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  • Neck sprain
  • Neck strain

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  • 847.0 Sprain of neck

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  • S13.4XXA Sprain of ligaments of cervical spine, initial encounter
  • S13.8XXA Sprain of joints and ligaments of other parts of neck, initial encounter

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Description

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  • Whiplash-associated disorders (WAD): injury dysfunction and symptoms
  • Cervical acceleration-deceleration injury (CAD): mechanism of injury
  • Traumatic neck pain from being hit from behind
  • Quick movement through an S-curve causing upper cervical flexion and lower cervical hyperextension2
  • Post-traumatic mechanism of injury to the head/neck, most commonly secondary to motor vehicle accident3

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Essentials of Diagnosis

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  • Symptoms may be delayed for 24 hours2
  • Quebec task force grade levels
  • Diagnosis made by clinical examination and patient history

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General Considerations

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  • More common in women than men, possibly from neck muscle strength and stability
  • Pain may become chronic if musculature strength not regained

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Demographics

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  • Women appear to be at greater risk secondary to less stiffness of the cervical structures4

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Signs and Symptoms

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  • Neck pain5
  • Muscle pain5
  • Stiffness
  • Headaches, 50% to 60%5
  • Dizziness
  • Generalized neck and upper back pain, typically absent of radiculopathy
  • Ringing in the ears
  • Blurred vision
  • Sleep disturbance
  • Guarded and limited active motion of the cervical spine
  • Hypertonic surrounding musculature
  • Compensatory neck motion initiated by global cervical musculature, including sternocleidomastoid and scalenes
  • Potential sympathetic symptoms
  • Post-traumatic psychosocial impairments

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Functional Implications

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  • Difficulty maintaining sustained sitting postures

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Possible Contributing Causes

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  • Occupation that requires prolonged sitting postures including desk work, driving, horseback riding falls, and overhead activities
  • Trauma from auto accident, physical abuse, contact sports

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Differential Diagnosis

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Imaging

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  • Severe muscle spasm, muscle weakness, or pain upon gentle compression of the cervical spine may indicate fracture1

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Medication

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  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroids

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  • For imaging and surgical consult if fracture/instability is suspected
  • For pain medication if self-care measures insufficient
  • For psychological consult if post traumatic stress suspected

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  • Guarded active cervical spine motion secondary to hypertonic musculature
  • Hypermobile cervical spine
  • Weakness noted of longus coli and longus capitus
  • ...

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