Neck Spasm

Neck Strain

Neck strain suggests an injury to the ligaments of the neck, either between the spinous processes as in a whiplash injury or, less commonly, in the ligaments holding the body of the vertebrae in alignment. In all cases, this leads to muscle spasm, which can make diagnosis difficult. The question becomes, “Is this the muscle causing the pain, or is it the muscle protecting an injury that is causing the muscle to spasm?”

Neck Pain in Sports

Neck injury most commonly occurs in contact sports, especially in football, where improper coaching or an ill-timed slip may lead to malpositioning of the neck during a tackle. Athletes in diving and water sports, wrestling, hockey, skiing, gymnastics (especially trampoline), soccer, martial arts, cheer-leading, and weight lifting are prone to neck injury.

Anatomy

The neck is formed by seven cervical vertebrae. Vertebrae are bones that create structure, allowing movement in some directions and restricting or limiting movement in others. They are separated by intervertebral disks, which serve as cushioning and help with dissipation of energy when the vertebrae are compressed. The zygoapophysial joints in the neck, also called the facet joints, are the joints that connect the vertebrae to each other. They are positioned in pairs, with one on each side of the vertebra connecting with the vertebra below and one on each side connecting to the vertebra above. Both intervertebral disks and facet joints are named by the vertebrae they connect. Because there are seven cervical vertebrae, the disk between the fourth and fifth vertebrae is called the C4-C5 disk, and the facet joint at that location is called the C4-C5 joint.

The vertebrae also create a space for the spinal cord, the vertebral foramen, which both the muscles and the bones in the neck work to protect. The peripheral nerves to both the neck and the arms extend from the spinal cord as it passes through the cervical vertebrae, and then these nerves pass through lateral openings in the cervical spine called intervertebral foramina. The muscles of the neck are numerous, with a posterior superficial, intermediate, and deep layer of muscles. The anterior muscles of the neck work to protect the neck, much like the abdominal muscles protect the lower back. The important muscles of the shoulder that connect to the neck include the trapezius, the levator scapula, the rhomboid minor, and the serratus posterior superior muscle.

Causes

The most common injuries to the neck muscles or ligaments are caused by motor vehicle accidents. Sports injuries and prolonged poor position of the [Page 977]neck during sleep or at work are also common precipitating factors. When the injury is to the muscle only, the muscle will heal within 2 to 3 weeks. If the muscle is protecting an injury to something else, or an infection, the spasm will tend to persist. In whiplash injuries, the injury is to the ligaments between the vertebrae. When the injury is to the facet joints, the muscles will spasm to keep the joints apart, as this reduces the pain from joint inflammation. If the injury is to the spinal cord, intervertebral disk, vertebrae, or peripheral nerves or is caused by infection, the muscles will spasm to keep the neck in an optimal position to create as much space for the spinal cord as possible. Sometimes the injury is actually to the shoulder, but because of muscle attachments and muscle spasm thresholds, the pain is felt more in the neck.

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