Cervical Strain Medication

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

Medication Summary

The pharmacology of cervical strain involves pain control and palliation. Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (Tylenol) are mainstays of therapy. Muscle relaxants may prove valuable when treating severe strain injuries to reduce pain and muscle contracture.

One randomized control trial found no benefit in adding cyclobenzaprine to standard ibuprofen therapy.[4]

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Analgesics

Class Summary

For minor strain injuries, oral outpatient analgesics provide adequate pain control. OTC medications also may suffice.

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Acetaminophen (Tylenol, Panadol, Aspirin Free Anacin)

 

Rapidly absorbed from GI tract and distributed widely to all body tissues. Serum half-life is 1-3 h but may be altered in impaired liver function. Posthepatic metabolites excreted in urine.

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Nonsteroidal anti-inflammatory agents

Class Summary

NSAIDs control mild to moderate pain and decrease inflammatory reactions. This entire family of medications may ease pain in strain injuries. Tailor dosage on an individual basis.

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Ibuprofen (Ibuprin, Advil, Motrin)

 

Rapidly absorbed orally and distributed widely through body tissues. Serum half-life is 1.8-2 h. Rapidly metabolized and excreted in urine. Complete clearance of single dose occurs in approximately 24 h.

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Ketorolac (Toradol)

 

Provides effective control of moderate to severe pain, with higher potency than other NSAIDs, which results in more marked GI upset, platelet inhibition, and renal effects.

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Muscle relaxants

Class Summary

These agents provide adjunctive therapy to allow rest, control pain, and aid physical therapy for musculoskeletal injury.

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Orphenadrine citrate (Norflex)

 

Action not well understood, but its analgesic properties make it clinically effective for muscular injury.

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Cyclobenzaprine hydrochloride (Flexeril)

 

Centrally acting skeletal muscle relaxant structurally related to TCAs with similar liabilities. Can be useful adjunct to other therapies for acute musculoskeletal pain.

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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

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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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