5 Most Common Causes of Neck Pain After a Car Accident
Neck injuries are one of the most common injuries experienced after a car accident. Thankfully, most neck injuries are not life-threatening and can be treated conservatively. In this post, we will examine the anatomy of the neck, the most common conditions that cause neck pain after an accident, and the signs and symptoms of neck injuries that require immediate medical intervention.
Anatomy of the neck
The neck, medically known as the cervical spine, consists of 7 vertebrae. Between each set of vertebrae there is a disc, as well as two joints that allow the vertebrae to rotate and move; these are called facet joints. In addition, there are also nerves that come out between each segment of the neck and descend into the arms. These are called nerve roots and they play an important role in conditions like neck pain and nerve injuries in the hand.
In addition to knowing the structures involved in the neck, it is also important to understand how each structure is named. The vertebrae themselves are given a number based on their position, with the first (top) vertebrae being labeled C1, the second one C2, all the way down to the bottom one being labeled C7.
The facet joints and discs are labeled based on which vertebrae they are between. For example, if we are talking about the disc that is between C2 and C3, we call it the C2-C3, or C2-3, disc. There is no disc between C1 and C2.
Finally, the nerves are also labeled based on where they exit the spine. For example, the nerve coming out between the base of the skull and C1 is called the C1 nerve root, the nerve coming out between C1 and C2 is the C2 nerve root, etc. This results in there being 8 cervical nerve roots, while there are only 7 cervical vertebrae (this is different than how the rest of the nerve roots in the spine are named).
Unlike the other regions of the spine, the shape of the vertebrae in the cervical spine is not consistent. In particular, C3-C7 have the same structure, while C1 and C2 are different. C2 looks similar to C3-C7, except that instead of having a flat body, it has what looks like a head; C1 is more circular than the rest of the cervical vertebrae and does not have a body (see picture below to see what these two vertebrae look like). It might seem like a weird configuration, but the way they are oriented allows significantly more rotation than between any other vertebrae. 50% of all of your head’s rotation comes from these 2 vertebrae!
5 Most Common Neck Injuries Following a Car Accident
1. Sprains and strains
While sprains and strains are similar, they are not the same. A sprain refers to an injured ligament (tissue that connects from a bone to another bone), while a strain refers to an injured tendon (tissue that connects from a bone to a tendon). Sprains and strains are very common following car accidents because the rapid force produced by a collision can stretch the tendons and ligaments beyond their typical capacity, causing tears within the tendons and ligaments. In low-velocity accidents (<30 mph), these tears are usually small and heal without surgery or injections. However, there are some ligaments that, if torn, can cause serious problems; we will address these in the next section.
2. Disc Herniation
When your body experiences a sudden, traumatic force from a car accident, it can put a lot of pressure on the discs, causing one or more to squish and press out of its location between the vertebrae. The most common directions for a disc herniation are backwards and slightly to the side (posterolateral), which is in the direction of the nerve roots, following by directly backwards (posterior), which is towards the spinal cord. Most disc herniations are 2-4 millimeters in diameter but can extend to 8 or more millimeters is some cases.
In addition to pain in the neck, one of the most common presentations of a disc herniation is pain into the arm. The location of the pain and symptoms in the arm can help determine which nerve root is injured. It is important to note that if you begin to lose feeling in the arm or begin losing strength, you should see a healthcare practitioner for further evaluation. To learn more about disc herniations in general and how physical therapy can help, click here.
3. Facet Joint
When involved in a MVA, it is common for the facet joints to become compressed, resulting in a feeling of your back being “locked up.” The most common presentation of this type of injury is pain when extending your neck or bending towards the side of the pain. This is because you are taking a joint that is already compressed and compressing it even further. This injury is very similar to the crick you sometimes get in your neck if you sleep funny.
4. Nerve injury
I mentioned nerve injuries a little under the Disc Herniation section. It is common for the nerve roots and/or the spinal cord to be injured in a car accident. This can occur due to pressure from a disc on the nerve, compression of the nerve between the two vertebrae, or simply due to irritation of the nerve by the chemicals involved in responding to the general injury in the neck region.
5. Muscle dysfunction
When your neck experiences a traumatic injury, such as a car accident, the muscles located deep in your neck, next to your spine, can stop working properly. This dysfunction is compounded by the degree of decreased activity you experience as you heal from the accident. Appropriately-dosed exercise is very important for maintaining the function of these muscles.
Neck Injury Red Flags
As I mentioned above, there are certain injuries that can be life threatening. These injuries range from damage to the brain or spinal cord, fracture of the cervical vertebrae, injured ligaments between C1 and C2, and many others. While not exhaustive, here is a list of signs and symptoms that can help you identify if you may have one of these serious injuries and seek immediate help:
- Bilateral (both sides of body) pins and needles or numbness
- Double vision (diplopia)
- Dizziness
- Nausea and Vomiting
- Drop attacks (sudden, unexplained falls)
- Difficulty speaking (dysarthria)
- Feeling of a lump in the throat/difficulty swallowing (dysphagia)
- Unexplained lack of coordinated movement (ataxia)
- Nystagmus
Summary
Neck pain following a car accident is very common and there are a variety of injuries that can cause pain in this region. While rare, there are some injuries to this region that can be life-threatening and require immediate medical attention. A physical therapist can help you recover from a neck injury after a car accident, as well as identify these life-threatening conditions and refer you to the appropriate provider.
Western Slope Rehab and Performance is Here to Help
If you are struggling with injuries or have recently been in a motor vehicle accident, we can help. We are a physical therapy company that provides home-based orthopedic services in the Grand Junction, CO, area, as well as telehealth appointments throughout Colorado. If you would like to schedule a free consultation, you can call us as 970-462-9177, or fill out our contact form here.
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