What are the symptoms and treatment options for cervical muscle strain (neck muscle strain)?

From the Guidelines

Neck muscle strain can be effectively managed with a combination of rest, pain relief, and gentle movement, as recommended by the most recent guidelines 1. The initial treatment should focus on nonpharmacological approaches, such as physical therapy, heat/cold, and orthotics, as suggested by the American Heart Association 1. When choosing any medication, both safety and efficacy should be considered, and the least risky medication should be tried first, with escalation only if the first medication is ineffective 1. Some key points to consider in the management of neck muscle strain include:

• Applying ice to the affected area for 15-20 minutes every 2-3 hours during the first 48-72 hours to reduce inflammation and pain
• Taking over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) as needed for pain relief
• Avoiding activities that worsen the pain and considering using a soft cervical collar for short periods if recommended by a healthcare provider
• Beginning gentle neck stretches and range-of-motion exercises to prevent stiffness and promote healing after the initial rest period
• Applying heat therapy using a warm towel or heating pad for 15-20 minutes several times daily after the first 72 hours to improve blood flow and relax tight muscles
• Maintaining good posture throughout the day and considering ergonomic adjustments to the work setup It is essential to note that most neck strains improve within 1-2 weeks with proper self-care, but persistent pain lasting more than two weeks, severe pain, numbness, tingling, or weakness in the arms or hands warrants medical attention as these could indicate a more serious condition 1.

From the FDA Drug Label

Cyclobenzaprine hydrochloride tablets are indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions Improvement is manifested by relief of muscle spasm and its associated signs and symptoms, namely, pain, tenderness, limitation of motion, and restriction in activities of daily living

Neck muscle strain can be considered a type of musculoskeletal condition.

• The medication cyclobenzaprine is indicated for relief of muscle spasm associated with acute, painful musculoskeletal conditions.
• Cyclobenzaprine may be used to treat neck muscle strain as an adjunct to rest and physical therapy. 2 2

From the Research

Treatment Options for Neck Muscle Strain

• The use of low-level continuous heat (LLCH) and Ibuprofen as an adjunct to physical therapy can improve pain relief, range of motion, and compliance for home exercise in patients with nonspecific neck pain 3.
• Applying heat or cold packs to the affected area can provide mild pain relief, with no significant difference between the two treatments 4.
• Combination therapy with cyclobenzaprine and ibuprofen may not be superior to cyclobenzaprine alone in treating acute neck and back pain with muscle spasm 5.
• Heat and cold therapy can reduce pain in patients with delayed onset muscle soreness, with cold water immersion and hot pack therapy showing the most significant effects 6.

Pain Relief and Management

• LLCH and Ibuprofen can significantly reduce pain and improve range of motion in patients with chronic neck pain 3.
• The addition of heat or cold packs to ibuprofen therapy can result in similar improvements in pain severity 4.
• Cyclobenzaprine, with or without ibuprofen, can provide significant improvements in pain, spasm, and patient global impression of change 5.
• Heat and cold therapy can reduce pain in patients with delayed onset muscle soreness, with effects lasting up to 24 hours 6.

Treatment Considerations

• Patient and practitioner preferences, as well as availability, should guide the choice of heat or cold therapy 4.
• The use of LLCH and Ibuprofen as an adjunct to physical therapy may improve compliance for home exercise 3.
• Combination therapy with cyclobenzaprine and ibuprofen may not offer additional benefits over cyclobenzaprine alone 5.
• High-quality studies are needed to confirm the effectiveness of cold or heat therapy in reducing pain and promoting recovery 6.