Neck pain is a problem that almost everyone faces.This is the most mobile and fragile part of the spine, and painful syndromes of varying intensity can arise for different reasons.Neck pain rarely indicates a serious illness.However, periodic recurring cervicalgia, which is persistent, should be a signal to find the cause of this condition.
Often this is muscle pain;the cause can also be degenerative changes in the spine, injuries and other (non-vertebrogenic) causes: angina pectoris, infectious, endocrine, rheumatic, oncological diseases, lymph node pathology, etc.
Neck pain may be accompanied by dizziness, weakness, headache, muscle spasms, pain and numbness in the arms, etc.
Classification, types and nature of pain syndromes
There are several classifications of cervicalgia:
- According to the duration of the course, it can be acute (less than 4 weeks), subacute (1-4 months) and chronic (more than 4 months).
- According to the nature of the pain syndrome, pain, dull, shooting pain are distinguished.
- According to the location, pain is distinguished in the anterior, posterior and side of the neck.When the pain radiates to the head, they talk about cervicocranialgia, and to the shoulders - cervicobrachialgia.
- Due to their occurrence, all neck pain can be divided into 2 large groups - vertebrogenic and non-vertebrogenic:
- Vertebrogenic: occurs as a result of disease, spinal injury.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 syndrome, myositis, cervical myopathy, poor posture, etc.
- Nonvertebrogenic: due to other reasons (myocardial ischemia, infectious, endocrine, oncological diseases, damage to lymph nodes, rheumatism, etc.).
Let's look at the individual reasons in more detail.
Causes of neck pain
Injuries (broken bones, whiplash)
The mechanism of whiplash injury is associated with a sharp bending of the neck forward or backward with further recoil in the opposite direction.This kind of damage is typical for accidents.In this case, stretching of tendon-ligamentous apparatus and muscles occurs, destruction of vertebrae (compression break) and intervertebral discs, subluxations and dislocations of cervical vertebrae, and hernia formation.
There are complaints of pain in the neck, radiating to the shoulders, head, and interscapular area;restriction of movement;dizziness;nauseam.b.impaired vision, swallowing (dysphagia).
Other injuries that can result include bruises, cuts and strained neck muscles.The consequences of traumatic injuries can be cervicalgia, migraines, muscle spasms, impaired neck mobility, fatigue, and impaired vision.
Dystrophic disease of the spine
Osteochondrosis is characterized by age-related degenerative-dystrophic changes in the spinal joints that occur due to a decrease in elasticity, flattening and destruction of the intervertebral discs.
The disc's shock absorbing function is gradually affected.This leads to increased load on the intervertebral joints (facets), arthrosis, radiculopathy - a pain syndrome due to pinching of the nerve roots by bone growths (osteophytes), and tension in the neck muscles.When the vertebral artery is compressed, ringing in the ears, flashing spots before the eyes, blurred vision, and dizziness occur.
Gradually, the intervertebral disc loses its elasticity.When it is compressed, protrusion (protrusion) occurs 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 affected with the development of numbness and paresthesia.Weakness appears in the hands, tendon reflexes change.
The pain is one-sided, shooting in nature, increases when leaning to the painful side, throwing the head back, so the patient intuitively bends his head forward and to the side opposite to the location of the pain.Osteochondrosis may be accompanied by cervicobrachialgia;cervicocranialgia.
Spondylosis usually accompanies osteochondrosis.With this pathology, bone growths (osteophytes) are formed on the edges of the vertebral bodies.At the same time, there is a reduction in the size of the intervertebral disc.When adjacent vertebrae are fused, neck mobility is limited.
With spondylolisthesis, the displacement (slippage) of the vertebra above it occurs in relation to the underlying one.This pathology manifests itself as pain in the location area.Diagnosis is confirmed by x-ray.
Muscle syndrome
Muscle pain - myofascial syndrome
Long-term tension of the neck muscles, sprained ligaments, and localized hypothermia lead to muscle pain.They are accompanied by limited mobility and neck muscle spasms.When palpating (feeling) the muscles, they feel tight and sore.
The pain syndrome in myofascial syndrome is moderate in intensity, short-term, intensifies with neck movement, and disappears on its own if not treated.
Muscle-tonic syndrome (muscle spasms of the cervicothoracic region)
Clinically manifested by prolonged and continuous muscle tension, their reflex contractions - muscle spasms.The muscle becomes firm to the touch, swollen, and painful.
A trigger point is formed - the most noticeable area of pain.Cervicalgia worsens when turning the head, flexion and extension of the cervical spine.It may be accompanied by numbness in the fourth and fifth fingers.
Mosite
With neck myositis, inflammation of muscle fibers develops.This disease most often occurs on the background of hypothermia.It manifests itself as severe pain during movement and impaired muscle tone.Due to the difference in muscle tone, the head tilts to one side, and secondary torticollis is formed.
Cervical myopathy
Myopathy or degenerative pathology of muscle tissue is characterized by a decrease in the contraction of myofibrils, progressive muscle weakness, limitation of movement, decreased tone, and the development of muscle atrophy with the subsequent replacement of muscle fibers by fat or connective tissue.
