Cervical hyperextension refers to the sudden or prolonged movement of the head backward, beyond the normal extension range of the cervical spine, resulting in excessive strain on the anterior structures of the neck, such as the anterior ligaments, intervertebral discs, and flexor muscles, as well as compression of the posterior elements, such as the facet joints.
It represents one of the main mechanisms causing whiplash injury, particularly in rear-end collision accidents, where the head undergoes a sudden hyperextension movement before a compensatory flexion movement follows, as well as in sports injuries or falls involving a forceful backward movement of the head.
Repeated or intense cervical hyperextension can cause ligament stretching or tearing, muscle spasm, and, in more severe cases, damage to the intervertebral discs or compression of nerve roots due to narrowing of the intervertebral foramen during this movement.
Symptoms include acute neck pain, stiffness, headache, and, in cases involving nerve involvement, tingling or weakness in the upper limbs.
Evaluation includes clinical examination and, where considered necessary, imaging studies to exclude more serious injuries, such as fracture or instability, while treatment is usually based on conservative measures, such as medication, physical therapy, and gradual mobilization of the neck.