From the Guidelines
Cervical strain is most strongly associated with risk factors such as female gender, older age, coexisting psychosocial pathology, and radicular symptoms, as these factors are linked to a poor prognosis 1. When considering the risk factors for cervical strain, it's essential to prioritize those that have the most significant impact on morbidity, mortality, and quality of life.
- Key risk factors include:
- Female gender
- Older age
- Coexisting psychosocial pathology
- Radicular symptoms These factors are crucial in determining the likelihood of developing cervical strain and its potential severity.
- Additionally, other factors such as poor posture, occupations requiring repetitive neck movements, sudden trauma from whiplash, weak neck muscles, and psychological stress can also contribute to the development of cervical strain. However, the most critical risk factors, as identified in the most recent and highest quality study, are female gender, older age, coexisting psychosocial pathology, and radicular symptoms 1. It's essential to consider these factors when assessing the risk of cervical strain and developing strategies for prevention and management.
- Understanding these risk factors can help individuals implement preventive measures like proper ergonomics, regular stretching, strengthening exercises, and stress management techniques to reduce the likelihood of developing cervical strain.
From the Research
Risk Factors for Cervical Strain
- Motor Vehicle Collision (MVC) is a significant risk factor for cervical spine injury, with an odds ratio (OR) of 1.61 (1.26,2.06) 2
- Falls are also a significant risk factor, with an OR of 2.14 (1.63,2.79) 2
- Age less than 40 years is a risk factor, with an OR of 1.75 (1.38-2.17) 2
- Pelvic fracture is a significant predictor of cervical spine injury, with an OR of 9.18 (6.96,12.11) 2
- Injury Severity Score (ISS) greater than 15 is also a significant predictor, with an OR of 7.55 (6.16-9.25) 2
Interactions Between Risk Factors
- Significant interactions between pelvic fracture and fall, and pelvic fracture and head injury, are associated with a markedly increased risk of cervical spine injury, with ORs of 19.6 (13.1,28.8) and 27.2 (10.0-51.3), respectively 2
Treatment and Management
- There is little benefit to routinely using or adding cyclobenzaprine to NSAIDs for patients with acute cervical strain 3
- Strong recommendations are made for the treatment of chronic neck pain with manipulation, manual therapy, and exercise in combination with other modalities 4
- Moderate recommendations are made for the treatment of acute neck pain with manipulation and mobilization in combination with other modalities 4