Neck Injuries: Cervical Spine Anatomy

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Neck or Cervical Spine Injuries

Neck injuries, or cervical spine injuries, affect a large majority of American’s each year. Injuries to the cervical spine range from soft tissue injury, like sprains or strains, to more serious and catastrophic injuries like vertebral fractures, dislocation, or spinal cord injury (SPI). Neck injuries can occur in a variety of ways, some of these may include overuse, increased stress, automobile accidents, or sport-related incidents. Some individuals may present with biomechanical risk factors that increase their susceptibility to neck injury such as forward head posture, hyper/hypomobility of the cervical spine, or tightness of the surrounding musculature.

Woman with a Neck Injury

Anatomy of the Neck or Cervical Spine

The anatomy of the cervical spine consists of the vertebral elements (C1-C7), the discs that separate the cervical vertebrae and absorb shock as you move, as well as the muscles and ligaments in the neck that provide the overall stability for the cervical spine. Neck pain may be caused by an injury to one or more of these areas, or may have an underlying cause. Conservative treatment will most often times resolve neck pain caused by minor injury. Neck pain may present as a “kink”, stiffness, or severe pain. Pain may radiate to the shoulders, upper back, arms, or may cause frequent headaches. Decreased range of motion may affect the entirety of the joint, but is not uncommon to affect one side more than the other.

Cervical Vertebrae Labeled

Cervical or Neck Sprains and Strains

Cervical or neck sprain and strains are extremely common in contact sports or those involved in manual labor, however- with the right mechanism anyone in the general population may suffer from this injury. A neck strain (kink in neck) is an injury to the muscles that move the cervical spine, whereas sprains are injuries to ligaments that provide stability to the overall joint. Both of these injuries usually occur by falls or sudden movements that overload or overstretch the joint. Symptoms can include muscle spasm, reduced range of motion, and pain. For moderate neck sprains and strains, pain can usually be managed by the patient through the use of non-steroidal anti-inflammatories (NSAIDs), ice, and rest.

Whiplash from Auto Accidents

Whiplash is another common neck injury that is often seen in motor vehicle accidents (MVA), sports injuries, falls, or trauma. Whiplash consists of a set of symptoms following an injury that sends the head into hyperextension followed by hyperflexion. This movement occurs in an instant. Neck sprains and strains may accompany whiplash due to the forces applied to the head during this moment in time. Whiplash may also affect joints or discs, which in turn may irritate nerve roots or possibly the spinal cord. Symptoms of whiplash may include pain, weakness/numbness/tingling down the arm, stiffness, dizziness, loss of function, or disturbed sleep. Delayed symptoms are not uncommon, and may present themselves a day or two following injury. It is suggested that you follow up with a health care professional following whiplash, pain medication and a cervical collar are most often times indicated as a method of treatment.

Herniated Discs in the Neck

Herniated discs are another common neck injury that occurs when the jelly-like substance on the inside of the disc, otherwise known as the nucleus pulposi, is pushed out and begins to seep into its outer fibrous tissue, the annulus fibrosis. Sometimes, the nucleus pulposi can move completely through the annulus fibrosis and put pressure on a nerve root- this is a disc herniation. When this occurs, you’ll most likely feel pain and have symptoms such as weakness, numbness, and/or pins and needles down your arm. Individuals may develop small tears in the annulus fibrosis over time which can lead to herniation. These tears may also occur in an acute event where there is a sudden, forceful stress to the cervical spine. Treatment for this injury generally starts with NSAIDs and physical therapy; however surgery may be indicated depending on individual patient outcomes. Click here to view a video explaining a herniated disc in the neck.

Illustration of disc herniation of the cervical spine

Stingers in the Neck

Stingers or burners are another common neck injury, most often times occurring in contact sports such as football and rugby. Stingers are temporary and short-lived injuries to the nerve root or brachial plexus and often occur following a forceful lateral bend of the neck, when the head and shoulder are forced in opposite directions simultaneously. Symptoms include burning, stinging, numbness/weakness, or an electrical sensation down one arm. Symptoms usually last less than a few minutes. If symptoms last longer than a few minutes, it is suggested that you follow up with a physician. You may suffer from spinal stenosis that places you at higher risk for catastrophic neck injury.

Cervical Fractures and Dislocations

Cervical fractures and dislocations are rare neck injuries that may be caused by trauma, falls, degenerative changes, or instability. The most serious neck fractures are generally accompanied by cervical dislocation. The angle of force at impact often determines that type and severity of the break. In the most severe dislocation, the bone is fully displaced anteriorly (forward), and locks in this position. The ligaments rupture completely, and in turn may damage the spinal cord and/or require surgical intervention. Treatment depends on a wide variety of factors including age, pre-existing medical conditions, and extent of damage to your spine. Prevention is the best treatment strategy.

X-Ray of C5 Cervical Fracture

Spinal Cord Injuries

Spinal cord injuries (SCI) result from a fracture, dislocation, or other neck injury that impedes on the spinal cord. If the spinal cord is damaged at C3 or above, the individual may die or need a respirator to live. Individuals who suffer from SCI often endure a lifelong disability with complete or incomplete paralysis below the level of the spinal lesion. Timeliness and type of medical treatment given at the time of injury are critical to survival and subsequent quality of life.

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By: Ehren Allen, DPT/Certified Manual Therapist