Neck pain

Almost 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 review is carried out. Based on the obtained diagnostic results, the doctor prescribes treatment. You should not self-medicate, as many cases do not tolerate delay. Pain, which at first glance seems harmless, can cause serious complications.

Main 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 framework. Poor posture or excessive tension creates congestion that reduces blood flow, causing muscle pain and myositis (inflammation).

Rarely, neck pain is felt locally. Most often it spreads to the shoulder, sometimes even to the hands, all the way to the fingers. It can be felt at 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 is different in nature and strength. Numbness of the hands or the back of the head, hyperemia and swelling of the skin may occur. Discomfort can be short-term 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 for more than three months. If, along with the pain in the neck, symptoms other than those mentioned appear, for example, nausea, vomiting, sensitivity to light, fever, chills, nervous disorders, symptoms of paralysis, etc. , you should consult a doctor.

Types of neck pain

Depending on its nature, neck pain can be non-specific and specific. In the first case, we are talking about discomfort for which there is no clear cause. Most often this is 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 cervical pain - lasts no more than 10 days, disappears after elimination of the provoking factor.
• Chronic cervical pain - persists for more than three weeks, recurs or is constant.

According to the etiopathogenetic classification, vertebral and non-vertebral pain in the neck area are distinguished. In the first case, we are talking about a primary lesion of the osteochondral structures of the cervical vertebra. 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.

According to the area of localization, the pain syndrome is distinguished in the anterior, posterior and lateral regions of the neck. Each of them has specific reasons. Accordingly, each individual case requires the appointment of an individual treatment scheme.

Causes of neck pain

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

Neck pain occurs for the following reasons:

• prolonged sitting at the computer;
• overexertion, 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.

Quite rarely, neck pain is a symptom of inflammation or damage to the cervical spine. The most common cause is excessive muscle-fascial tension in the shoulder area. After a few days, the complaints usually disappear on their own. If the discomfort lasts longer, becomes chronic or additional symptoms appear, a 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 real cause without a comprehensive diagnosis.

The causes of front neck pain are:

• Diseases of the thyroid gland (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, rapid heart rate, feeling of heat and increased sweating.
• Sialadenitis is damage to the jaw salivary glands. The pain progresses with swallowing, chewing movements 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, which leads to the formation of a retropharyngeal abscess. Discomfort is accompanied by reddening 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, sharp pain occurs from the anterior-lateral part of the neck. Has difficulty coughing and speaking. Discomfort radiates to the ear, chest and back of the head. There is a sensation of "crawling" and paresthesia. Occurs due to injury, hypothermia or after vaccination.
• Rheumatic diseases are systemic connective tissue disorders (collagenosis) with skin and muscle damage. Dermatomyositis and scleroderma are characterized by persistent pain and soreness. Swelling and thickening of the skin occurs. Shooting 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. 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 angina attacks. The pain is more pronounced and is accompanied by shortness of breath. It becomes difficult to speak and there is difficulty in swallowing.

The pain is localized in the front and with inflammation of the mucous membrane of the trachea and esophagus. Discomfort is a consequence of painful cough and tracheitis. Rare causes include cervical compression syndrome and spinal lesions.

Pain in the back of the neck: causes

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

Pain in the back of 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. Protrusions are caused by damage to the vertebral artery and nerve structures.
• Intervertebral hernias occur when the protrusions are advanced. The internal contents of the intervertebral disc protrude into the spinal canal, pressing on the nerve endings.
• Spondylosis - bony protrusions (osteophytes) appear at the ends 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 individual muscles spasm. 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 joint structures and is characterized by limited mobility. Accompanied by the formation of fixed and permanent conglomerates due to the fusion of individual vertebrae with each other. Less commonly, pain in the back of the neck is associated with spinal tuberculosis, Reiter's syndrome, and osteomyelitis.

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

Side pain in the neck: causes

Pain in the side of the neck can be throbbing, throbbing, or burning. It radiates to the shoulder or ear. Accompanied by the formation of secondary torticollis. This causes the head to tilt to the affected side. Characteristic of atherosclerosis and other diseases of blood vessels.

