Cervical Strain Follow-up

  • Author: Warren Magnus, DO; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Apr 19, 2011
 

Further Outpatient Care

Follow-up with a primary care physician is strongly recommended in cervical strain injuries to facilitate further care. For patients involved in occupational injuries, appropriate referral for follow-up is particularly important.

Physical therapy should be encouraged early to reduce the risk of long-term loss of function due to lost range of motion.

Vigilance for decreased function secondary to disuse or long-standing injury should be maintained to prevent long-term sequelae from the strain injury.

Recent literature such as the cohort study by Pape et al in the European Journal ofPain suggests that initial conservative management is associated with a better long-term outcome than overly aggressive, multidisciplinary approaches.[5] Therefore, limiting follow-up to primary care referral only and avoiding other interventions such as chiropractic care or physical therapy may be most desirable.

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Inpatient & Outpatient Medications

  • Outpatient medications should include acetaminophen or an NSAID.
  • Muscle relaxant medications may be considered adjunctive care.
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Deterrence/Prevention

  • Avoidance of unusual postures (eg, painting overhead, sitting in the front row at the movies) for extended periods can prevent acute low-speed strain injuries.
  • Avoidance of chronic straining (eg, using the neck to hold the telephone, other malposition syndromes) or repetitive motion of neck muscles and/or ergonomic planning and regular breaks can assist in avoiding a significant number of cervical strain injuries.
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Complications

  • Long-term complications of strain injuries are typically related to decreased function secondary to disuse.
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Prognosis

  • Patients with cervical strain injuries who are compliant with recommended therapy, including rest, ice, and physical therapy or exercise programs, often make full, rapid recoveries.
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Patient Education

  • Prior to discharge from the ED, patients should be made aware of the potential for long-term injury due to noncompliance.
  • Patients should be advised of the benefits of ice versus heat in acute injuries.
  • Patient education in basic exercises can enhance mobility and minimize discomfort during the recovery period.
  • During follow-up visits, referral to a physical therapist for patients with markedly decreased range of motion or long-standing injury prior to presentation can be significantly beneficial in regaining range of motion as well as strengthening cervical musculature.
  • For excellent patient education resources, visit eMedicine's Back, Ribs, Neck, and Head Center and Arthritis Center. Also, see eMedicine's patient education articles Neck Strain and Whiplash.
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Contributor Information and Disclosures
Author

Warren Magnus, DO  Staff Physician, Fremont Medical Center, Las Vegas, NV

Warren Magnus, DO is a member of the following medical societies: American Osteopathic Association

Disclosure: Nothing to disclose.

Coauthor(s)

Paul D Moczarski†, DO  Former Attending Physician, Emergency Resources Group and EmCare, Jacksonville, Florida

Paul D Moczarski†, DO is a member of the following medical societies: American Osteopathic Association

Disclosure: Nothing to disclose.

Specialty Editor Board

David FM Brown, MD  Associate Professor, Division of Emergency Medicine, Harvard Medical School; Vice Chair, Department of Emergency Medicine, Massachusetts General Hospital

David FM Brown, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Eric L Legome, MD  Chief, Department of Emergency Medicine, Kings County Hospital Center; Associate Professor, Department of Emergency Medicine, New York Medical College

Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD 

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

References

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External craniocervical ligaments.
Internal craniocervical ligaments.
Lateral view of the muscles of the neck.
Anterior view of the muscles of the neck.
Radiograph of the cervical spine shows a normal lordotic curve.
Radiograph of the cervical spine shows straightening of the lordotic curve.
 
 
 
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