Pulled muscle is an alternate term for a muscle strain. Either way, it sounds -- and is -- painful. In his book, "Conservative Management of Cervical Spine Syndromes," Donald Murphy, D.C., defines a neck strain as a partial or complete tearing of the muscles and associated tissues supporting the neck. Knowing the signs and symptom patterns of this injury can help distinguish it from other conditions and facilitate appropriate treatment decisions.
Muscle Strain or Something Else
Medical literature often lumps neck strains with other types of simple, or uncomplicated, neck pain. This is done to draw a distinction between these conditions and more complicated neck problems, such as disc herniation, infection, arthritis or tumors. But uncomplicated cases of neck pain can be further differentiated. A true pulled or strained neck muscle can usually be distinguished from other sources of uncomplicated neck pain by looking at how the pain started. Pulling a muscle requires some element of force. This means that a fall, jolt or muscular exertion precipitates the injury. Sitting at the computer too long or sleeping in an awkward position may lead to symptoms similar to a pulled neck muscle, but those activities do not introduce the types of forces necessary to tear muscle or associated tissue in the neck. The timing of the onset of symptoms is a helpful clue. Sudden pain associated with a force or exertion is characteristic of a pulled neck muscle.
What Makes It Feel Worse
When muscle fibers and associated structures tear, the contents of the fibers spill into the nearby tissues. Small blood vessels are often also torn, causing blood to leak into the environment. This results in localized inflammation and pain. The pain will be localized to the side of the injured muscle. This pain is typically achy, but it may be sharp with movement. The damaged muscle feels worse when it is under tension, so stretching a newly strained muscle is painful. Attempting to strongly contract the damaged muscle is also painful. Increased pain while pushing the head against resistance is expected with a pulled muscle. The injured muscle is also tender when pressed on or rubbed.
What Makes It Feel Better
A pulled muscle feels better when placed in a position of rest. This is in contrast to many other types of neck stiffness that feel better with movement or light stretching. The best first-aid treatments for a pulled muscle injury include rest and ice applications. These measures help reduce inflammation and usually make a pulled muscle feel better. According to a review article published in 2012 in the "International Scholarly Research Network," these measures may also reduce bleeding and swelling and minimize the scar formation near the tear.
Could It Be Something Else?
Guidelines from the Medical College of Wisconsin warn that certain symptoms in the presence of neck pain may indicate something more serious than a pulled muscle. Unexplained weight loss, fever or chills, recent infection, numbness or weakness into the arms or legs and pain that is worse at night or during rest typically indicate a problem other than a pulled muscle and should prompt a visit to your doctor. Medical evaluation may also be needed in cases of traumatic injury to the neck to determine whether there is any loss of spinal stability. Significant trauma to the neck may damage the ligaments or bones that protect the spinal cord.
Is This an Emergency?
- Conservative Management of Cervical Spine Syndromes; Donald R. Murphy
- Journal of the American Board of Family Medicine: Evaluation and Treatment of Posterior Neck Pain in Family Practice
- International Scholarly Research Network, Orthopedics: Treatment of Skeletal Muscle Injury -- A Review
- Medical College of Wisconsin: Management of Back and Neck Pain