Cervical Sprain and Strain

Cervical strain is one of the most common musculoskeletal problems encountered by generalists and neuromusculoskeletal specialists in the clinic.
A normal and straightened lordatic curve are shown below.
Radiograph of the cervical spine shows a normal lordotic curve. Radiograph of the cervical spine shows straightening of the lordotic curve. One cause of cervical strain is termed cervical acceleration-deceleration injury; this is frequently called whiplash injury.
Whiplash, one of the most common sequela of nonfatal car injuries, is one of the most poorly understood disorders of the spine, and the severity of the  is often not correlated with the seriousness of the clinical problems.^[1] A history of neck injury is a significant risk factor for chronic neck pain.^[2] Pretorque of the head and neck increases facet capsular strains, supporting its role in the whiplash mechanism.^[3]
The Quebec Taskforce on Whiplash-Associated Disorders has suggested the following system for classifying the severity of cervical sprains^[4] :

• 0 - No neck pain complaints, no physical signs
• 1 - Neck pain complaints, only stiffness or tenderness, no other physical signs
• 2 - Neck complaints and musculoskeletal signs (decreased range of motion [ROM] and point tenderness)
• 3 - Neck complaints and neurologic signs (weakness, sensory and reflex changes)
• 4 - Neck complaints with and/or dislocation