Neck pain is a problem that almost everyone is familiar with.This is the most mobile and sensitive part of the spine, and pain syndromes of varying intensity can arise for very different reasons.Neck pain rarely indicates a serious illness.Nevertheless, periodically recurring and persistent cervicalgia should be a signal to look for the cause of this disease.
The most common is muscle pain;The cause can also be degenerative changes in the spine, injuries and other (non-vertebral) causes: angina pectoris, infectious, endocrine, rheumatic, oncological diseases, pathology of lymph nodes, etc.
Neck pain may be accompanied by dizziness, weakness, headache, muscle cramps, pain and numbness in the arms, etc.
Classification, types and nature of pain syndromes
There are different classifications of cervicalgia:
- Depending on the duration of the course, it can be acute (less than 4 weeks), subacute (1-4 months) and chronic (more than 4 months).
- Depending on the type of pain syndrome, aching, dull, stabbing pains are distinguished.
- Depending on the location, pain is differentiated in the front, back and side areas of the neck.If the pain radiates to the head, it is called cervicocranialgia and to the shoulder - it is called cervicobrachialgia.
- Based on their occurrence, all neck pain can be divided into 2 large groups - vertebrogenic and non-vertebral:
- Vertebrogenic: occur as a result of diseases and injuries to the spine.This is the most common group of causes of cervicalgia.According to statistics it is > 70%.The most common cause is muscle pain.It can be caused by conditions such as myofascial, muscle tonic syndromes, myositis, cervical myopathy, poor posture, etc.
- Nonvertebral: caused by other reasons (myocardial ischemia, infectious, endocrine, oncological diseases, damage to lymph nodes, rheumatism, etc.).
Let's take a closer look at each of the reasons.
Causes that cause neck pain
Injuries (fractures, whiplash)
The mechanism of whiplash is associated with a sharp forward or backward bend of the neck and further recoil in the opposite direction.Such damage is typical of an accident.This leads to stretching of the tendons and ligaments and the muscles, destruction of the vertebrae (compression fractures) and intervertebral discs, subluxations and dislocations of the cervical vertebrae and the formation of hernias.
There are complaints of pain in the neck radiating to the shoulders, head and interscapular area;restriction of movement;Dizziness;nausea.M.b.Visual disturbances, swallowing (dysphagia).
Other possible injuries include bruises, wounds and strained neck muscles.The consequences of a traumatic injury can include a sore throat, migraines, muscle spasms, limited neck mobility, fatigue and vision problems.
Dystrophic diseases of the spine
Osteochondrosis is characterized by age-related degenerative-dystrophic changes in the joints of the spine, which arise due to reduced elasticity, flattening and destruction of the intervertebral discs.
The shock-absorbing function of the intervertebral discs gradually weakens.This leads to increased load on the intervertebral joints, arthrosis, radiculopathy - pain syndrome due to pinching of the nerve roots by bone growths (osteophytes) and tension in the neck muscles.When the vertebral arteries are compressed, ringing in the ears, flickering spots in front of the eyes, blurred vision, and dizziness occur.
The intervertebral discs gradually lose their elasticity.Compression causes a bulge (bulging) into the spinal canal with further hernia formation.This leads to compression and the development of pathological changes in the spinal cord (myelopathy).As a result, the pain syndrome increases, the sensitivity of the arms, legs and scalp is impaired, numbness and paresthesia occur.Weakness appears in the hands, tendon reflexes change.
The pain is one-sided, shooting in nature and increases when leaning to the painful side and throwing the head back, so the patient intuitively bends his head forward and to the side opposite to the place of pain.Osteochondrosis may be accompanied by cervicobrachialgia;Cervicocranialgia.
Spondylosis is usually accompanied by osteochondrosis.With this pathology, bone growths (osteophytes) form on the edges of the vertebral bodies.At the same time, the intervertebral discs become smaller.When adjacent vertebrae fuse, neck mobility is limited.
In spondylolisthesis, the vertebra above it shifts (slips) relative to the vertebra below it.This pathology is manifested by pain in the area of localization.The diagnosis is confirmed by x-ray.
