Neck pain

Nearly two-thirds of people suffer from neck pain (cervicalgia). Causes include acute conditions such as muscle strains and whiplash, and chronic conditions such as cervical spondylosis and myofascial pain syndrome. Pinched nerves, infections, fractures, and spinal cord problems can also cause neck pain.

For effective treatment, you need to understand the causes of neck pain. For this, a comprehensive examination is carried out. Based on the diagnostic results obtained, the doctor prescribes therapy. You should not self-medicate, as many cases cannot be delayed. Pain that seems harmless at first glance can cause serious complications.

general characteristics

The neck is a sensitive area of the body: the cervical spine is made up of seven vertebrae. Muscles, ligaments and nerves provide stability: the muscular structure. Poor posture or excessive tension creates overload that reduces blood flow, causing muscle pain and myositis (inflammation).

Neck pain is rarely felt locally. Very often it extends to the shoulder, sometimes also to the arms, up to the fingers. It can be felt in the back of the head, causing headaches, dizziness and vision problems. When the neck is stiff, turning and tilting the head becomes difficult and is accompanied by severe discomfort.

Pain in the neck area varies in nature and severity. Numbness in the hands or the back of the head, hyperemia and swelling of the skin may occur. The discomfort can be short-lived or long-lasting, making daily activities difficult.

Acute neck pain usually goes away within a few days to 2 weeks and is not a cause for concern. Neck pain is considered chronic if it lasts more than three months. If symptoms other than those mentioned appear together with neck pain, for example nausea, vomiting, sensitivity to light, fever, chills, nervous disorders, symptoms of paralysis, etc. , you need to consult a doctor.

Types of neck pain

Depending on the nature, neck pain can be nonspecific and specific. In the first case it is discomfort, the obvious cause of which is absent. Most often this occurs due to overload of the trapezius muscle. Specific pain has a specific cause associated with a specific disease.

Depending on the duration there are:

• Acute cervical pain - lasts no more than 10 days, disappears after elimination of the provoking factor.
• Chronic cervical pain: persists for more than three weeks, is recurrent or constant.

According to the etiopathogenetic classification, vertebrogenic and non-vertebrogenic pain in the neck area is distinguished. In the first case it is a primary lesion of the osteochondral structures of the cervical vertebral region. It develops against the background of spondylogenic and discogenic cervicalgia due to compression of the spinal cord, damage to bone structures and deformation of the intervertebral discs.

Depending on the area of localization, the painful syndrome is distinguished in the anterior, posterior and lateral regions of the neck. Each of them has specific causes. Accordingly, each case requires the appointment of an individual treatment plan.

Causes of neck pain

Most neck pain is nonspecific. This means that doctors cannot determine a concrete medical cause for disorders, such as injuries to the intervertebral discs or vertebrae. Often the discomfort occurs due to poor posture, which leads to muscle-fascial tension.

Neck pain occurs for the following reasons:

• prolonged sitting at the computer;
• overwork, for example during sports or physical work;
• underdeveloped muscles;
• increased muscle tone;
• hypothermia, exposure to drafts;
• incorrect position during sleep;
• accident (whiplash, cervical spine injury);
• degenerative-dystrophic changes in the spine;
• colds and viral infections;
• changes in hormones during menopause;
• stress, depression and anxiety;
• mineral deficiency.

Very rarely, neck pain is a symptom of inflammation or damage to the cervical spine. The most common cause is excessive musculofascial tension in the shoulder area. After a few days, the complaints usually disappear on their own. If the discomfort persists longer, becomes chronic or additional symptoms appear, consultation with a specialist is necessary.

Pain in the front of the neck: causes

On the anterior surface of the neck, discomfort of varying severity is felt. There are many structures here, any of which can cause pain. It is not easy to determine the true cause without a complete diagnosis.