Cervical plexitis
Cervical plexitis is a disorder 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 it radiates to the ears, chest, and back of the head.The pain increases when coughing, talking, and is accompanied by a crawling sensation, paresthesia - a violation of sensitivity in the form of numbness, burning, tingling.
Poor posture
Posture is disturbed when a person spends a long time in front of a computer or is in another boring position.Predisposing factors also include using pillows that are too soft or too high for sleeping.With poor posture, the load on the ligaments and muscles of the neck increases, the head moves forward, and the form is hunched over.
Another reason
Pain in the neck can also be caused by other causes that are not vertebrogenic, for example, coronary artery disease (coronary heart disease. In an atypical form, the pain can spread to the neck, left arm, shoulder. The disease is characterized by changes in the ECG. Clinical symptoms include heaviness in the chest, shortness of breath, weakness with minimal physical activity.
With meningitis (inflammation of the soft meninges), pain in the neck and head is accompanied by a stiff neck, fever, and vomiting.A similar clinical picture is observed with meningism.To differentiate this condition, a spinal tap is performed.
Cervical lymphadenitis, or enlarged cervical lymph nodes, is the most common cause of cervicgia (about 50% of all cases) in children.These symptoms occur in various infectious and inflammatory diseases (tonsillitis, pharyngitis, otitis, stomatitis, ARVI, influenza, rhinosinusitis, measles, mononucleosis, tuberculosis), and oncological pathologies.Pain increases when swallowing, palpation (palpation) of lymph nodes.
Neck pain can accompany juvenile rheumatoid arthritis.This autoimmune connective tissue disease appears before the age of 16 and is characterized by joint damage and extra-articular manifestations.
Other systemic collagenoses that can cause neck pain:
- Ankylosing spondylitis is a connective tissue disease that affects the spine.With this disease, individual vertebrae can fuse together.
- Dermatomyositis is characterized by inflammation of muscle tissue and skin, similar to photodermatosis, especially in exposed areas of the body.
- Scleroderma includes fibrous-sclerotic changes in the skin, muscles, joints, blood vessels and internal organs.
Cervicalgia is observed with torticollis, an orthopedic disease with deviation of the neck from the vertical axis.This congenital defect is diagnosed in early childhood and is more common in girls.
Neck pain accompanying tumor disease; purulent-inflammatory process: abscess (limited inflammation of soft tissue), phlegmons (inflammation of soft tissue without clear boundaries); pathology of the thyroid gland; salivary glands; plexite; osteoporosis; tracheitis (inflammation of the tracheal mucosa); esophagitis (inflammation of the esophageal mucosa); atherosclerosis; Reiter's syndrome; foreign body.
With pathology of the thyroid gland (diffuse toxic goiter, Hashimoto's thyroiditis), the pain syndrome is combined with increased body temperature, feeling hot, increased sweating, increased heart rate, increased irritability, and tears.
Sialadenitis is an inflammation of the salivary glands.The pain increases when chewing and swallowing.There is swelling in the area where the salivary glands are located, dry mouth, weakness, chills, and fever.
With a lack of minerals (especially calcium, phosphorus) and vitamins (D 3), bone loss develops (osteoporosis). The risk of its 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 prevent normal blood flow) and other vascular pathologies, neck pain is combined with dizziness and tinnitus.
Reiter's syndrome is a complex of symptoms shown by the classic triad: damage to the genitourinary system (urethritis + prostatitis), joints, conjunctivitis.It is most often caused by mycoplasma infection and has a chronic course.
Localization of neck pain - what problems do they indicate?
Localization of pain helps to correctly determine the cause of the cervix and take the necessary measures in time.
The main causes of front neck pain are:
- Pathology of the thyroid gland.
- Sialadenitis.
- A retropharyngeal abscess is an inflammation of the tissue located in the retropharyngeal space.The pain in the neck intensifies when swallowing, accompanied by redness of the skin on the front surface of the neck, an increase in temperature to the level of fever (38-39°).
- Cervical plexitis.
- Systemic connective tissue disease (dermatomyositis, scleroderma).The pain is aching, pulling, radiating to the neck and spine.
- Cervical lymphadenitis.
- Atypical forms of ischemic heart disease.
- Tracheitis, esophagitis.
- Compression fracture of the cervical vertebrae.
Causes of pain in the back of the neck:
- Osteochondrosis, disc protrusion, spinal hernia, spondylosis, spondylolisthesis.
- Myofascial syndrome.
- Ankylosing spondylitis.
- Tuberculosis of the spine.
- Osteomyelitis.
- Reiter's syndrome.
- Compression fracture of the cervical vertebral body, fracture of the arch and vertebral process.
Pain in the side of the neck may occur with atherosclerosis;myofascial syndrome;foreign bodies;tumor process in pharynx, larynx, thyroid gland.Cervicalgia on the side can cause secondary torticollis, because the patient always tries to tilt his head to the painful side.
