Pain in the neck

Almost two-thirds of people experience neck pain (cervicalgia). Causes include acute conditions such as muscle strains and sprains, 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 conducted. Based on the obtained diagnostic results, the doctor prescribes therapy. You should not self-medicate, as many cases cannot be postponed. 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 overload, which reduces blood flow, causing muscle pain and myositis (inflammation).

Rarely, neck pain is felt locally. It most often spreads to the shoulder, sometimes even to the arms, all the way 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 intensity. 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 resolves within a few days to 2 weeks and is not a cause for concern. Neck pain is considered chronic if it lasts longer than three months. If neck pain is accompanied by symptoms that differ from those listed, 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, which has no clear cause. It most often occurs 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 cervicalgia - lasts no more than 10 days, disappears after elimination of the provoking factor.
• Chronic cervicalgia - lasts longer than three weeks, repeats or is constant.

According to the etiopathogenetic classification, vertebrogenic and non-vertebrogenic pain in the neck area is 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 differs in the front, back and side of the neck. Each of them has specific causes. Accordingly, each case requires the determination 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 complaints, such as injuries to intervertebral discs or vertebrae. Discomfort often occurs as a result of improper posture, which leads to muscle-fascial strain.

Neck pain occurs for the following reasons:

• long-term sitting at the computer;
• excessive work, 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;
• 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, the discomfort usually disappears on its own. If the discomfort lasts longer, becomes chronic or additional symptoms appear, a consultation with a specialist is required.

Pain in the front of the neck: causes

Discomfort of varying intensity 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 pain in the front of the neck are:

• Diseases of the thyroid gland (toxic goiter, Hashimoto's thyroiditis) - discomfort is caused by inflammatory processes and endocrine pathologies. Increased pain is observed when bending forward and during movement. It is accompanied by an increase in temperature, rapid heartbeat, feeling hot and increased sweating.
• Sialadenitis is damage to the salivary glands of the jaw. The pain progresses with swallowing, chewing movements and turning the head. Followed by swelling and compaction. It is characterized by dry mouth and difficulty eating. It appears 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 discomfort is accompanied by redness of the skin on the front of the neck, which becomes bright pink and hot to the touch. The pain is pulsating and intense, so the patient may refuse to eat. Associated with 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 occurs from the anterolateral part of the neck. There is difficulty in coughing and speaking. The discomfort spreads to the ear, chest and back of the head. There is a sensation of "crawling" and paresthesia. It occurs due to injury, hypothermia or after vaccination.
• Rheumatic diseases are systemic disorders of connective tissue (collagenosis) with skin and muscle damage. Dermatomyositis and scleroderma are characterized by constant pain and soreness. 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 in atypical attacks of angina. The pain is more pronounced and is accompanied by difficulty breathing. It becomes difficult to speak and swallowing is difficult.

The pain is localized in the front and in inflammation of the lining 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 head is a consequence of long-term work at the computer and low level of physical activity. Pain is caused by pathological changes in the spinal column.

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 protrusion of the intervertebral disc. Protrusions are caused by injury to the vertebral artery and nerve structures.
• Intervertebral hernias occur when the protrusions have progressed. The internal contents of the intervertebral disc come out into the spinal canal, compressing the nerve endings.
• Spondylosis – bony protrusions (osteophytes) appear at the edges of the vertebral bodies, while the intervertebral discs shrink, adjacent vertebrae fuse, and neck mobility is limited.

Pain in the back of the neck is characteristic of myofascial syndrome, in which certain muscles spasm. It is accompanied by acute pain when pressing on the back of the head, as well as during physical activity.

Among the systemic diseases, ankylosing spondylitis stands out, which affects joint structures and is characterized by limited mobility. Followed by the formation of solid 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 that requires immediate medical attention is a compression fracture of the spine. It is caused by a whiplash injury to the neck.

Neck pain on the side: causes

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

It is also a cause of 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. Things should not be left to chance. If primary symptoms appear, it is necessary to consult a doctor. This approach allows you to take timely treatment measures and eliminate the development of complications.

