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Acute Neck Injury (no fracture)
Acute Neck Injury (no fracture) → Pain and restricted movement, but radiology excludes fracture. Very common: ~1 in 10 adults experience neck pain during their lifetime.
⚡ Common Causes
- 💻 Repetitive Strain Injury – prolonged posture (e.g. desk work, keyboard use) → muscle tension + strain.
- 🚗 Whiplash – after road traffic accidents or falls. Symptoms: neck pain, occipital headache, stiffness, ± swelling. – Imaging usually normal. – Recovery varies; pain may persist up to 12 months. – 🔎 Longer recovery sometimes associated with compensation claims (“secondary gain”).
- 🧠 Cervical Radiculopathy – nerve root irritation/compression, commonly C6–T1. – Presents with radiating arm pain, paraesthesia. – ⚠️ Always perform full neurological exam to exclude motor/sensory deficit.
🔎 Investigations
- 🩻 Cervical Spine X-ray – to rule out fracture.
- 🖥️ CT Cervical Spine if:
- High-impact trauma (RTA, fall from height, axial load).
- Neurological deficit (weakness, numbness).
- Persistent severe pain despite conservative care.
- Inconclusive/poor-quality X-ray.
- Canadian C-Spine Rule positive (e.g. age >65, dangerous mechanism, paraesthesia in extremities).
🛠️ Management
- ⏳ Time & reassurance – most improve within days–weeks.
- 💊 Analgesia – paracetamol, NSAIDs first-line.
- 🚫 Muscle relaxants – not routinely helpful.
- 💉 Opiates (short course) – e.g. tramadol, 3–5 days if severe.
- 🧑⚕️ Physiotherapy – if symptoms persist beyond 2–3 weeks → improves mobility, prevents chronicity.
- 🦺 Cervical collars – not recommended; may delay recovery.
💡 Clinical pearl: Always screen for “red flags” → neurological deficit, progressive weakness, incontinence, or systemic features (infection, malignancy). These mandate urgent imaging & senior review.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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