Neck strain

A neck strain or sprain occurs when one or more neck muscles, ligaments or tendons are injured. Most cases are mild or moderate, but severe cases need medical attention.

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Symptoms of neck strain

Even though a majority of neck strain cases are mild or moderate and will resolve without needing medical care, nearly all cases are bothersome. Here’s what to look for in telling the difference between mild or moderate cases and more severe cases of neck strain.

Symptoms of mild to moderate neck strains

Symptoms of a mild or moderate neck strain can include:

  • Achy or throbbing pain
  • Muscle spasms
  • Pain in the back of the neck or shoulders
  • Pain that worsens with movement
  • Sharp pain
  • Stiffness

Symptoms of more severe neck strains

If you experience any of these more severe symptoms, be sure to see your doctor.

  • Difficulty with finger dexterity.
  • Gait disturbances or feeling off balance.
  • Headache or dizziness.
  • Loss of bladder or bowel control.
  • Neck instability.
  • Pain, tingling, numbness and/or weakness that radiates down into the shoulder, arm or hand.
  • Visual problems or sensitivity to bright lights.

Causes of neck strain

Some common causes of neck strain include:

  • Lifting heavy items. The exertion when working to move something too heavy can easily strain the neck muscles.
  • Performing a new activity. Stressing your neck muscles in a new way makes them more susceptible to strain.
  • Poor posture. When you hold your head too far forward or tilted at an odd angle for too long from working on the computer or sleeping, your neck’s muscles, tendons and other soft tissues can become overstretched. One of the more common causes of neck strain now is “text neck,” which is caused by looking down at your device for too long or too often.
  • Repetitive motions. Even when your neck is used to doing the same motion, too many repeated movements can cause muscle strain.
  • Violent collision or fall. A sudden impact may cause whiplash or other neck injuries. Examples include auto accidents, bike accidents or injuries from sports like football.

Treatments for neck strain

Treatments for mild to moderate neck strains

Treatments for mild to moderate neck strains might include:

Modifying activities. Rest is one of the simplest ways to help your neck start feeling better. If you try to “push through” your pain in order to continue your normal level of activity, you’re increasing the chance of worsening your injury and its associated pain.

Using ice and/or heat therapy. You should apply ice within the first 48 hours of your injury to help reduce swelling. After that, heat or ice may be applied, depending on your preference. Heat helps blood circulate and helps damaged tissue heal. Keep applications between 10-20 minutes with rest periods in between (be sure to place something between your skin and the hot/cold source to avoid skin damage).

Over-the-counter pain medication. Anti-inflammatory medicines, such as ibuprofen (e.g. Advil) or naproxen (e.g. Aleve), help reduce inflammation and pain. Pain relievers, such as acetaminophen (e.g. Tylenol), may also be an option.

Treatments for severe neck strains

More serious neck strains require more involved treatments in order to bring relief. They might include:

Manual manipulation. You can have a trained medical professional manually adjust your neck and back. Their goal will be to realign joints, improve your neck’s range of motion and reduce pain.

Massage therapy. Massage is an effective way to loosen up and relax your neck muscles. It can also increase blood flow to any damaged tissues, which may provide some relief. You can sometimes find massage therapy offered together with manual manipulation.

Physical therapy. Physical therapy helps improve flexibility and strengthen the muscles in the neck. Once you learn how to do the exercises with a physical therapist, you’ll eventually be able to continue the program at home, as needed.

Prescription medications. On rare occasions, a neck strain may be severe enough to require a prescription medication in order to get relief.

Acupuncture. This treatment strategically places thin needles into key pressure points in your body in order to restore balanced energy flows and reduce pain. Although not clinically proven, anecdotal evidence indicates pain relief from acupuncture treatments.

Frequently asked questions (FAQs) about neck strains

How do you sleep with a strained neck?

If you have a strained neck, sleep on your back or side for best results. Compared to sleeping on your stomach, both positions are much better for your spine and neck.

Can a neck strain cause headaches?

If the muscles in the upper part of your neck are tense due to neck strain, a headache can result.

Can a neck strain cause dizziness?

Not typically. If you’re experiencing dizziness, it’s likely a symptom of something other than neck strain.

Can a muscle strain cause swollen lymph nodes in the neck?

Swollen lymph nodes aren’t caused by muscle strain. Swelling in the lymph nodes is typically caused by a bacterial or viral infection.

What is better for a neck strain: heat or ice?

Both work well for neck strain. Please see the “Treatments for Neck Strain” section to learn more.

Should you massage a pulled neck muscle?

Yes. Massage can be a very effective treatment for a pulled neck muscle.


Orthoinfo: American Academy of Orthopaedic Surgeons. Neck Sprain (–conditions/neck-sprain/)

American Association of Neurological Surgeons (AANS). Neck Pain (