Muscle syndromes
Muscle pain - Myofascial syndrome
Long-term overloading of the neck muscles, ligament stretching and local hypothermia lead to muscle pain.They are accompanied by limited mobility and cramps in the neck muscles.When you feel (feel) the muscles, they feel tense and sore.
The pain syndrome in myofascial syndrome is of moderate intensity, short-lived, increases with neck movements and disappears on its own if untreated.
Muscular tonic syndrome (muscle spasm of the cervicothoracic region)
Clinically, the disease is manifested by persistent and persistent muscle tension, their reflex contraction – muscle spasm.The muscles condense when touched, swell and hurt.
Trigger points form - areas of the most severe pain.Cervicalgia worsens when turning the head, bending and extending the cervical spine.It may be accompanied by numbness in the fourth and fifth fingers.
Mosite
Neck myositis involves inflammation of the muscle fibers.The disease most often occurs against the background of hypothermia.It is manifested by severe pain during movements and impaired muscle tension.Due to the difference in muscle tone, the head tilts to the side and secondary torticollis forms.
Cervical myopathy
Myopathy or degenerative pathology of muscle tissue is characterized by a decrease in myofibril contractility, progressive muscle weakness, limitation of movement, reduced tone and the development of muscle atrophy with subsequent replacement of muscle fibers with fatty or connective tissue.
Cervical plexitis
Cervical plexitis is a disease of the cervical nerve plexus.More often it develops against the background of injury or hypothermia.The pain is localized in the anterolateral surface of the neck and radiates to the ear, chest and back of the head.The pain increases when coughing and speaking and is accompanied by a crawling feeling, paresthesia - a sensitivity disorder in the form of numbness, burning and tingling.
Bad posture
Posture is disrupted when a person sits at a computer for a long time or is in another monotonous position.Predisposing factors also include using a pillow that is too soft or too high to sleep.If you have poor posture, the strain on the ligaments and neck muscles increases, the head moves forward and a forward bend forms.
Other reasons
Neck pain can also be caused by other nonvertebral causes, for example coronary artery disease (coronary artery disease).In the atypical form, pain can radiate to the neck, left arm and shoulder.This disease is characterized by changes in the ECG.Clinical symptoms include chest heaviness, shortness of breath, and weakness with minimal physical activity.
With meningitis (inflammation of the soft meninges), neck pain and headaches are accompanied by neck stiffness, fever and vomiting.A similar clinical picture is observed with meningism.A spinal puncture is performed to differentiate between these diseases.
Cervical lymphadenitis, or enlarged cervical lymph nodes, is the most common cause of cervicalgia (about 50% of all cases) in children.This symptom occurs in various infectious and inflammatory diseases (tonsillitis, pharyngitis, otitis, stomatitis, ARVI, influenza, rhinosinusitis, measles, mononucleosis, tuberculosis) and oncological pathology.The pain increases when swallowing, palpation of the lymph nodes.
Neck pain can be associated with juvenile rheumatoid arthritis.This autoimmune connective tissue disease begins before the age of 16 and is characterized by joint damage and extra-articular manifestations.
Other systemic collagen diseases that can cause neck pain:
- Ankylosing spondylitis is a connective tissue disease that affects the spine.This disease can cause individual vertebrae to fuse.
- Dermatomyositis is characterized by inflammation of muscle tissue and skin, similar to photodermatosis, mainly in exposed areas of the body.
- Scleroderma includes fibrous-sclerotic changes in the skin, muscles, joints, blood vessels and internal organs.
Cervicalgia is observed in torticollis, an orthopedic disease involving deviation of the neck from the vertical axis.This congenital malformation is diagnosed in early childhood and is more common in girls.
Neck pain accompanies tumor diseases; purulent-inflammatory processes: abscesses (limited soft tissue inflammation), cellulitis (soft tissue inflammation without clear boundaries); pathology of the thyroid gland; salivary glands; Plexiites; Osteoporosis; tracheitis (inflammation of the lining of the trachea); Esophagitis (inflammation of the lining of the esophagus); Arteriosclerosis; Reiter's syndrome; Foreign body.
