Cervical Spine Sprain/Strain

General Overview
A sprain is a stretch or tear in the ligament resulting from a sudden movement that causes the neck to extend to an extreme position. For example, in the rapid acceleration and deceleration of a car crash, your head and neck can stretch far forward and backward before stopping. This movement can also easily concussions.

Cervical sprain/strain occurs when an impact pushes your head one way, and then another when it recoils back. About 20 percent of people involved in rear-end collisions later experience symptoms that center in the neck region. Although most of these people recover quickly, a small number develop chronic conditions that result in severe pain and sometimes disability.

The term “whiplash”, although purely a legal term, is probably best reserved for describing the mechanism of injury, and is of little value as a diagnosis. The actual cause of the symptoms can be either a stretch or tear of the ligament (sprain/strain), a muscle stretch or tear, or pinching on the nerves caused by the hinging that occurs due to the bending that occurs with a whiplash injury.

It is important to remember that patient’s symptoms may well be worse a day after the injury. X ray results for neck injuries seldom add much to the clinical assessment, but the consequences of unrecognized cervical spine injuries are so severe that it is still worth while to x ray relatively mild injuries.

Stiffness or decrease in range of motion, pain in the back of the neck that worsens with movement, pain that often peaks a day or so after the injury instead of immediately, possible muscle spasms and pain in the upper regions of the shoulders, headache in the rear of the head, increased irritability, fatigue, numbness in the arm or hand, tingling or weakness in the arms.


The diagnosis of cervical sprain is not difficult, but is most often derived from the mechanism of injury as described above. In this type of injury, there is such a rapid acceleration and deceleration of the head on the neck that the normal alignment of the vertebra is lost. When there is a typical C-shaped curve of the neck when viewed from the side, that curve can become reduced, straightened or reversed. The subsequent subluxations of the vertebrae, stretching of the ligaments and protective contraction of the muscles generate a tremendous amount of pain. Headaches are a frequent development following an injury of this type since the nerves that innervate the skull are often compressed and/or tractioned as a result.

Near normal curve
Post-accident X-Ray (Note the straightening of the spine)

Chiropractic Treatment

One of the most common reasons for seeing a chiropractor is for this exact kind of injury. Usually a set of x-rays will help confirm a diagnosis of cervical spine sprain/strain. Gentle cervical adjustments are the best remedy for removing these subluxations of the spine while restoring nerve function and range-of-motion. Physical therapy modalities are often utilized in conjunction with care in order to help facilitate the healing process, either by reducing inflammation or calming muscle spasms. Stretching and exercises are introduced at the proper time.  Depending on the condition, treatment and recovery times vary, ranging from 6 weeks to 6 months. Considering the involvement of the spine and nervous system, if the sprain is significant enough to cause a permanent problem, follow-up treatments may be recommended in order to help stabilize the affected area.