The evaluation of a neck sprain or strain begins with a history and physical examination.

Physical findings in someone with a neck sprain or strain may include:

• Neck muscle spasm
• Neck swelling
• Neck tenderness:
• Muscles may be tender on either side of the spine
• Tenderness overlying the spine may indicate a ligament sprain or a neck fracture

Tests are not necessary to make the diagnosis of a neck sprain or strain. Tests may be required to exclude a neck fracture.

Tests that may be used to evaluate a neck sprain or strain include:

• X-rays of the neck:
• Normal cervical spine
• Torn ligaments
• Fracture of the odontoid process of the second vertebra
• Fracture of a vertebral body
• Fracture of a spinous process in the back of a neck vertebra
• CT scan of the neck
• MRI scan