The cause is also muscle spasm, which occurs with sudden movements, excessive stress and hypothermia. Pain on the side of the neck is observed in 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 measures for treatment 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 gland - 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 examination or CT (computed tomography) - determines the displacement of the vertebrae and bone deformations. It allows you to determine the degree of vertebral disorders and the nature of the disorders.
• Functional diagnostics - damage to the muscular system is determined using MRI of the cervical vertebrae.

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

Neck pain treatment

For neck pain, conservative rather than surgical methods of treatment 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 the pathology, the cause of the disorders, age and characteristics of the patient's body.

In order 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 turns 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. Gentle rubbing and kneading helps relieve pain.

During the first 24 hours after the onset of discomfort, you can use cool or warm compresses. Door heating with a heating pad is only permissible from the side or the back.

Tablets and ointments for neck pain

It is recommended to take any analgesic drugs that temporarily improve the condition. NSAIDs are prescribed, which not only relieve pain, but also have an anti-inflammatory effect.

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

Exercises for neck pain

With moderate painful pain, you can perform light gymnastic exercises yourself. It is important to monitor your well-being so as not to harm.

Smooth and non-abrupt movements will help reduce discomfort:

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

In case of acute and severe pain, any exercises are contraindicated. You should stop exercising if you feel dizzy or weak. 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 often occurs in the cervical spine, it is unacceptable:

1. For a long time, maintain a forced position of the body, in which the neck is in a tense state.
2. Lift heavy objects and perform physical labor.
3. Be exposed to severe stress that causes vasospasm, which negatively affects blood circulation.
4. Frequent drinking of alcohol and smoking, which contributes to the constant narrowing of vascular structures.
5. Dress inappropriately for the weather, stay current and don't 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 sharp turns of the head, which can lead to sudden pinching of the nerve.

When you need to see a doctor urgently

The help of a specialist is necessary if the pain does not subside after 5-7 days or intensifies. You should consult a doctor if you have severe pain that prevents you from sleeping and does not go away 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. Numbness in the hands also requires professional help.

Medication treatment

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, improve motor activity.

In case of severe pain, injections into trigger points 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 vertebrae. 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, stabilization techniques are popular for pain in the cervical spine - arthrodesis, vertebroplasty, implantation of a fragment of bone tissue and installation of fixed metal structures.

Surgical intervention is aimed at removing the cause (hernia, tumor, osteophytes, etc. ). The aim of the operation is to restore the locomotor functions of the spine. After surgical treatment, long-term rehabilitation is necessary, which is necessary to prevent various complications, which are not rare. 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, ligaments-joints and bone structures. Manual therapy improves the condition 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 subsides, the back and neck muscles relax. The patient's well-being improves.

Physiotherapy

Physiotherapy treatment is aimed at the effects of magnetic field, electric current, temperature and mechanical effects on the body. The procedures are painless, do not cause side effects and 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. Procedures increase the effectiveness of 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 by 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 beams) – provides a pronounced therapeutic effect. The procedure is aimed at activating specific enzymes, changing capillary osmotic pressure and improving blood circulation.
• UVT (shock wave therapy) - with the help of low-frequency acoustic waves, processes are started that improve microcirculation. Inflammation decreases, swelling is eliminated and pain decreases.

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

Exercise therapy

Therapeutic physical culture is aimed at creating a muscular framework of the neck, removing tension and restoring blood circulation. An individual approach is applied to each patient, tailored to his capabilities and needs.

The physical therapy program is drawn up by a doctor, taking into account the 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 allows you to get the expected result.

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

• the main task is to tone the muscles, they must be elastic;
• it is important that the movements are carried out smoothly, since sharp and fast movements will only worsen 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 discomfort occurs, you should 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. It ensures mobility of the cervical vertebrae.
• Exercise No. 2 - Lower your head, pressing the chin to the chest, so that you feel the chest cavity. This exercise improves neck mobility and relieves muscle stiffness.
• Exercise No. 3 – Moving the head back, retracting the chin. The exercise improves posture in the cervical spine.

A set of exercises has also been developed to strengthen weak muscles to create a muscular 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 see for neck pain?

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

conclusions

Between 30 and 70% of the population experiences 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, proper 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.