Your neck is made up of a number of bones bound together by strong discs and ligaments. It is also protected by strong muscles.

Neck sprains can involve an overstretching of the ligaments and muscles. Often symptoms may not arise for several hours or even one to two days after injury.

Common complaints include pain and stiffness in the neck, jaw, shoulders, upper back and sometimes lower back.

Headaches, nausea, dizziness, loss of concentration and tearfulness can also occur. Symptoms may last from a few days to a few weeks.

It is reassuring to know that most neck sprains are not serious and rarely result in permanent harm.

All recent research strongly advises an early return to normal activity.

This page gives general advice on how to manage your injury.

During the first 24 - 48 hours

• You may be aware of your neck becoming more stiff and painful. Depending on your level of symptoms and the type of job you do, you may need to rest and stay off work for a day or two. However, if symptoms allow, try to continue with normal daily activities. This will not cause further damage to your neck. Just be sensible and take things steady, or change the way you do them.
• Where necessary take medication to ease the symptoms. It will be most effective if taken at regular intervals.
• Either heat or cold can be used to relieve pain in the back of the neck and shoulders. Use whatever gets best results for you. A bag of frozen peas wrapped in a damp towel can be applied for up to 20 minutes. For maximum effect apply every two hours. Alternatively, you may prefer heat using a heat pad, hot water bottle (in a cover) or having a hot shower. Heat and cold can cause burns so remove if uncomfortable.
• Adopt positions that are comfortable for you, but move around frequently to prevent stiffness. Good posture is important, so avoid slumping when sitting. If necessary, place a small rolled towel or a cushion in the lower back to give support.
• When lying, you may find it helpful to alter your pillow height. A small rolled towel can be placed in the bottom edge of your pillow case, or you can tie your pillow in half (butterfly pillow) for extra support.
• Avoid sleeping on your front.

After 48 hours

It is essential to start exercising your neck and shoulders. Restoring range of movement will make everyday activities easier and less uncomfortable. Remember - movement is good for you.

The following exercises should be performed slowly and thoroughly moving into discomfort but short of pain. Before you start, make sure you are sitting up straight on a firm chair.

Exercise 1

• Sit up tall, gently tuck your chin in and lengthening the back of your neck as you do so. Relax your shoulders.
• Repeat 5 times.

Exercise 2

• Sit up tall, with the chin tucked in turn your head, looking over each shoulder in turn. Move within comfortable limits, feeling a pull or stretch but do not push into pain.
• Repeat 5 times each side.

Exercise 3

• Tilt your head to one side dropping your left ear down towards your left shoulder. Hold for a count of three and repeat to the right side. Relax your shoulders away from your ears.
• Repeat 5 times each side.

Exercise 4

• Neck Tilt: Gently drop your chin towards your chest, hold for 3 seconds and return to the start position.
• Repeat 5 times. 

Exercise 5

• Stretch up above your head as far as is comfortable with each arm in turn. Then reach up behind your back with one arm then the other.

Repeat each exercise 3 times. 

Other useful advice

• If the pain in your neck becomes worse do the exercises less frequently or a little more gently.
• Aches and twinges can last for quite a few weeks.
• Tense muscles caused by stress, poor posture or anxiety can make things feel worse, you might find controlled breathing, relaxation and dropping your shoulders away from your ears helps.
• Normal activities are good for the healing process but if things are too painful try and find alternative ways of doing things.

You can return to exercise such as swimming, cycling and gentle gym activities. However, avoid impact and contact sports until you feel fully fit, free of pain, mobile and strong.

Depending on how severely your neck is sprained it may take up to eight weeks to recover, occasionally longer.

If you are still struggling to get back to your normal level of activity after 8 weeks consult your GP.

It is quite normal to be aware of the following:

• Morning stiffness in the neck.
• Discomfort at the end of stretching movements.
• Discomfort after being in one position for some time.

All this should gradually settle as your neck recovers and strengthens.

Remember

• Rest is needed for no more than 1 - 2 days.
• After 48 hours start exercises to regain movement.
• Stay active and keep moving.
• Try and continue with normal daily activities, just modify them.
• By 8 weeks you should have returned to all of your usual activities.

Following a neck sprain injury some people can complain of dizziness, headaches, blurred vision and problems with swallowing these symptoms should only last for a short while.

See your GP if any of these symptoms don’t clear up.

Children: if symptoms persist please come back to the Emergency Department.

Warning

Stop the exercises above if any of the following consistently occur and contact your doctor.

• Pins and needles or numbness in arms or legs.
• Difficulty with balance or walking.
• Disturbed vision.
• Dizziness.
• Pain spreading into your arm.

© North Bristol NHS Trust. This edition published April 2024. Review due April 2027. NBT002258.