The soft tissues structures of the neck are the ligaments and muscles. They provide support and protection for the underlying spinal column and spinal nerves. A stretched ligament or muscle is often a strain. This can occur with or without obvious injury.
Symptoms of a strain can arise immediately or 1 to 2 days after a known injury. Neck pain and stiffness are common complaints. Additionally these symptoms can involve the upper back and/or shoulders. Radiating pain to the arms or numbness/tingling of the hands may suggest a more significant injury and should lead to more urgent evaluation.
Positioning of the head, tenderness of the neck, pain and limitation of motion on direct exam help determine the significance and accurate diagnosis of a strain. Most neck strains do not require imaging tests.
Treatment often starts with analgesics and/or anti-inflammatory medications. Ice is usually the first recommended modality and then progression to using moist heat or alternating with ice. Short-term use of muscle relaxants can be of benefit but are not recommended for extended periods of time. Increasing range of motion is encouraged. Directed physical therapy also may have a place for those strains that are taking longer to heal. A towel roll may provide positional support for the neck.
Neck strains usually resolve within a couple of weeks. Rarely are injections required for these soft tissue conditions.