Who to contact for neck pain
A therapist, pediatrician or neurologist will help with neck pain.If neck pain is caused by an injury, then you should contact a traumatologist or surgeon.Depending on the cause of the pain, therapists and pediatricians may also refer patients to specialists such as rheumatologists, infectious disease specialists, cardiologists, oncologists or otolaryngologists.
Disease diagnosis, tests and examinations
To determine the cause of the cervix, the doctor examines the patient, questions him about existing complaints, explains the duration of the symptoms, the nature of the pain, its localization, irradiation, combination with other symptoms, and performs palpation.Determining the cause of the cervix is important for proper treatment.
If necessary, the following are set:
- narrow specialist consultation;
- instrumental examination methods: ECG, Holter monitoring, EMG - electromyography (determines the bioelectric activity of muscles and neuromuscular transmission), electroneurography (determines the speed of transmission of nerve impulses along peripheral nerve fibers).
- X-ray of the cervical spine, CT, MRI;
- myelography - contrast radiography of the subarachnoid space (subarachnoid) of the spinal cord.
- Ultrasound (ultrasound examination) salivary gland, thyroid gland;duplex scanning (to assess the condition of blood vessels and blood flow).
Treatment methods
Cervicalgia treatment should be comprehensive.There are conservative treatments aimed at relieving muscle pain, spasms, stopping the inflammatory process, and surgical interventions are carried out to stabilize the spine and ensure the outflow of pus.
Conservative treatment methods:
- Drug therapy.Prescribed only by medical experts, self-medication is not acceptable!For muscle syndrome, this can be either local therapy (the use of anesthetic ointments, gels) or the use of systemic drugs aimed at relieving muscle pain and spasms.
- Methods of physiotherapeutic influence.These include magnetotherapy, phonophoresis, electrophoresis with medicinal substances, ultrasound, laser, UHF (heat procedure), cryotherapy (cold exposure), SMT (sinusoidal modulated current), UVT (shock wave therapy), MLT (magnetic field + laser exposure), paraffin/ozokerite application and others.
- Exercise therapy.The set of exercises is selected individually depending on the cause of the pain.Exercise therapy helps strengthen the muscles of the neck, back, and the formation of correct posture.
- massageIt can be carried out either separately or combined with exercise therapy and manual therapy.Improves blood circulation, relieves muscle spasms, normalizes muscle tone.
- Manual therapy.Allows you to relieve muscle tension, pain, and remove blocks.
Important: exercise therapy, massage, manual therapy are contraindicated during the acute period of pain, as well as in case of injury!
- Reflexology or influencing acupuncture points using needles, cauterization, hirudotherapy.The combination of points, duration and number of procedures will be different for different pathologies.
- Orthopedic technique.This is immobilization using a Chance bandage or collar.It is performed for compression fractures of the cervical vertebrae, in the acute period for muscle syndrome, osteochondrosis.
- Taping or kinesio taping is the application of a special patch (tape) on the skin of the neck.It is used to relieve pain, swelling, relieve muscle spasms and pinched nerve endings, improve blood circulation and lymph flow, and rehabilitate after injury and surgery.Scheme to use different tapes for different pathologies.Depending on the method of use, the tape improves lymphatic drainage, has anti-inflammatory and analgesic effects, normalizes muscle tone, and stabilizes joints.
Surgical treatment is carried out for spinal hernia (if conservative therapy is ineffective), neoplasms, abscesses, cellulitis, and foreign bodies in the neck.
What medicine to treat
Non-vertebral syndromes are treated by specialists;each group of causes has its own therapy.To relieve muscle pain in the neck, the following groups of drugs are used:
- 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 aimed at relieving pain and other signs of inflammation.To reduce the risk of side effects, it is recommended to use NSAIDs with selective action on COX 2.
- Local anesthetic.They are injected into the area where the nerve exits (block).
- Relax the muscles.Helps relieve muscle spasms and relax muscles.
- Preparations that improve tissue microcirculation.
- Steroid hormones (glucocorticoids).Relieves inflammation, tissue swelling, pain.Usually used when NSAIDs are ineffective or combined 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 bone fractures.
- Chondroprotectors.Increase trophism (nutrition) of cartilage tissue, promote cartilage regeneration.
- Anticonvulsants.Prescribed for convulsions and muscle spasms.
Drug therapy is prescribed only after a full examination and identification of the cause of the cervix.
Prevent neck pain
To avoid neck pain, it is recommended to follow simple rules:
- Arrange your workplace correctly (lighting, monitor level, distance of the monitor to the eyes and other parameters must comply with generally accepted standards).
- Reduce risk factors: avoid drafts, hypothermia;do not allow the head to bend or tilt suddenly, etc.
- Pay attention to your posture, including when working in front of the computer.
- During rest, do exercise therapy to strengthen neck muscles and shoulder girdle.
- Optimize physical activity.
- For sleep, it is better to use an orthopedic pillow not high, but normal, or better.
- Correct body weight.
- Undergo medical examinations on time.
Following preventive measures will help maintain health and well-being for many years.See a doctor when the first signs of pathological symptoms appear and timely treatment will help avoid the chronicity of the process and the development of complications.