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 an effective treatment, it is necessary to understand the causes of neck pain. For this, a comprehensive examination is carried out. Based on the obtained diagnostic results, 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 consists of seven vertebrae. Muscles, ligaments and nerves provide stability - the muscular framework. Poor posture or excessive tension creates congestion, which reduces blood flow, causing muscle pain and myositis (inflammation).

Rarely, neck pain is felt locally. More often it spreads to the shoulder, sometimes even 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 of the hands or the back of the head, hyperemia and swelling of the skin may occur. Discomfort can be short-term or long-term, 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, together with neck pain, 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 the nature, neck pain can be non-specific and specific. In the first case, we are talking about discomfort, the clear cause of which is missing. It most often occurs due to excessive straining of the trapezius muscles. 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, disappears after the elimination of the provoking factor.
• Chronic cervicalgia - continues for more than three weeks, is recurrent or constant.

According to etiopathogenetic classification, vertebrogenic and non-vertebrogenic pains in the neck area are distinguished. In the first case, we are talking about 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.

According to the area of localization, the pain syndrome is distinguished in the front, back and side regions of the neck. Each of them has specific causes. Therefore, 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 complaints, such as injuries to the intervertebral discs or vertebrae. Discomfort often occurs as a result of incorrect posture, which leads to muscle-fascial strain.

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;
• increase in muscle tone;
• hypothermia, exposure to currents;
• wrong 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;
• lack of minerals.

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, complaints usually go away 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

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 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 observed when bending forward and during movement. It is 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 with swallowing, chewing movements and turning the head. It is accompanied by the formation of swelling and compression. 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. The disturbance 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. It is accompanied by febrile fever. It is the result of an extensive paratonsillar abscess.
• Cervical plexitis - the intensity of clinical manifestations depends on the number of damaged nerve structures. Most often, sharp pain appears from the anterolateral part of the neck. There is difficulty in coughing and speaking. The discomfort radiates to the ears, chest and back of the head. There is a feeling 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 constant pain and nagging pain. Swelling and thickening of the skin occurs. Shooting pain radiates to the front of the neck and spine.
• Lymphadenitis - 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 head tilt and speech. The skin is hyperemic and swollen. It is 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 even with inflammation of the mucous membrane of the trachea and esophagus. Discomfort is a consequence of a 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 at the computer and low levels of physical activity. Pain occurs due to pathological changes in the spine.

Pain in the back of the neck has the following causes:

• Osteochondrosis is associated with degenerative-dystrophic disorders of the intervertebral discs, a decrease in their strength and a decrease in height.
• Sprains are a complication of osteochondrosis, accompanied by protrusion of the intervertebral disc. Creeps are caused by damage to the vertebral artery and nerve structures.
• Intervertebral hernias occur when protrusions are advanced. The internal contents of the intervertebral disc protrude into the spinal canal, compressing 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. It is accompanied by acute pain when pressing on the back of the neck, as well as during physical activity.

Among the systemic diseases, ankylosing spondylitis can be distinguished, which affects the articular structures and is characterized by limited mobility. It is accompanied by the formation of fixed and stable conglomerates due to the fusion of individual beads 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.

Lateral neck pain: causes

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

The cause is also muscle spasm that occurs during sudden movements, excessive stress and hypothermia. Pain in the side of the neck is observed with malignant processes in the larynx, pharynx and thyroid gland. You should not leave things to chance. If primary symptoms appear, you should consult a doctor. This approach allows you to take treatment measures in time 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 provoke pain in the neck. Duplex scanning is performed to scan the large vessels and determine the state of blood flow.
• X-ray or CT (computed tomography) examination - determines the displacement of the vertebrae and the deformations of the bones. 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 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 a throat swab is prescribed. Serological tests (PCR, ELISA, RIF) are also required.

Treatment for neck pain

For neck pain, conservative and non-surgical methods are prescribed. Drug treatment is aimed at relieving pain, eliminating the cause of discomfort and restoring the body. The therapy is prescribed depending on the stage of the pathology, the cause of the occurring disorders, 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

Animations 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. Gentle rubbing and agitation helps relieve pain.

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

Tablets and ointments for neck pain

It is recommended to take some 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 heating patch or ointment. They relieve hyperemia and swelling, which reduces pressure on nerve endings and reduces spasm.

Exercises for neck pain

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

Smooth, not jerky movements will help reduce discomfort:

• lie on your back, press your head against a flat, but not soft pillow until you count 5 (from 5 to 7 approaches);
• lie on your side, raise your head and hold until you count 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 exercise is 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 muscular corset will weaken and the situation will worsen.

What not to do if you have neck pain

If discomfort often appears in the cervical spine, it is unacceptable that:

1. Maintain a forced position of the body for a long time, in which the neck is in a tense state.
2. Lift heavy objects and do manual labor.
3. You are exposed to severe stress, which causes vasospasm, which negatively affects blood circulation.
4. Frequent drinking of alcohol and smoking, which contributes to a continuous narrowing of vascular structures.
5. Dress inappropriately for the weather, stay in shorts and don't wear a hat or scarf during the cold season.

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

When you should go to the doctor urgently

Specialist help 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 falling asleep and does not subside 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 of the hands also requires professional help.

Drug 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, affect muscle excitability;
• muscle relaxants - relieve painful muscle tension, improve motor activity.

In case of severe pain, injections at 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 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 known - 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 purpose of the operation is to restore the supporting motor functions of the spine. After surgical treatment, a long-term rehabilitation is required, which is necessary to prevent various, not rare, complications. The results of the operation depend on the duration of the procedure and compliance with medical recommendations for recovery.

Manual therapy

The minimally invasive technique involves the use of manual techniques. Effectiveness targets joints, muscles, ligamento-articular and bone structures. Manual therapy improves the condition of spinal hernias, poor posture, elongation and osteochondrosis. Improves neck pain condition.

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 is aimed at influencing the magnetic field, electric current, temperature and mechanical effects on the body. The procedures are painless, do not cause negative reactions or complications if you follow the doctor's recommendations. Physiotherapy is indicated for the treatment of chronic diseases and 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 (modulated sinusoidal 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 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 that improve microcirculation are initiated. Inflammation is reduced, swelling is eliminated and pain is reduced.

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. It is described when the process is chronic and in the recovery phase.

Exercise therapy

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

The physical therapy program is designed by a doctor, taking into account the medical history and contraindications. If necessary, adjustments are made to it 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 an exercise group, it's important to consider:

• the main task is to tone the muscles, they must become elastic;
• it is important that the movements are carried out without problems, because sharp and fast movements will only worsen the condition;
• Exercises should be performed on a flat surface using a mat and special rollers.

It is important to observe regularity and frequency. If discomfort appears, 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 extreme right, then to the left. It ensures the 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, pulling your chin. Exercise improves posture in the cervical spine.

A set of exercises have also been developed to strengthen weak muscles in order 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 right and left animations.

Which doctors should I contact for neck pain?

If discomfort appears, you should 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 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.

Therapy for neck pain 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.