A 13 year old boy comes to clinic with neck pain. He was playing football about thirty minutes before arrival to the clinic and was struck by an opponent head on. He said the player “head-butted” him in the helmet, snapping his neck backwards. He immediately felt pain in the back of his neck and mild dizziness. He denies numbness, tingling, or weakness in any of his limbs. His parents drove him over in their car for evaluation.
On exam, the boy is still in his football uniform with shoulder pads in place. He is in a hard neck collar which was placed on him by the triage nurse. He is crying, more from pain, he says, than embarrassment. He has normal strength and sensation in his arms and legs but has tenderness along his cervical (neck) spine.
An ambulance is called and the child is sent on a back-board to the Emergency Room to have a CAT scan of his neck.
Neck injuries are very common and usually occur after a direct blow to the head or neck, after a fall, or during a car accident. The spinal cord which contains nerves that carry information between your brain and the rest of the body pass through the neck and back. An injury in this area can cause nerve damage and if severe, paralysis below the site of the injury.
Symptoms to suggest a spinal injury include neck pain, numbness and tingling in an arm or leg, weakness, or trouble walking.
If you suspect that someone has a spinal injury, keep them very still and call 911. Do not attempt to move them (unless it’s an emergency) or straighten their neck. Any additional movement can cause more damage. Sometimes a medical professional can determine that a cervical spine injury is unlikely based solely on history and exam. Sometimes special x-rays are needed to be sure.
In the emergency room, the patient was sent for a CAT scan of his neck which was normal. He was diagnosed with a neck sprain. He was sent home with a soft collar for comfort and pain medication. Within two weeks, his neck pain had completely resolved.
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