Mostly due to sudden twisting of the head and neck during work or daily life, where muscles contract or stretch unpreparedly and violently, causing tears in muscle fibers or ligaments. It can also result from sudden braking in a high-speed car, causing the cervical spine to rapidly swing back and forth. Some patients experience it upon waking up (also known as "stiff neck").

bubble_chart Pathological Changes

Most patients have weak neck muscles, with the more commonly affected muscles being the trapezius, levator scapulae, and sternocleidomastoid muscles, or the cervical fascia and ligament tissues. Fibers at the muscle origins, insertions, or muscle bellies are torn, causing swelling and bleeding in the injured tissues, which irritate nerve endings and lead to local pain, triggering neck muscle spasms. These spasms, in turn, can cause referred pain to the head, back, or even the ipsilateral upper limb through spinal nerve conduction. A small number of severe cases may also exhibit symptoms of nerve root irritation.

bubble_chart Clinical Manifestations

Neck sprains are mostly unilateral, with males slightly more affected than females. The main symptoms are neck pain and restricted movement, with severe cases experiencing knife-like or tearing pain. The pain is primarily in the neck but can vaguely radiate to the head, back, and upper limbs. Any movement can worsen the pain, causing the shoulders to turn along with the head. Examination reveals significant tenderness in the affected muscles, such as the trapezius, often over a wide area, sometimes with multiple tender points. There may be mild swelling in the local soft tissues, and the patient's head is often tilted to one side, hence the term "stiff neck." Neurological examinations show no abnormalities.

X-ray examinations are often negative, but in a few patients, lateral X-ray films may show a reduction or straightening of the cervical physiological lordosis, as well as widening of the interarticular spaces.

bubble_chart Diagnosis

Based on the sudden onset of symptoms, a history of relatively minor trauma, and local signs, the diagnosis is not difficult. If necessary, X-ray examination should be performed to rule out conditions such as C1-C2 subluxation or cervical subcutaneous nodules.

bubble_chart Treatment Measures

The course of acute soft tissue injury in the neck is not long, and it usually heals on its own after a few days of rest. However, many patients experience severe symptoms and require treatment, such as local plaster application, hydrocortisone acetate injections at tender points, physical therapy, acupuncture, and tuina. During tuina, gentle techniques should be used, avoiding strong and rapid rotational maneuvers to prevent worsening the injury or causing dislocation of the cervical vertebrae. Temporary immobilization with a neck brace can also help alleviate symptoms.