoulders; and perhaps a new work environment, working in a certain posture (e.g., at computer), and trauma. Clinical findings include tenderness posterior to neck, with or without ROM limitation. Diagnosis may be apparent from the history and physical examination. Uncomplicated pain is managed by conservative treatment and correction of causative factors, such as changes in associated environmental factors (e.g., adjustment of height of desk or chair, avoiding straps on shoulders). Stress reduction is beneficial to aid reduction of muscle tension. Warmth applied to the neck is helpful, as are ROM exercises, pain relief, and referral to physical therapy. Persistent symptoms, history of trauma, or neurologic signs in the extremities require further evaluation with radiography.

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