Patient education: Cervical collars for adults (The Basics)

What are cervical collars? — 

A cervical collar, or "C-collar," is a type of neck brace. They are sometimes called "cervical immobilizers" or just "neck braces." A common brand is "Miami J."

The neck has 7 bones that are stacked on top of each other. These bones are called the "cervical vertebrae." They make up the top part of the spine, called the "cervical spine." Ligaments attach the bones to each another. A thick bundle of nerves called the "spinal cord" runs through the cervical vertebrae, and connects the brain to the rest of the body. C-collars help protect the cervical spine.

There are different types of C-collars:

●Rigid C-collars (figure 1) – These are made of hard plastic and foam. They usually have a piece that goes under your chin. They keep your neck very still. These are usually used after surgery or a serious injury, such as a neck fracture. They support your head and limit how much you can move your head and neck while you heal.

●Soft C-collars – These are made of foam. They give your neck some support and limit your side-to-side movement. They might help with neck pain. But doctors generally do not recommend people wear these, especially for long periods of time. This is because they can actually make your neck muscles weak and slow down improvement. If you use a soft C-collar, only wear it for less than 3 hours at a time each day, and for no more than 1 to 2 weeks.

This article focuses on rigid C-collars. If you are interested in using a soft C-collar for neck pain, talk to your doctor or nurse.

How do I wear a C-collar? — 

You will learn how to wear the collar in the hospital. Before you go home with the collar, make sure you know:

●When to wear it – You might need to wear it all the time, or you might be able to remove it for certain tasks. Follow your doctor's or nurse's instructions.

●If you will need help – For example, you might need someone else to put the collar on, wash your hair, or help you do other tasks while you wear the collar.

Each C-collar is slightly different, so follow the instructions for your specific collar.

The general steps for putting on and taking off the collar are below. You must be lying down to remove the collar, unless your doctor gives you permission to do this while seated. It might be easier if someone helps you.

To take the C-collar off and put it back on while lying down:

●Lie down flat on your back on a bed, without a pillow. Keep your head in a neutral position, looking at the ceiling.

●Undo the straps on the side of the collar.

●Carefully open the front of the collar, and bring it to the other side of your head. Gently slide the back panel out from under your neck.

●While the collar is off, clean your neck area and check for any skin irritation. You can also clean the collar. You might need someone to help you.

●To put the collar back on, stay lying down. Keep your head in a neutral position, looking at the ceiling.

●Without moving your head or neck, carefully slide the back panel of the neck brace under your neck. Make sure the back panel is in the right position, centered on the back of your neck. If you have long hair, make sure it is outside the collar.

●Carefully bring the rest of the collar around your neck. It might help to gently pull the collar down toward your belly button as you bring it around your face, and then bring it back up toward your head. Your chin should rest on the chin piece.

●Fasten the collar into place. Rigid C-collars usually have straps on 1 side.

●The collar should be snug, but not uncomfortable. Your head and neck should not be able to move very much once the collar is on. If your head and neck are moving a lot, try putting on the collar again. If you are still having trouble, call your doctor or nurse.

If you are allowed to remove the C-collar and put it back on while seated:

●Sit down, and keep your head still while you remove the collar.

●Carefully undo the straps on the side of the collar. Open the collar, and pull it away from your skin. Move slowly, and be gentle.

●Try not to move your head and neck too much while the collar is off.

●While the collar is off, clean your neck area and check for any skin irritation. You can also clean the collar. You might need someone to help you.

●Then, you can put the C-collar back on. Make sure the back piece is centered on the back of your neck. Then, carefully bring the rest of the collar around your neck. It might help to gently pull the collar down toward your belly button as you bring it around your face, then bring it back up toward your head. Your chin should rest on the chin piece.

●Fasten the collar into place. Rigid C-collars usually have straps on 1 side.

●The collar should be snug, but not uncomfortable. Your head and neck should not be able to move very much once the collar is on. If your head and neck are moving a lot, try putting on the collar again.

What else should I know? — 

The exact instructions depend on what type of collar you have and why you need it. Ask questions if there is anything you do not understand. Talk to your doctor or nurse about whether there are things you shouldn't do while wearing the collar.

Some general tips:

●Clean the collar once a day (you might need someone else to do this for you):

•Handwash any plastic pieces with mild detergent, and dry with a towel.

•Some rigid C-collars come with removable liners for the chin, front of the collar, and back of the collar. Handwash the liners with mild detergent. Let the liners air dry. Follow the collar manufacturer's instructions for how to change the liners.

●When you take the collar off for cleaning, check your neck for redness, sores, or skin irritation. If you have any of these and they do not go away within 20 minutes after removing the collar, tell your doctor or nurse.

●Use good posture while wearing the collar. Try not to slouch.

●Do not do any heavy lifting or heavy exercise while wearing the collar.

●Sleep with the collar on, unless your doctor tells you not to.

●Never drive when wearing the collar.

●Be careful when walking, since the collar makes it hard to look down.

●Ask your doctor about bathing. Unless instructed otherwise, wear the collar in the shower or bath. After you wash, you might need to take the collar off to clean your neck and change any pads.

●Keep the collar away from heat or flames.

When should I call the doctor? — 

Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●Your arms or legs are weak.

●You have trouble breathing, swallowing, eating, drinking, or talking.

Go to the emergency department if:

●Your arms or legs are numb or tingling.

Call your doctor or nurse for advice if you:

●Can move your neck or head easily with the collar on

●Have pain in or around your ears or face

●Have skin irritation that does not go away within 20 minutes of opening or removing the collar

More on this topic

Patient education: Cervical collars for children (The Basics)
Patient education: Cervical spinal stenosis (The Basics)
Patient education: Neck fracture (The Basics)