With pathology of the thyroid gland (diffuse toxic goiter, Hashimoto's thyroiditis), the pain syndrome is accompanied by increased body temperature, feeling of heat, increased sweating, increased heart rate, increased irritability and lacrimation.
Sialadenitis is an inflammation of the salivary glands.The pain increases when chewing and swallowing.Swelling of the salivary glands, dry mouth, weakness, chills and fever occur.
A lack of minerals (especially calcium, phosphorus) and vitamins (D 3) leads to bone loss (osteoporosis). The risk of their occurrence increases in women during menopause.Osteoporosis of the cervical spine is accompanied by cervicalgia.
Tracheitis is characterized by increased pain when coughing, while esophagitis is characterized by increased pain when eating.
With atherosclerosis (damage to the walls of large arteries with the formation of atherosclerotic plaques that impede normal blood flow) and other vascular diseases, neck pain is accompanied by dizziness and tinnitus.
Reiter's syndrome is a symptom complex that manifests itself in the classic triad: damage to the urogenital system (urethritis + prostatitis), joints, conjunctivitis.It is most often caused by a mycoplasma infection and is chronic.
Localization of neck pain – what problems does it indicate?
Localization of pain helps to correctly determine the cause of cervicalgia and take the necessary measures in a timely manner.
The main causes of front neck pain are:
- Thyroid pathology.
- Sialadenitis.
- A retropharyngeal abscess is an inflammation of the tissue located in the retropharyngeal space.When swallowing, pain in the neck increases, accompanied by redness of the skin on the front of the neck and an increase in temperature to a feverish level (38-39°).
- Cervical plexitis.
- Systemic connective tissue diseases (dermatomyositis, scleroderma).The pain aches, pulls and radiates to the neck and spine.
- Cervical lymphadenitis.
- Atypical form of ischemic heart disease.
- Tracheitis, esophagitis.
- Compression fractures of the cervical vertebrae.
Causes of neck pain:
- Osteochondrosis, herniated disc, spinal hernia, spondylosis, spondylolisthesis.
- Myofascial syndrome.
- Ankylosing spondylitis.
- Spinal tuberculosis.
- Osteomyelitis.
- Reiter's syndrome.
- Compression fracture of the cervical vertebral bodies, fracture of the arches and processes of the vertebrae.
With arteriosclerosis, side pain in the neck may occur;myofascial syndrome;foreign body;Tumor process in the throat, larynx, thyroid.Lateral cervicalgia can lead to secondary torticollis because the patient always tries to tilt the head to the painful side.
Who to contact if you have neck pain
If you have neck pain, a therapist, pediatrician or neurologist can help.If neck pain is caused by an injury, you should contact a traumatologist or surgeon.Depending on the cause of the pain, the therapist and pediatrician may also refer the patient to specialists such as a rheumatologist, infectious disease specialist, cardiologist, oncologist or otolaryngologist.
Diagnosis of the disease, tests and examinations
To determine the cause of cervicalgia, the doctor examines the patient, asks him about existing complaints, clarifies the duration of the symptom, the nature of the pain, its localization, radiation, combination with other symptoms and carries out palpation.For proper treatment, it is important to determine the cause of cervicalgia.
If necessary, the following is prescribed:
- advice from narrow specialists;
- Instrumental examination methods: ECG, Holter monitoring, EMG – electromyography (determination of bioelectric activity of muscles and neuromuscular transmission), electroneurography (determination of the speed of nerve impulse transmission along peripheral nerve fibers).
- X-ray of the cervical spine, CT, MRI;
- Myelography – contrast radiography of the subarachnoid space (subarachnoid space) of the spinal cord.
- Ultrasound (ultrasound examination) of the salivary glands, thyroid;Duplex scanning (to assess the condition of blood vessels and blood flow).
Treatment methods
Treatment of cervicalgia should be comprehensive.There are conservative treatments aimed at relieving muscle pain and spasms, stopping the inflammatory process, and surgical interventions that are performed to stabilize the spine and ensure the drainage of pus.
