Pain in the neck

Nearly two-thirds of people suffer from neck pain (cervical pain). Causes include acute conditions such as muscle strains and whiplash, as well as 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 thorough examination is carried out. Based on the diagnostic results obtained, the doctor prescribes treatment. You should not self-medicate, as many cases cannot be delayed. Pain that seems harmless at first glance can lead to serious complications.

Main Features

The neck is a sensitive area of the body - the cervical spine is made up 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, up to the fingers. May be felt in the back of the head, causing headache, dizziness and vision problems. When the neck is stiff, it becomes difficult to turn and tilt the head and is accompanied by significant discomfort.

Pain in the neck region varies in nature and intensity. Numbness of the hands or back of the head, hyperemia and swelling of the skin may occur. The discomfort may be short or long lasting, making daily activities difficult.

Acute neck pain usually resolves within a few days to 2 weeks and is not cause for concern. Neck pain is considered chronic if it lasts more than three months. If, in addition to 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 their nature, neck pain can be nonspecific and specific. In the first case, we are talking about discomfort in which the obvious cause is absent. Most often this occurs due to overload of the trapezius muscle. Specific pain has a specific cause associated with a specific disease.

Depending on the duration, there are:

• Acute neck pain - lasts no more than 10 days, 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 region are distinguished. In the first case, we are talking about a primary lesion of the osteochondral structures of the cervical vertebral region. It develops in the context of spondylogenic and discogenic neck pain due to compression of the spinal cord, damage to bone structures and deformation of the intervertebral discs.

Depending on the area of localization, the pain syndrome is distinguished in the anterior, posterior and lateral regions of the neck. Each of them has specific causes. Accordingly, each case requires the appointment of an individual treatment plan.

Causes of neck pain

Most neck pain is nonspecific. This means that doctors cannot determine a specific medical cause for complaints, such as injuries to the intervertebral discs or vertebrae. Discomfort often results from poor posture, which leads to musculofascial tension.

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;
• hormonal changes during menopause;
• stress, depression and anxiety;
• mineral deficiency.

Very rarely, neck pain is a symptom of inflammation or injury to the cervical spine. The most common cause is excessive musculo-fascial tension in the shoulders. After a few days, the complaints usually disappear on their own. If the discomfort persists 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 anterior 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 complete 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, increased heart rate, a 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 of the head. Accompanied by the formation of swelling and compaction. Characterized by dry mouth and difficulty eating. This occurs with weakness, chills and fever.
• Purulent inflammation of the pharynx - the inflammatory process spreads to adjacent tissues, which leads 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 warm to the touch. The pain is throbbing and intense, so the patient may refuse to eat. Associated with febrile fever. It is the consequence of an extensive para-tonsillar abscess.
• Cervical plexitis - the intensity of clinical manifestations depends on the number of damaged nerve structures. Most often, sharp pain originates from the anterolateral part of the neck. There is difficulty coughing and speaking. The discomfort radiates to the ear, 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 disorders of connective tissue (collagenosis) leading to damage to the skin and muscles. Dermatomyositis and scleroderma are characterized by constant, throbbing pain. Swelling and thickening of the skin occurs. The shooting pain radiates forward through 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 tilting the head and speaking. 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 during atypical attacks of angina. The pain is more pronounced and is accompanied by shortness of breath. It becomes difficult to speak and there is difficulty swallowing.

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

Neck pain: causes

Neck discomfort is a consequence of prolonged work at the computer and a low level of physical activity. The pain is due to pathological changes in the spine.

Neck pain has the following causes:

• Osteochondrosis is accompanied by degenerative-dystrophic disorders of the intervertebral discs, a decrease in their strength and a decrease in size.
• Protrusions are a complication of osteochondrosis, accompanied by a protrusion of the intervertebral disc. Protrusions are caused by a violation of the vertebral artery and nerve structures.
• Intervertebral hernias occur when the protrusions are advanced. The internal contents of the intervertebral disc exit into the spinal canal, compressing the nerve endings.
• Spondylosis – bony protrusions (osteophytes) appear at the edges of the vertebral bodies, while the intervertebral discs decrease in size, adjacent vertebrae fuse, and neck mobility is limited.

Neck pain is characteristic of myofascial syndrome, characterized by individual muscle spasms. Accompanied by sharp pain when pressing on 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 durable conglomerates due to the fusion of individual vertebrae with each other. More rarely, neck pain 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 to the neck.

