Neck Pain After a Fall: When to Seek Medical Attention

Neck pain

Hello doctor, I slipped in the bathroom the day before yesterday and hit the back of my head on the threshold.
That night, I noticed that when lying down, lifting my neck caused some pain and tightness.
It has persisted until today; turning my head slightly to the left or right and moving it up and down also causes pain.
There is a specific spot in the front of my neck that hurts when I touch it.
When lying down, I need to support my head to sit up without experiencing pain.
I would like to know if this is a neck strain and if I need to see a doctor again.
Thank you.

Jiaxuan, 20~29 year old female. Ask Date: 2020/07/19

Dr. Jiang Junyi reply Neurology

Hello, based on your description, your symptoms seem more like a neck muscle strain.
Regarding intracranial hemorrhage, if there is no loss of consciousness, no anticoagulant use, or obvious local hematoma, head trauma is mostly mild.
However, consider delayed bleeding and seek emergency care if you experience any of the following: (1) worsening vision, seeing double (diplopia), or unequal pupil sizes.
(2) Clear fluid or blood leaking from the ears or nose.
(3) Confusion or abnormal behavior.
(4) Numbness or inability to move limbs.
(5) Localized involuntary twitching or seizures.

As for cervical myofascial pain, I recommend the following:
1.
Change positions: Change your position every 15 minutes to allow the neck tissues to rest.
Any position (including normal ones) maintained for a prolonged period can lead to fatigue and inflammation, so moving around briefly can reduce the chance of muscle inflammation.

2.
Rest: Rest is important to allow the muscles to utilize their self-repair capabilities; avoid vigorous exercise during this time.

3.
Heat therapy: Apply a warm compress for 15 to 20 minutes, ensuring the temperature is safe to avoid burns.

4.
Nonsteroidal anti-inflammatory drugs (NSAIDs): If you do not have a history of peptic ulcers, allergies to NSAIDs, or impaired kidney function, consider using NSAIDs to reduce inflammation and alleviate pain as needed.

5.
Neck muscle stretching exercises: After the acute pain phase, develop a habit of slow, gentle neck stretches every 15-20 minutes at angles that do not cause discomfort, moving the neck up, down, left, and right.

I suggest discussing examination and treatment options with a neurologist or a rehabilitation specialist.
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Hospital cares about you.

Reply Date: 2020/07/19

More Info

Experiencing neck pain after a fall, especially one that involves a direct impact to the back of the head, can be concerning. Your symptoms, which include pain when moving your neck, tightness, and discomfort when trying to sit up, suggest that you may have sustained a soft tissue injury, such as a strain or sprain, or possibly a more serious injury like a concussion or cervical spine injury.

Understanding Your Symptoms
1. Soft Tissue Injury: The neck is composed of muscles, ligaments, and tendons that can be strained during a fall. Symptoms of a strain may include localized pain, stiffness, and difficulty moving the neck. The tightness you feel could be due to muscle spasms in response to the injury.

2. Cervical Spine Injury: Given that you hit your head, there is a possibility of a cervical spine injury. Symptoms of a more serious injury may include severe pain, numbness, tingling in the arms or hands, or weakness. If you experience any of these symptoms, it is crucial to seek medical attention immediately.

3. Concussion: If you experienced any dizziness, confusion, or headaches after the fall, you might also be at risk for a concussion. This is a type of traumatic brain injury that can occur even if you did not lose consciousness. Symptoms can include headache, nausea, balance issues, and cognitive difficulties.

When to Seek Medical Attention
Given your current symptoms, it is advisable to consult a healthcare professional for the following reasons:
- Persistent Pain: If the pain does not improve or worsens over the next few days, it is essential to have it evaluated. Persistent pain can indicate a more serious underlying issue that may require imaging studies, such as X-rays or an MRI, to assess for fractures or other injuries.

- Neurological Symptoms: If you experience any neurological symptoms, such as numbness, tingling, weakness, or changes in vision or coordination, you should seek immediate medical attention. These symptoms could indicate nerve involvement or a more severe injury.

- Difficulty Moving: If you find it increasingly difficult to move your neck or if the pain becomes unbearable, it is a sign that you should see a doctor. They may recommend physical therapy, pain management strategies, or further diagnostic testing.

Recommendations for Management
While waiting to see a doctor, you can take some steps to manage your symptoms:
- Rest: Avoid activities that exacerbate your pain. Give your neck time to heal.

- Ice Therapy: Applying ice to the affected area can help reduce swelling and numb the pain. Do this for 15-20 minutes every hour as needed.

- Over-the-Counter Pain Relief: Medications such as ibuprofen or acetaminophen can help alleviate pain and reduce inflammation. Always follow the recommended dosage.

- Gentle Stretching: Once the acute pain subsides, gentle neck stretches may help improve flexibility and reduce stiffness. However, avoid any movements that cause pain.

Conclusion
In summary, while your symptoms may indicate a soft tissue injury, the mechanism of injury and the presence of pain warrant a thorough evaluation by a healthcare professional. It is always better to err on the side of caution, especially when it comes to potential head and neck injuries. If your symptoms persist or worsen, please seek medical attention promptly. Your health and safety should always be the priority.

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