Conservative treatment methods:
- Drug therapy.Prescribed only by a specialist, self-medication is not acceptable!For muscle syndromes, this can be either local therapy (use of anesthetic ointments, gels) or the use of systemic drugs to relieve muscle pain and spasms.
- Physiotherapeutic influence methods.These include magnetic therapy, phonophoresis, electrophoresis with drugs, ultrasound, laser, UHF (thermal procedure), cryotherapy (cold exposure), SMT (sinusoidally modulated currents), UVT (shock wave therapy), MLT (magnetic field + laser exposure), paraffin/ozokerite applications and others.
- Movement therapy.The set of exercises is selected individually depending on the cause of the pain.Exercise therapy helps to strengthen the neck and back muscles and form correct posture.
- Massage.It can be performed either separately or in combination with exercise therapy and manual therapy.Improves blood circulation, relieves muscle spasms and normalizes muscle tone.
- Manual therapy.Allows you to relieve muscle tension and pain and eliminate blockages.
Important: Exercise therapy, massage, manual therapy are contraindicated in the acute pain phase and in the event of injuries!
- Reflexology or influencing acupuncture points using needles, cauterization, hirudotherapy.The combination of points, duration and number of procedures differ depending on the pathology.
- Orthopedic techniques.This involves immobilization with a bandage or collar.It is carried out for compression fractures of the cervical vertebrae, in the acute phase for muscle syndromes and osteochondrosis.
- Taping or Kinesio taping refers to the application of special plasters (tapes) to the skin of the neck.It is used to relieve pain and swelling, eliminate muscle spasms and pinched nerve endings, improve blood circulation and lymphatic flow, and restore after injuries and surgeries.The schemes for applying tapes differ depending on the pathology.Depending on the type of application, tapes improve lymphatic drainage, have an anti-inflammatory and pain-relieving effect, normalize muscle tone and stabilize the joints.
Surgical treatment is performed for spinal hernias (when conservative therapy is ineffective), neoplasms, abscesses, cellulitis, and foreign bodies in the neck.
Which medications should be treated?
Non-vertebral syndrome is treated by specialists;Each group of causes has its own therapy.The following groups of drugs are used to relieve muscle pain in the neck:
- NSAIDs (non-steroidal anti-inflammatory drugs).They inhibit the enzyme cycloxygenase (COX).There are COX 1 and COX 2. The use of NSAIDs is a symptomatic therapy to relieve pain and other signs of inflammation.To reduce the risk of side effects, it is recommended to use NSAIDs with a selective effect on COX 2.
- Local anesthetics.They are injected into the area where the nerve exits (blockage).
- Muscle relaxants.Helps relieve muscle spasms and relax muscles.
- Preparations that improve tissue microcirculation.
- Steroid hormones (glucocorticoids).Relieves inflammation, tissue swelling and pain.Usually used when NSAIDs are ineffective or in combination with them.
- Vitamins B, C (ascorbic acid), D and minerals: calcium, phosphorus, potassium, magnesium.Calcium is a vitamin and mineral complex recommended for the treatment and prevention of osteoporosis and fractures.
- Chondroprotectors.Improve the trophism (nutrition) of cartilage tissue and promote cartilage regeneration.
- Anticonvulsants.Prescribed for cramps and muscle spasms.
Drug therapy is prescribed only after a complete examination and identification of the cause of cervicalgia.
Prevent neck pain
To prevent neck pain, it is recommended to follow simple rules:
- Properly organize your workplace (lighting, monitor height, monitor distance to eyes and other parameters must comply with generally accepted standards).
- Minimize risk factors: avoid drafts, hypothermia;Do not allow sudden bending or tilting of the head, etc.
- Pay attention to your posture, even when working on the computer.
- During breaks, do exercise therapy to strengthen the neck and shoulder girdle muscles.
- Optimize physical activity.
- For sleeping, it is better to use not a high pillow, but a regular or, even better, orthopedic pillow.
- Correct body weight.
- Get a medical examination in good time.
Following preventive measures will help maintain health and well-being for many years.A visit to the doctor at the first signs of pathological symptoms and timely treatment will help avoid chronicity of the process and the development of complications.