The causes of neck pain in the front are:

• Thyroid diseases (toxic goiter, Hashimoto's thyroiditis) - discomfort occurs due to inflammatory processes and endocrine pathologies. Increased pain is observed when bending forward and during movement. Accompanied by an increase in temperature, increased heart rate, feeling of heat and increased sweating.
• Sialadenitis is damage to the salivary glands of the jaw. The pain progresses with swallowing, chewing movements and head rotation. Accompanied by the formation of swelling and compaction. Characterized by dry mouth and difficulty eating. It manifests itself with weakness, chills and fever.
• Purulent inflammation in the pharynx: the inflammatory process spreads to adjacent tissue, leading to the formation of a retropharyngeal abscess. The discomfort is accompanied by redness of the skin on the front of the neck, which becomes bright pink and warm to the touch. The pain is excruciating and intense, so the patient may refuse to eat. Associated with febrile fever. It is a consequence of an extensive paratonsillar abscess.
• Cervical plexitis: the intensity of clinical manifestations depends on the number of damaged nervous structures. Most often, acute pain occurs in the anterolateral part of the neck. There is difficulty coughing and speaking. The discomfort radiates to the ear, chest and back of the head. There is a sensation of "crawling" and paresthesia. It occurs due to injury, hypothermia, or after vaccination.
• Rheumatic diseases are systemic disorders of the connective tissue (collagenosis) with damage to the skin and muscles. Dermatomyositis and scleroderma are characterized by constant, nagging pain. Swelling and thickening of the skin occurs. The excruciating pain radiates to the front of the neck and spine.
• Lymphadenitis: The discomfort is localized in the upper part of the neck. Lymphoid tissue is affected. The discomfort is localized in the submandibular region, usually on one side. Symptoms progress with tilting the head and talking. The skin is hyperemic and swollen. Accompanied by inflammation of the lymph nodes, general weakness and fever.

Pain in the front of the neck can also occur with atypical attacks of angina. The pain is more pronounced and is accompanied by shortness of breath. It becomes difficult to speak and there is difficulty swallowing.

The pain is localized in the anterior part also with inflammation of the mucosa of the trachea and esophagus. Discomfort is a consequence of a painful cough and tracheitis. Rare causes include cervical compression syndrome and spinal injuries.

Neck pain: causes

Neck discomfort is a consequence of prolonged computer work and low levels of physical activity. Pain occurs due to pathological changes in the spine.

Neck pain has the following causes:

• Osteochondrosis is accompanied by degenerative-dystrophic disorders of the intervertebral discs, a decrease in their strength and a decrease in height.
• Protrusions are a complication of osteochondrosis, accompanied by protrusion of the intervertebral disc. Protrusions are caused by violation of the vertebral artery and nerve structures.
• Intervertebral hernias occur when the protrusions are advanced. The internal contents of the intervertebral disc exit into the spinal canal, compressing the nerve endings.
• Spondylosis: bony protuberances (osteophytes) appear on the edges of the vertebral bodies, while the intervertebral discs decrease in size, adjacent vertebrae fuse and the mobility of the neck is limited.

Neck pain is characteristic of myofascial syndrome, in which individual muscles spasm. Accompanied by sharp pain when pressing on the back of the neck and during physical activity.

Among systemic diseases, ankylosing spondylitis can be distinguished, which affects the joint structures and is characterized by limited mobility. Accompanied by the formation of fixed and durable conglomerates due to the fusion of the individual vertebrae with each other. Less commonly, neck pain is associated with spinal tuberculosis, Reiter syndrome, and osteomyelitis.

A more serious cause requiring emergency medical attention is a compression fracture of the spine. It occurs due to whiplash to the neck.

Lateral neck pain: causes

Pain on the side of the neck may be throbbing, tingling, or burning. It radiates to the shoulder or ear. Accompanied by the formation of secondary torticollis. This causes the head to tilt towards the affected side. Typical of atherosclerosis and other blood vessel disorders.

The cause is also muscle spasm that occurs during sudden movements, excessive stress and hypothermia. Pain on the side of the neck is observed with malignant processes in the larynx, pharynx and thyroid gland. You shouldn't leave things to chance. If primary symptoms appear, you should consult a doctor. This approach allows you to take timely therapeutic measures and eliminate the development of complications.

Diagnosis of the causes of neck pain

The examination includes laboratory tests and instrumental diagnostics aimed at visualizing the affected areas and identifying signs of pathology:

• Ultrasound of the submandibular salivary glands and thyroid is prescribed for rapid visualization of cervical structures and identification of diseases of internal organs that provoke neck pain. Duplex scanning is performed to scan large vessels and determine the state of blood flow.
• X-ray or CT (computed tomography) examination: determines the displacement of the vertebrae and bone deformations. It allows you to determine the degree of spinal disorders and the nature of the disorders.
• Functional diagnostics: damage to the muscular system is determined using MRI of the cervical spine.

