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neck injury

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Site of neck X-ray

Neck X-ray

Alternative Names 
C-spine injury, neck fracture, neck strain

Definition
A neck injury is any injury to the soft tissue, bony, or nerve structures of the neck.

What are the signs and symptoms of the injury? 
A neck injury can cause:
  • neck pain
  • neck stiffness
  • weakness on one or both sides of the body
  • difficulty walking
  • holding the head in an unusual position
  • feeling like "my head is going to slip off"
  • shock
  • headache
  • numbness or tingling in various parts of the body
  • loss of bladder or bowel control
What are the causes and risks of the injury? 
The most common causes of neck injuries are motor vehicle accidents. Other causes include:
  • recreational and sports activities, especially contact sports such as football
  • bullet or stab wounds
  • direct trauma to the face
  • electrical injury
  • falling
What can be done to prevent the injury? 
While some neck injuries cannot be prevented, good safety techniques can minimise a person's risk. It is important to:
  • Get regular exercise.
  • Practice good posture and proper lifting techniques.
  • Wear a seat belt and be sure the headrest is properly adjusted when in a moving vehicle.
  • Avoid alcohol when driving.
  • Avoid diving into lakes, rivers, and surf where depth is not known.
  • Wear protective gear and take care during contact sports such as football.
  • Follow sports safety guidelines for children, adolescents, and adults.
  • Wear a helmet when riding motorcycles and all-terrain vehicles.
When someone has a spinal injury, any motion of the neck could cause paralysis. It is important to seek medical help immediately and avoid moving the person.

How is the injury recognised? 
The first step in diagnosing a neck injury is a complete history and physical examination. For diagnosing bony abnormalities, X-rays are normally used. A CAT scan may be used to rule out fractures. An MRI can also be used to diagnose injuries to the discs as well as injuries to the spinal cord.

What are the treatments for the injury? 
First aid for a person with a neck injury includes the following steps:

1. Call for emergency medical help immediately. Check to see if the victim is breathing and whether the airway is blocked. If necessary, start cardiopulmonary resuscitation, or CPR. The chin should be lifted without moving the head and neck. It is important to steady the victim's head, using belts, tape, pillows, or a helper's hands.

2. Keep the person's head, neck, and back in a straight line. If the person needs to be moved, several people should roll him or her as a whole unit. A plank, gurney, or back board can be used to roll the individual as a unit.

3. If the person must be moved to protect him or her from further injury, and there is only one rescuer, grab the victim's clothes and drag the victim away from the danger.

4. If the victim is choking or vomiting, roll him or her as a whole unit to one side to help clear the airway.

5. Keep the person warm.

6. Give first aid for obvious injuries and stay with the person until medical help arrives.

What are the side effects of the treatments? 
The biggest risk in dealing with a person with a neck injury is worsening the injury. This can lead to permanent paralysis on one side or in both legs.

What happens after treatment for the injury? 
Severe neck injuries generally require fairly lengthy neurosurgical treatment. Frequent evaluations will be needed over the next several months to years. If there is paralysis, lifelong treatment will be needed. Many people recover fully and have no long-lasting side effects from the injury. An individual who retains some function after the injury will usually benefit from physiotherapy and occupational therapy.

Author: James Broomfield, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 17/10/2004
Contributors
Potential conflict of interest information for reviewers available on request
 


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