MANUAL MINORS
Soft tissue injuries of the neck involve muscles, tendons, ligaments, and nerves surrounding the cervical spine. These injuries can result from sudden movements, direct trauma, or repetitive overuse of the neck muscles, such as in “whiplash” following car accidents.
Common injuries include cervical sprains, muscle strains, myofascial pain syndrome, and nerve injuries. These conditions often cause pain, stiffness, and functional limitation in the neck and shoulders.
Diagnosis
Diagnosis is based on the clinical history, often involving trauma, sudden movements, or prolonged postures. Patients typically present with localised pain, stiffness, and, in some cases, limited range of motion.
Physical examination reveals tenderness on palpation of the cervical muscles and the presence of trigger points. In cases of significant trauma or suspected nerve damage, imaging studies such as X-rays or magnetic resonance imaging (MRI) are used to rule out fractures or disc injuries.
Differential Diagnosis
Pathology | Characteristics |
Cervical disc herniation | Radiating pain to the arm, associated with muscle weakness and tingling |
Cervical fracture | Severe pain following major trauma, with significant movement restriction |
Whiplash syndrome | Pain and stiffness following trauma, with no visible bone changes on X-rays |
Myositis | Muscle pain without trauma, often related to infections or inflammation |
Acute torticollis | Painful neck muscle spasm, with antalgic posture and limited mobility |
Emergency Management
Emergency management includes pain control using non-steroidal anti-inflammatory drugs (NSAIDs) and, in acute cases, muscle relaxants to relieve muscle spasm. Temporary immobilisation with a soft cervical collar may help reduce tension in affected muscles.
Rest is recommended, along with ice or heat application depending on the type of injury. For severe trauma-related injuries or suspected neurological involvement, imaging studies are essential, and the patient should be referred for specialised evaluation.
Definitive Treatment
Definitive treatment includes physiotherapy to strengthen the cervical muscles, improve range of motion, and prevent future muscle contractures. For mild to moderate sprains, conservative management with stretching exercises and relaxation techniques is effective.
For patients with myofascial pain syndrome or chronic contractures, trigger point therapy and therapeutic massages may be beneficial. In severe injuries involving nerve damage, surgical treatment may be required, particularly if there is compression of neural structures.
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