A blood test is performed to confirm inflammatory processes. The level of thyroid hormones is also determined. If general infectious symptoms are present, a bacteriological culture or throat swab is prescribed. Serological tests (PCR, ELISA, RIF) are also required.

Treatment for neck pain

Conservative rather than surgical treatment methods are prescribed for neck pain. Drug treatment is aimed at relieving pain, eliminating the cause of discomfort and restoring the body. Therapy is prescribed based on the stage of the pathology, the cause of the disorders occurring, the age and characteristics of the patient's body.

To increase the effectiveness of the drugs used, physical therapy and physiotherapy are prescribed. Manual techniques are effective. In some cases, if the expected result is not achieved, surgery is performed.

Help before diagnosis

Head tilts and rotations, as well as light massage, will help relieve acute neck pain. The tension gradually decreases, which helps improve the condition. There are muscle knots or trigger points in the neck muscles that cause discomfort when irritated. Rubbing and kneading gently helps relieve pain.

In the first 24 hours after discomfort occurs, cold or warm compresses can be used. Heating the neck with a heating pad is allowed only on the side or back.

Tablets and ointments for neck pain

It is recommended to take any analgesic drug that temporarily improves the condition. An NSAID is prescribed that not only relieves pain, but also has an anti-inflammatory effect.

For local effects, you can apply a plaster or warming ointment. Relieves hyperemia and swelling, which reduces pressure on nerve endings and reduces spasm.

Exercises for neck pain

For moderate, aching pain, you can perform light gymnastic exercises on your own. It is important to monitor your well-being so as not to cause harm.

Smooth and non-abrupt movements will help reduce discomfort:

• lie on your back, press your head against a flat, but not soft pillow, until you count to 5 (5 to 7 is close);
• lie on your side, raise your head and hold the position until the count of 5 (at least 5 is approaching);
• lie on your stomach, cross your arms behind your head, raise your head, providing light resistance (4 to 6 approaches).

In case of acute and severe pain any exercise is contraindicated. You should stop exercising if you feel weak or dizzy. In this case, the Shants collar will help reduce pain. Immobilization should not be prolonged. Otherwise, the muscle corset will weaken and the situation will worsen.

What not to do if you have neck pain

If discomfort occurs frequently in the cervical spine, it is unacceptable:

1. Maintain a forced position of the body for a long time, in which the neck is in a state of tension.
2. Lift heavy objects and do physical labor.
3. Being exposed to severe stress, which causes vasospasm, which negatively affects blood circulation.
4. Frequently drinking alcohol and smoking, which contributes to persistent narrowing of vascular structures.
5. Dress inappropriately for the climate, stay exposed to drafts and do not wear hats or scarves during cold weather.

It is unacceptable to sleep on a soft mattress and a high pillow. It is necessary to avoid sudden rotations of the head, which can lead to sudden pinching of the nerve.

When you need to urgently consult a doctor

The help of a specialist is necessary if the pain does not decrease after 5-7 days or intensifies. You should see a doctor if you experience severe pain that prevents you from falling asleep and does not decrease when you change your body position.

The absolute indication for a visit to the clinic is a deterioration in general health: the appearance of nausea, dizziness and weakness. Hand numbness also requires professional help.

Pharmacological treatment

Combined therapy is usually prescribed, which includes:

• non-steroidal anti-inflammatory drugs – relieve discomfort and swelling, eliminate residual inflammation;
• analgesics – relieve pain and improve the general condition, but do not eliminate the cause;
• corticosteroids: reduce inflammation, influence muscle excitability;
• muscle relaxants – relieve painful muscle tension, improve motor activity.

In case of intense pain, injections into trigger points are indicated. Antioxidants, anticonvulsants and antidepressants are also prescribed.

Chondroprotectors stop inflammation and degenerative processes of the spine. Vitamins improve blood circulation and have a healing effect.

Surgery

The operation is performed to restore the functionality of the cervical spine. The most commonly used decompression tactics are indicated for compression syndrome, when the nerve roots are compressed by a pathological defect. Microsurgical discectomy, laminectomy, and nucleoplasty are used. Also, for pain in the cervical spine, stabilization techniques are popular: arthrodesis, vertebroplasty, implantation of a fragment of bone tissue and installation of fixed metal structures.

