Pain in the neck

Nearly two-thirds of people experience 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, it is necessary 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. It is not advisable to self-medicate, since many cases cannot be delayed. Pain that seems harmless at first glance can lead to serious complications.

general characteristics

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

Rarely, neck pain is felt locally. Most often it extends to the shoulder, sometimes even to the arms and to the fingers. It can be felt in the back of the head and cause headaches, dizziness, and vision problems. When the neck is stiff, turning and tilting the head becomes difficult and is accompanied by great discomfort.

Pain in the neck area varies in nature and severity. Numbness of the hands or the back of the head, hyperemia and swelling of the skin may occur. The discomfort can be short 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 along with neck pain, for example, nausea, vomiting, sensitivity to light, fever, chills, nervous disorders, symptoms of paralysis, etc. , a doctor should be consulted.

Types of neck pain

Depending on the nature, neck pain can be nonspecific and specific. In the first case, we are talking about discomfort whose clear cause is absent. Most often it occurs due to overstrain of the trapezius muscle. Specific pain has a specific cause associated with a specific disease.

Depending on the duration, there are:

• Acute cervicalgia: lasts no more than 10 days and disappears after removal of the provoking factor.
• Chronic neck 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 we are talking about a primary injury to 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, pain syndrome is distinguished in the anterior, posterior and lateral regions of the neck. Each of them has specific causes. Consequently, each case requires the appointment of an individual treatment plan.

Causes of neck pain

Most neck pain is non-specific. This means that doctors cannot determine a specific medical cause for the discomfort, such as injuries to the intervertebral discs or vertebrae. Discomfort often occurs as a result of incorrect posture, which causes muscle-fascial tension.

Neck pain occurs for the following reasons:

• sitting for a long time 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;
• hormonal changes 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 discomfort usually disappears on its 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.

Discomfort of varying severity is felt on the front surface of the neck. There are many structures here, each of which can cause pain. It is not easy to determine the true cause without a comprehensive diagnosis.

The causes of neck pain in the front are:

• Diseases of the thyroid gland (toxic goiter, Hashimoto's thyroiditis) - discomfort occurs due to inflammatory processes and endocrine pathologies. Increased pain is noted when bending forward and during movement. Accompanied by increased temperature, increased heart rate, feeling of heat and increased sweating.
• Sialadenitis is damage to the salivary glands of the jaw. The pain progresses when swallowing, chewing, and turning the head. Accompanied by the formation of swelling and compaction. It is characterized by dry mouth and difficulty eating. It occurs with weakness, chills and fever.
• Purulent inflammation in the pharynx - the inflammatory process spreads to the 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 hot to the touch. The pain is throbbing 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 nerve 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 neck. There is a feeling 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, persistent pain. Swelling and thickening of the skin occurs. The stabbing pain radiates to the front of the neck and spine.
• Lymphadenitis: the discomfort is located in the upper part of the neck. Lymphoid tissue is affected. The discomfort is located in the submandibular region, usually on one side. Symptoms progress with head tilt and speaking. The skin is hyperemic and swollen. Accompanied by swelling of the lymph nodes, general weakness and fever.

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

The pain is localized in the front part also with inflammation of the mucous membrane of the trachea and esophagus. The discomfort is a consequence of a painful cough and tracheitis. Rare causes include cervical impingement syndrome and spinal injuries.

Pain in the neck: causes.

Discomfort in the neck is a consequence of prolonged work in front of the computer and low levels of physical activity. Pain arises due to pathological changes in the spine.

Pain in the neck 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 a protrusion of the intervertebral disc. The bulges are caused by infringement of the vertebral artery and nerve structures.
• Intervertebral hernias occur when the protuberances 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 neck mobility is limited.

Pain in the back of the neck is characteristic of myofascial syndrome, in which spasms occur in individual muscles. It is accompanied by sharp pain when pressing on the back of the neck, as well as 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 individual vertebrae with each other. Less commonly, neck pain is associated with spinal tuberculosis, Reiter's syndrome, and osteomyelitis.

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

Lateral neck pain: causes

Pain in 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 toward 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 is observed on the side of the neck 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 treatment measures and eliminate the development of complications.

