The most common cervical spine injuries are not spinal cord injuries or fractures, but cervical sprains and strains. A sprain is an injury to the ligaments; a strain is an injury to the muscle; in both conditions, pain is usually localized to the cervical area with limitation in motion that can be minimal to significantly severe, as, for example, in whiplash injuries.
Treatment is with mild analgesics, anti-inflammatories, ice, and physical therapy. A soft cervical collar can be helpful early on but should be eliminated as soon as symptoms abate. Surgery is not indicated.
Diagnosis is made primarily from clinical examination. An X-ray may be necessary to rule out acute injuries such as fractures or instability patterns, and an MRI might be required if a herniated disc problem is suspected.
Return to work at modified duties should be early (within 2-10 days after injury), even if at just sedentary tasks. Full duty can be started once the acute symptoms have resolved, in the great majority of cases within the first one to three months after the injury, even in severe sprains.