The surgical intervention is aimed at eliminating the cause (hernia, tumor, osteophytes, etc. ). The aim of the surgery is to restore the motor support functions of the spine. After surgical treatment, long-term rehabilitation is required, which is necessary to prevent various complications, which are not uncommon. The results of the operation depend on the timeliness of the procedure and compliance with medical recommendations for recovery.

Manual therapy

The minimally invasive technique involves the use of manual techniques. The effectiveness is aimed at the joints, muscles, ligament-articular and bone structures. Manual therapy improves the conditions of spinal hernias, poor posture, protrusion and osteochondrosis. Improves the condition of neck pain.

A course of manual therapy restores mobility, restores damaged tissues and eliminates dizziness. The pain gradually decreases, the back and neck muscles relax. The patient's well-being improves.

Physiotherapy

Physiotherapy treatment aims at the influence of magnetic field, electric current, temperature and mechanical effects on the body. The procedures are painless, do not cause adverse reactions or complications if you follow your doctor's recommendations. Physiotherapy is indicated for the treatment of chronic diseases and is prescribed for preventive purposes. Used to strengthen the immune system, treat chronic inflammation and improve posture. The procedures increase the effectiveness of the drugs.

Physiotherapy treatment for neck pain includes:

• SMT (sinusoidal modulated currents) - stimulate the production of biologically active substances in the body. Electrophoresis relieves pain and restores mobility, activating your defenses. The complex of procedures allows you to achieve a pronounced and long-lasting analgesic effect, complemented by anti-inflammatory and anti-edematous effects.
• MLT (magnetic field and laser beams) – provides a pronounced therapeutic effect. The procedure aims to activate specific enzymes, change capillary osmotic pressure and improve blood circulation.
• UVT (shock wave therapy) - with the help of low-frequency acoustic waves, processes are started that improve microcirculation. Inflammation is reduced, swelling is eliminated and pain decreases.

To achieve a pronounced effect, it is recommended to undergo a course of physiotherapeutic procedures. Improvements, as a rule, are noticed after the first session. Physiotherapy is contraindicated in acute inflammation. Prescribed when the process is chronic and in the recovery phase.

Physical therapy

Therapeutic physical culture is aimed at creating the muscular structure of the neck, eliminating tension and restoring blood circulation. An individual approach is used for each patient, taking into account her abilities and needs.

The physiotherapy program is drawn up by a doctor, taking into account the medical history and contraindications. If necessary, changes are made taking into account the dynamics of the patient's condition, which eliminates the development of complications and allows you to achieve the expected result.

When starting a series of exercises, it is important to consider:

• the main task is to tone the muscles, they must be made elastic;
• it is important to perform the movements smoothly, because sudden and fast movements will only aggravate the condition;
• Exercises must be performed on a flat surface using a special mat and rollers.

It is important to observe regularity and frequency. If discomfort occurs, it is necessary to reduce the load.

Exercises to restore the plasticity of muscle structures and improve the mobility of the vertebrae:

• Exercise no. 1 – Turn your head to the far right, then to the left. Provides mobility of the cervical vertebrae.
• Exercise no. 2 – Lower your head, pressing your chin to your chest so you can feel your chest cavity. This exercise improves neck mobility and relieves muscle stiffness.
• Exercise no. 3 – Move your head back, retracting your chin. The exercise improves the posture of the cervical spine.

A series of exercises has also been developed to strengthen weak muscles in order to create a muscle corset and reduce pain. While sitting, place your hand on your forehead and tilt your head forward to create resistance. You can also perform similar tilts to the right and left.

Which doctors should I contact for neck pain?

If discomfort occurs, you should visit a therapist. Based on the complaints, the general practitioner will prescribe an examination and, if necessary, refer you to a specialist: a neurologist, an endocrinologist or an oncologist.

conclusions

Between 30 and 70% of the population suffers from neck pain. This problem reduces the quality of life and often leads to disability. With timely consultation with a doctor and treatment, the prognosis is usually favorable.

Neck pain therapy includes physical, behavioral, and pharmacological methods. The most effective are therapeutic exercises, manual therapy, the correct organization of the work space and compliance with ergonomic rules. NSAIDs, injections and antidepressants are prescribed. In advanced cases and when conservative treatment is ineffective, surgery is performed.