Diagnosis of the causes of neck pain.

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

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

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

Treatment for neck pain

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

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

Help before diagnosis

Tilts and rotations of the head, as well as a light massage, will help relieve acute neck pain. The tension gradually decreases, which helps to improve the condition. There are muscle knots or trigger points in the neck muscles that cause discomfort when irritated. Gently rubbing and kneading helps relieve pain.

In the first 24 hours after discomfort occurs, you can use cold or warm compresses. Heating the neck with a heating pad is only allowed from the side or behind.

Pills and ointments for neck pain.

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

For local effects, you can apply a warm patch or ointment. They relieve hyperemia and swelling, which reduces pressure on nerve endings and reduces spasms.

Exercises for neck pain.

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

Gentle, non-sudden movements will help reduce discomfort:

• lie on your back, press your head against a flat, but not soft, pillow for a count of 5 (approximately 5 to 7);
• lie on your side, raise your head and hold it up for a count of 5 (get closer to at least 5);
• Lie face down, cross your arms behind your head, raise your head and provide slight resistance (4 to 6 approaches).

In case of acute and severe pain, any exercise is contraindicated. You should stop exercising if you feel dizzy or weak. In this case, the Shants necklace will help reduce the 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 in the cervical spine frequently occurs, it is unacceptable:

1. Maintaining a forced body position for a long time, in which the neck is tense.
2. Lift heavy objects and perform physical labor.
3. Being exposed to severe stress, which causes vasospasm, which negatively affects blood circulation.
4. Frequent drinking of alcohol and smoking, which contributes to persistent narrowing of vascular structures.
5. Dress inappropriately for the weather, stay out of drafts, and do not wear a hat or scarf during the cold season.

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

When you need to see a doctor urgently

Specialist help is necessary if the pain does not subside or intensifies after 5 to 7 days. You should consult a doctor if you have severe pain that prevents you from falling asleep and does not go away when you change your body position.

The absolute indication for visiting the clinic is a deterioration in general well-being: the appearance of nausea, dizziness and weakness. Numbness in the hands also requires professional help.

Pharmacotherapy

A combination 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, affect muscle excitability;
• Muscle relaxants: relieve painful muscle tension and improve motor activity.

In cases of severe pain, trigger point injections are indicated. Antioxidants, anticonvulsants and antidepressants are also prescribed.

Chondroprotectors stop inflammation and degenerative processes in 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.

Surgical intervention aims to eliminate the cause (hernia, tumor, osteophytes, etc. ). The goal of the operation is to restore the motor support functions of the spine. After surgical treatment, long-term rehabilitation is required, 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 joints, muscles, ligamentous-articular and bone structures. Manual therapy improves the condition of spinal hernias, poor posture, protrusions and osteochondrosis. Improves the condition of neck pain.

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

Physiotherapy

Physiotherapeutic treatment targets 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 the doctor's recommendations are followed. Physiotherapy is indicated for the treatment of chronic diseases and is prescribed for preventive purposes. It is used to strengthen the immune system, treat chronic inflammation and improve posture. The procedures increase the effectiveness of medications.

Physiotherapeutic 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 one's own 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 rays) - 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 is reduced.

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

exercise therapy

Therapeutic physical culture aims to create the muscular structure of the neck, eliminate tension and restore 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 medical history and contraindications. If necessary, adjustments are made taking into account the dynamics of the patient's condition, which eliminates the development of complications and makes it possible to obtain the expected result.

When starting a series of exercises, it is important to keep in mind:

• the main task is to tone the muscles, it is necessary to make them elastic;
• It is important to perform the movements gently, because sudden and rapid movements will only aggravate the condition;
• Exercises should be performed on a flat surface using a special mat and rollers.

It is important to observe regularity and frequency. If any 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. Tip #1: Turn your head to the extreme right and then to the left. Provides mobility of the cervical vertebrae.
• Exercise no. Tip #2: Lower your head and press your chin to your chest so you can feel your chest cavity. This exercise improves neck mobility and relieves muscle stiffness.
• Exercise #3 – Move your head back, retracting your chin. Exercise improves posture in the cervical spine.

A series of exercises have 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 if I have neck pain?

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

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