What is the treatment for a crick in the neck?

Treatment for Acute Neck Strain ("Crick in Neck")

For acute neck strain, you should remain active with early mobilization and exercise rather than immobilization, combined with NSAIDs or muscle relaxants for short-term pain control, while avoiding prolonged use of soft collars that lead to muscle weakness. 1

Immediate Management Approach

Activity and Movement

• Stay active and avoid complete immobilization – activity promotes better healing while prolonged rest leads to stiffness, muscle weakness, and delayed recovery 1
• Begin gentle range-of-motion exercises as soon as tolerable 1
• Return to normal daily activities progressively rather than waiting for complete pain resolution 2

Pain Control Options

• NSAIDs (ibuprofen, naproxen) provide effective pain relief for acute neck strain 3, 2
• Muscle relaxants can be used for short-term symptom control 2
• Low-level continuous heat applied between therapy sessions significantly reduces pain and improves range of motion 3
• Cold applications may also provide relief, though evidence is limited 4, 2

Physical Therapy Interventions

• Multimodal care (combination of manual therapy, exercise, and self-management) is the most effective approach for recent-onset neck pain 5
• Manipulation or mobilization by trained practitioners can be offered for grades I-II neck pain 5
• Range-of-motion home exercises should be initiated early 5
• Consider referral to physiotherapy if pain persists beyond expected timeframe 1

What to Avoid

Common Pitfalls

• Do not use soft collars beyond 1-2 days – prolonged use causes muscle weakness and delays recovery 1, 2
• Avoid complete bed rest or immobilization – this worsens outcomes 1
• Do not prescribe antibiotics unless clear signs of bacterial infection are present (fever, warmth, erythema, localized swelling) 1
• Avoid unnecessary imaging in the absence of red flags – this does not improve outcomes and increases costs 1

When to Escalate Care

Red Flags Requiring Urgent Evaluation

• Constitutional symptoms (fever, unexplained weight loss) suggest serious underlying pathology 1
• Neurological deficits (weakness, numbness, tingling radiating to arms) or signs of spinal cord involvement require urgent imaging 1
• Severe trauma history or mechanism suggesting fracture 1
• If these are present, MRI without contrast is the appropriate imaging modality 1

Follow-Up Monitoring

• Monitor weekly for changes in pain intensity 1
• Contact healthcare provider if strain worsens, doesn't improve within 2-3 weeks, or new symptoms develop 1
• Nearly 50% of individuals with neck pain experience recurrent symptoms, making patient education about self-management crucial 1

Ergonomic Modifications

• Implement workplace and home ergonomic adaptations to reduce ongoing neck strain 1
• Address postural factors that may contribute to symptoms 2