This depends on the specific type of injury and it is up to the doctors looking after you how long you have to wear the collar for. For a fracture, it is usually 12 weeks from the date of injury.

The decision to place you in a collar is made by the neurosurgery team at Edinburgh Royal Infirmary. They will usually organise a follow up appointment with you after 12 weeks, either in person or by telephone and they will advise if/when you can stop wearing the collar. If you have any questions for the team about your use of the collar, please contact them on 0131 536 1000 (this number is a central NHS Lothian Switchboard. When asked which department you are looking for, state “neurosurgery”).

The collar needs to be worn all of the time, even for sleeping and showering. You should not attempt to remove the collar on your own for any reason (unless you have been specifically advised it is OK to do so by your doctor.) Do not try to tighten or loosen the collar yourself.

For most patients, a collar will be fitted while you are in the emergency department by the medical team looking after you.

After the collar has been fitted, you will be referred by the doctors to the Orthotics department. The orthotists are responsible for checking the fit of the collar as well as supplying you with a spare collar for hygiene purposes.
If you are admitted to a ward, an orthotist will come and see you on the ward as soon as they are able.

If you are discharged home straight from the emergency department, someone from orthotics will contact you as soon as they can after discharge. You will be asked to come into the orthotics department at Stirling Community Hospital for an appointment. If you are housebound, we may be able to arrange a home visit.

If you have been admitted, while you are an inpatient, the nursing staff will be in charge of your collar care day to day.

Once you have been discharged home, continue to wear your collar all of the time. On your discharge, district nurse care will be organised for you. They will attend your home 2-3 times per week (depending on their availability) to provide collar care.

This will involve removing your collar, washing the skin on your neck, checking your skin for any signs of pressure/rubbing and replacing the collar with your spare one. It is then your responsibility to wash the pads from the collar that has been removed, so it ready to be changed when the district nurses visit again. If your local district nursing team have not been in touch with you after discharge, contact your GP and inform them you have been fitted with a hard collar.

On the days when the district nurse team are coming in to visit if you wish you can have a full shower, including washing your hair, with the collar on. The pads will then be wet but these will be changed by the nursing team for clean and dry ones. To avoid any rubbing or skin irritation, it is important that you avoid getting the pads on your collar wet at any other time.

Once the collar is off, you can remove the blue/grey pads from the hard plastic shell. Pay attention to the shape of the pads so you can put them back on in the correct place. They attach with Velcro. Pads should be washed with a mild soap and water, avoid bleach or any harsh chemicals. Rinse thoroughly, wring out any excess water and squeeze them in a towel. Lay the pads flat out to dry. The white plastic shell can be wiped clean, again use a mild soap and water and then dried with a towel or left to air dry.

When putting the pads back on, ensure the pads overhang the shell so no plastic is touching the skin. The blue side of the pads should be in contact with your skin, the grey side will be in contact with the plastic.

It is recommended you walk for short distances as able to prevent stiffness in your muscles and joints and also to help prevent blood clots. You can also do some gentle standing or seated exercises. Take extra care when doing any activity however, especially if you are at risk of falls, as the collar will prevent you from being able to look at the ground directly in front of you. Use a handrail when walking up or down stairs.

Avoid any heavy lifting, heavy exercise or contact sports. Avoid anything that would involve twisting or bending of the neck.

Yes-you must keep the collar on at all times, even overnight in bed. You can move freely in bed but avoid lying on your front. You can use pillows to support your head but try not to use more than 2 as this can put more pressure on your neck in the collar.

When getting up out of bed, it is recommended you roll on to your side, bring your legs over the side of the bed and push up with your arms.

Yes-the collar must also be kept on for eating and drinking. This will feel difficult at first but you should get used to this with time. You will struggle with looking down at your plate of food and tilting a glass/cup to drink will be tricky. Try moving your plate to where you can see it and consider using a straw to drink.

No-the collar restricts the movement of your neck which will stop you from being able to turn your head, which is required for safe driving.

This will depend on the type of work that you do. You may be able to return to working at a desk when you feel able to do so, but avoid any manual work. Speak to your doctor for advice if required.

While your neck is healing and you are still wearing the collar, you will not require any physiotherapy.

After you have been advised it is safe to stop wearing the collar, your neck may feel weak or stiff, but this should improve on its own with time and does not routinely require physiotherapy input. If you feel this weakness/stiffness is not resolving, you can speak to your GP to determine if a physiotherapy referral would be beneficial.

If there are any issues with the collar at home such as the collar breaking or issues with skin breakdown, please contact the orthotics department on 01786 434062. The Orthotics department are based at Stirling Community Hospital and work Monday-Friday, 8:30am to 4:30pm. Outside these hours, you can contact the out of hours district nursing team or phone 111 for advice.

If you experience any sudden neck or back pain, numbness or tingling in your arms or legs, difficulty swallowing or breathing or any new changes in your bladder or bowel, contact your doctor immediately, go to the emergency department, or phone 999.

Please note this care plan only applies if you live in the Forth Valley area. If you were seen here but live in a different health board, you should be referred to the appropriate services in your area. If you have any concerns about follow up care, contact your own GP.