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Cervical Strain Medication

  • Author: Warren Magnus, DO; Chief Editor: Trevor John Mills, MD, MPH  more...
Updated: Oct 15, 2015

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.[7]



Class Summary

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

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.


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.

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.

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.


Muscle relaxants

Class Summary

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

Orphenadrine citrate (Norflex)


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

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.

Contributor Information and Disclosures

Warren Magnus, DO Center Medical Director, Concentra

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

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Eric L Legome, MD Chief, Department of Emergency Medicine, Kings County Hospital Center; Professor Clinical, Department of Emergency Medicine, State University of New York Downstate College of Medicine

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

Disclosure: Nothing to disclose.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Natalie T Shum, MD, to the development and writing of this article.

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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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