Lateral neck pain: causes

Pain on the side of the neck may be throbbing, tingling, or burning. It radiates up 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 spasms that occur during sudden movements, excessive stress and hypothermia. Pain on the side of the neck is observed with malignant processes in the larynx, pharynx and thyroid gland. We must not 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 the thyroid gland is prescribed for rapid visualization of cervical structures and identification of diseases of internal organs causing neck pain. Double-sided scanning is performed to scan large vessels and determine blood flow status.
• X-ray examination or computed tomography (CT scan) - determines the displacement of the vertebrae and bone deformities. Allows you to determine the degree of spinal disorders and the nature of the disorders.
• Functional diagnostics - 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. In case of general infectious symptoms, a bacteriological culture or throat swab is prescribed. Serological tests (PCR, ELISA, RIF) are also required.

Treatment of 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. Treatment is prescribed depending on the stage of the pathology, the cause of the disorders that have arisen, 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

Head tilts and turns, along with 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.

Within 24 hours after the onset of discomfort, you can use cool or warm compresses. Warming your neck with a heating pad is only allowed from the side or back.

Tablets and ointments for neck pain

It is recommended to take any analgesic medication 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 patch or warming ointment. They relieve hyperemia and swelling, which reduces pressure on nerve endings and reduces spasms.

Exercises for neck pain

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

Smooth, non-sudden movements will help reduce discomfort:

• lie on your back, press your head against a flat, but not soft, pillow to the count of 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 with light resistance (4 to 6 sets).

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 frequently occurs in the cervical spine, it is unacceptable to:

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

It is unacceptable to sleep on a soft mattress and a high pillow. Sudden turns of the head should be avoided, 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 see a doctor if you experience severe pain that prevents you from falling asleep and does not subside when you change body position.

The absolute indication for a visit to the clinic is a deterioration in general health - the appearance of nausea, dizziness and weakness. Hand numbness also requires professional help.

Medical 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 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 the 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. In addition, 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.

The surgical intervention aims to eliminate the cause (hernia, tumor, osteophytes, etc. ). The aim of the operation is to restore the supporting motor functions of the spine. After surgical treatment, long-term rehabilitation is necessary, necessary to prevent various complications, which are not uncommon. The results of the operation depend on the speed of the intervention and compliance with medical recommendations for healing.

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 postures, 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 is aimed at the influence of magnetic field, electric current, temperature and mechanical effects on the body. The procedures are painless, do not cause side effects and complications if you follow the doctor's recommendations. Physiotherapy is indicated for the treatment of chronic diseases and is prescribed for preventive purposes. Used to strengthen the immune system, treat chronic inflammation and improve posture. The procedures increase the effectiveness of medications.

Physiotherapeutic treatment of neck pain includes:

• SMT (sinusoidal modulated currents) - stimulates the production of biologically active substances in the body. Electrophoresis relieves pain and restores mobility, thereby activating your own defenses. The set of procedures allows you to achieve a pronounced and long-lasting analgesic effect, supplemented by anti-inflammatory and anti-edematous effects.
• MLT (magnetic field and laser beams) – 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 launched that improve microcirculation. Inflammation is reduced, swelling is eliminated and pain is reduced.

To achieve a pronounced effect, it is recommended to undergo a series of physiotherapeutic procedures. Typically, improvements are seen after the first session. Physiotherapy is contraindicated in cases of acute inflammation. Prescribed when the process is chronic and in the recovery phase.

Exercise therapy

Therapeutic physical culture aims to create the muscular framework of the neck, eliminate tension and restore blood circulation. An individual approach is used for each patient, taking into account their capabilities and needs.

The physiotherapy program is established by a doctor taking into account 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 achieving the expected result.

When starting a series of exercises, it is important to consider:

• the main task is to tone the muscles, they must be made elastic;
• it is important to perform movements smoothly, since sharp and rapid movements will only aggravate the situation;
• 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 #1 – Turn your head to the far right, then to the left. Provides mobility of the cervical vertebrae.
• Exercise #2 – Lower your head, resting your chin against your chest to feel the chest cavity. This exercise improves neck mobility and relieves muscle stiffness.
• Exercise #3 – Move your head back by tucking your chin. Exercise improves cervical spine posture.

A series of exercises has also been developed to strengthen weak muscles to create a muscular corset and reduce pain. While seated, 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 for neck pain?

If you experience any discomfort, you should consult a therapist. Depending 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 quality of life and often leads to disability. With prompt consultation with a doctor and treatment, the prognosis is usually favorable.

Treatment of neck pain includes physical, behavioral and pharmacological methods. The most effective are therapeutic exercises, manual therapy, proper organization of the workspace and compliance with ergonomic rules. NSAIDs, injections and antidepressants are prescribed. In advanced cases and when conservative treatment proves ineffective, surgical intervention is performed.