{"id":27887,"date":"2026-05-14T09:37:16","date_gmt":"2026-05-14T08:37:16","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=27887"},"modified":"2026-08-07T08:19:15","modified_gmt":"2026-08-07T07:19:15","slug":"traumatic-onset-neck-pain","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/traumatic-onset-neck-pain\/","title":{"rendered":"Traumatic onset neck pain"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">Definition<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Acute cervical spine trauma encompasses a wide range of potential injuries ranging from a seemingly innocuous fall to a high-energy motor vehicle accident. Most patients present immediately after a traumatic incident, but some may present days to weeks later.&nbsp; The presentation of the individual case will determine urgency considerations.&nbsp; Further information is provided below about traumatic neck pain and specifically Whiplash Associated Disorder (WAD).<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Typical signs &amp; symptoms:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Central neck pain<\/li>\n\n\n\n<li>Loss of sensation or paralysis in the body, arms, and\/or legs<\/li>\n\n\n\n<li>Pain that radiates from the neck into the arms and\/or shoulders<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Prevalence<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Cervical trauma results primarily from motor vehicle accidents, falls (especially in the elderly), sports activities, and diving into shallow water.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Risk Factors<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Age 18-25 (80%) or &gt;65 years (especially if they have risk factors for osteoporosis)<\/li>\n\n\n\n<li>A fall from a height &gt;1 metre or 5 steps<\/li>\n\n\n\n<li>An axial load to the head (e.g., diving, high-speed motor vehicle collision, rollover motor accident, ejection from a motor vehicle, accident involving motorised recreational vehicles, bicycle collision, horse riding accident)<\/li>\n\n\n\n<li>Approximately one third of patients with cervical spine and\/or spinal cord injuries have an associated head injury<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Prognosis<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Most patients with acute neck pain or whiplash will recover completely in a matter of days to weeks. Approximately one third of patients will experience persistent symptoms.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><em>Risk factors for poor outcome<\/em><\/h5>\n\n\n\n<ul class=\"wp-block-list\">\n<li>High intensity initial pain is associated with persistent neck pain and disability<\/li>\n\n\n\n<li>There is a positive association between post-traumatic stress symptoms and outcome<\/li>\n\n\n\n<li>Negative expectations of recovery are associated with ongoing neck pain and disability<\/li>\n\n\n\n<li>Self-rated collision severity may be predictive of poor recovery<\/li>\n\n\n\n<li>Decreased initial neck range of motion and initial cold hyperalgesia are predictive of ongoing disability<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Other considerations<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline\"><em>Canadian C Spine rule<\/em><\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Patients with traumatic neck pain are typically managed through A&amp;E. However, prior to completing a physical examination, it is important to apply the&nbsp;<a href=\"https:\/\/www.mdcalc.com\/calc\/696\/canadian-c-spine-rule\" target=\"_blank\" rel=\"noreferrer noopener\">Canadian C Spine Rule<\/a>&nbsp;if appropriate.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Patients with&nbsp;known vertebral disease (i.e. ankylosing spondylitis, rheumatoid arthritis, spinal stenosis, previous cervical spine surgery), hypermobile patients (inc. Ehlers Danlos syndrome and Marfan&#8217;s), Down\u2019s syndrome, and gymnasts should have a higher level of suspicion of cervical spine injury.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Whiplash Associated Disorder (WAD)<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Whiplash is subcategory of traumatic neck pain, some specific WAD information is below.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">WAD Patient Resources<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/bestpractice.bmj.com\/patient-leaflets\/en-gb\/pdf\/1554094933496\/Whiplash.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">BMJ \u2013 Best Practice \u2013 Whiplash Patient Leaflet<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/muscle-bone-and-joints\/conditions\/whiplash\/#:~:text=Whiplash%20happens%20when%20your%20head,involved%20in%20a%20car%20accident\" target=\"_blank\" rel=\"noreferrer noopener\">NHS Inform &#8211; Whiplash<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Whiplash Classification &#8211; Quebec Task Force Classification of whiplash-associated disorders<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>neck pain and associated symptoms in the absence of objective physical signs.<\/li>\n\n\n\n<li>neck pain and associated symptoms in the presence of objective physical signs and without evidence of neurological involvement.<\/li>\n\n\n\n<li>neck pain and associated symptoms with evidence of neurological involvement including decreased or absent reflexes, decreased or limited sensation, or muscular weakness.<\/li>\n\n\n\n<li>neck pain and associated symptoms with evidence of fracture or dislocation.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Differential diagnosis<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Non-traumatic neck pain<br>Acquired torticollis<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>M.A &amp; P.A &#8211; 14-05-26<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Definition Acute cervical spine trauma encompasses a wide range of potential injuries ranging from a seemingly innocuous fall to a high-energy motor vehicle accident. Most patients present immediately after a traumatic incident, but some may present days to weeks later.&nbsp; The presentation of the individual case will determine urgency considerations.&nbsp; Further information is provided below<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[1388,1391],"class_list":["post-27887","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-serious-cervical-spine-conditions-red-flags","category-https-apps-nhslothian-scot-refhelp-traumatic-onset-neck-pain"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"mariamazoysaavedra","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/mariamazoysaavedra\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/musculoskeletal-physiotherapy\/cervical-thoracic-spine\/https-apps-nhslothian-scot-refhelp-serious-cervical-spine-conditions-red-flags\/\" rel=\"tag\">Serious Cervical Spine Conditions<\/a><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/musculoskeletal-physiotherapy\/cervical-thoracic-spine\/https-apps-nhslothian-scot-refhelp-serious-cervical-spine-conditions-red-flags\/https-apps-nhslothian-scot-refhelp-traumatic-onset-neck-pain\/\" rel=\"tag\">Traumatic onset neck pain<\/a>","rttpg_excerpt":"Definition Acute cervical spine trauma encompasses a wide range of potential injuries ranging from a seemingly innocuous fall to a high-energy motor vehicle accident. Most patients present immediately after a traumatic incident, but some may present days to weeks later.&nbsp; The presentation of the individual case will determine urgency considerations.&nbsp; Further information is provided below","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27887","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=27887"}],"version-history":[{"count":3,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27887\/revisions"}],"predecessor-version":[{"id":27919,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27887\/revisions\/27919"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=27887"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=27887"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}