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What to Know About Neck Collars

Medically Reviewed by Dan Brennan, MD on April 12, 2021

Neck collars: we've all seen them. They're the soft squishy collars that people wear after car accidents or neck surgery. Or they're the stiff plastic things paramedics are always yelling for on TV shows, just before someone gets strapped to a board.

But what is a cervical collar really for? And when should you really use one?

What Is a Neck Collar?

A neck collar, also known as a neck brace or cervical collar, is an instrument used to support the neck and spine and limit head movement after an injury. Its purpose is to prevent you from moving your head and neck until the injury is healed.

What Are the Types of Neck Collars?

In general, there are three types of neck collars.

Soft collars. They are made of foam rubber, polyethylene, or sometimes, inflatable cuff, and they fit around the neck. These collars allow for some range of movement, mostly forward and backward, while limiting side-to-side movement.

Soft collars are used in the rehabilitation of whiplash and neck sprains and to provide support for chronic neck pain, especially in older people.

Rigid collars. These collars are made of a plastic shell over a foam or vinyl core. They are most restrictive among all neck collars. They are used when the doctors want to stop almost all movement of the neck in any direction.

A rigid collar is used after surgery or after severe trauma, such as cervical fractures, where healing will take a long time. Rigid or hard collars usually extend from the jaw to the collarbone.

Sport Collars. These collars represent a specialized type of rigid collars. They are used by racecar drivers, motocross riders, and ATV riders, all of whom engage in high-speed, high-impact driving, to prevent neck damage in cases of collisions or sudden stops.‌‌

They are extremely effective in saving lives and preventing the need for the other types of neck collars.

Do You Need a Neck Collar?

Your neck is the most delicate part of your spine. Think of it as a thin bundle of spaghetti holding up a 12-pound bowling ball. If any of those strands of spaghetti are cracked or broken — by a car accident or a sports injury — then the other strands have to do extra work to hold up that bowling ball.

A neck collar helps support your head until the muscles and bones in your neck heal.

Chronic neck pain has many causes — from things as minor as a backpack too full of textbooks to those as major as bone spurs or arthritis. In these cases, the collar helps relieve pain while treatment is ongoing.

When seeing a doctor about neck pain, you should let your doctor know if you have a habit of carrying your purse or bag on one arm, if you sit in one position for long periods, or if you talk on the phone a lot (especially your cell phone).

The doctor will also ask you if the pain radiates into your shoulders or hands or if it is accompanied by headaches. All these things can mean your neck muscles are weak and tired of holding up your head.

Will You Always Need a Neck Collar?

Current medical thought is that the longer a brace is worn, the less effective it becomes. Doctors and therapists want you to strengthen and move the weakened muscles as soon as you can.

Whiplash treatment, which requires immobilization, bed rest, and pain killers, is better treated by exercise therapy and massage now.

Recovery from surgery for a herniated disc or bone spurs, or after a fracture, will require long-term immobilization while the nerves and bones heal.

But the negative effects of full immobilization are outweighed by the benefits of letting the injury heal. After that, rigid collars are removed in favor of movement therapy.

When Should You Not Use a Neck Collar?

Doctors are rethinking the use of the cervical collar for extended therapy.

Muscle deterioration increases when the patient uses a collar for a long time. Also, doctors believe that in many patients using a collar, pain relief may be partially due to the psychological support of the collar as much as the physical support.

A collar should not be worn for more than 10 days after a whiplash-type injury. But you may need support for a long time after surgery or traumatic injury. 

Emergency care is also trending away from the use of rigid collars. Paramedics would put everyone in a hard c-collar and strap them on a backboard, just in case they had spinal trauma.

In patients who are intoxicated or have had a stroke or traumatic brain injury or in case the collar is improperly fitted (as often happens in children and adolescents), the chances of choking or vomiting are very high.

Current paramedic training includes assessing the patient for spinal trauma before placing them in cervical protection. First responders are being taught not to use cervical collars at all.

Neck pain is a common issue today, with varied causes and numerous treatments. A cervical collar may help in many cases, or discussions may lead to further diagnoses and options. Whatever you decide to do, be sure to discuss all your concerns with your doctor.

Show Sources

SOURCES:

ActionSports EMS: "Neck Brace Effectiveness Case Study."‌

Asian Spine Journal: "The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects."

Current Review of Musculoskeletal Medicine: "When Should a Cervical Collar be Used to Treat Neck Pain?"

‌EMResident: "Cervical Collar: Friend or Foe?"

Journal of Neurotrauma: "Prehospital Use of Cervical Collars in Trauma Patients: A Critical Review."

‌Mayo Clinic: "Neck Pain."

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