Diagnosis of the cause 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 - prescribed for rapid visualization of cervical structures and identification of diseases of internal organs that cause neck pain. A duplex scan is performed to scan large blood vessels and determine the state of blood flow.
• X-ray examination or CT (computed tomography) - determines the displacement of the vertebrae and deformations of the bones. It allows you to determine the degree of spinal disorders and the nature of the disorders.
• Functional diagnosis - damage to the muscular system is determined by MRI of the cervical spine.

In order to confirm inflammatory processes, a blood analysis is done. The thyroid hormone level is also determined. If general infectious symptoms are present, a bacteriological culture or throat swab is prescribed. Serological tests (PCR, ELISA, RIF) are also required.

Treatment of neck pain

Conservative, not surgical treatment methods are prescribed for neck pain. Drug treatment is aimed at alleviating pain, eliminating the cause of discomfort and restoring the body. Therapy is prescribed depending on the stage of the pathology, the cause of the disorder, the age and characteristics of the patient's body.

In order 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

Head tilts and rotations, as well as light massage, will help relieve acute neck pain. The tension gradually decreases, which contributes to the improvement of 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.

In the first 24 hours after the onset of discomfort, you can use cold or warm compresses. Heating the door with a heating pad is only allowed from the side or the back.

Tablets and ointments for neck pain

It is recommended to take any analgesic that temporarily improves the condition. NSAIDs are prescribed, which not only relieve pain, but also have 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 spasm.

Exercises against neck pain

For moderate aching pains, you can perform light gymnastic exercises on your own. It is important to monitor your condition so that you do not cause damage.

Smooth and non-sharp movements will help reduce discomfort:

• lie on your back, press your head on a flat, but not soft pillow until you count 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, offering 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 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. 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. Be exposed to severe stress, which causes vasospasm, which negatively affects blood circulation.
4. Frequent consumption of alcohol and smoking, which contributes to the permanent narrowing of vascular structures.
5. Dress inappropriately for the weather, stay out of drafts and don't wear a hat or scarf in the cold season.

It is unacceptable to sleep on a soft mattress and a high pillow. It is necessary to avoid sudden 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 stop 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 the position of your body.

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

Drug treatment

Combination therapy is usually prescribed, which includes:

• non-steroidal anti-inflammatory drugs - relieve discomfort and swelling, remove residual inflammation;
• analgesics – relieve pain and improve the general condition, but do not remove 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.

Operation

The operation is performed to restore the functionality of the cervical spine. The most commonly used decompression tactics are indicated for compression syndrome, when nerve roots are compressed by a pathological defect. Microsurgical discectomy, laminectomy and nucleoplasty are used. Also, in case of pain in the cervical spine, stabilization techniques are popular - arthrodesis, vertebroplasty, implantation of fragments of bone tissue and installation of fixed metal structures.

Surgical intervention is aimed at removing the cause (hernia, tumor, osteophytes, etc. ). The purpose of the operation is to restore the motor functions of the spine. After surgical treatment, long-term rehabilitation is required, 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 focused on the joints, muscles, ligamento-articular and bone structures. Manual therapy improves the condition of spinal hernias, poor posture, protrusion and osteochondrosis. It improves the condition of neck pain.

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 condition is improving.

Physiotherapy

Physiotherapy treatment is focused on the influence of magnetic field, electric current, temperature and mechanical action on the body. The procedures are painless, do not cause unwanted reactions or complications if you follow the doctor's recommendations. 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, activating its own defenses. The complex of procedures makes it possible 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 is aimed at activating specific enzymes, changing capillary osmotic pressure and improving blood circulation.
• UVT (shock wave therapy) - processes that improve microcirculation are triggered with the help of low-frequency acoustic waves. Inflammation is reduced, swelling is removed and pain is reduced.

In order to achieve a pronounced effect, it is recommended to undergo a course of physiotherapeutic procedures. Improvements are usually noticed 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 aims to create the muscular framework of the neck, relieve tension and restore blood circulation. An individual approach is used for each patient, taking into account his capabilities and needs.

The physical therapy program is drawn up by the doctor taking into account the medical history and contraindications. If necessary, they are adjusted taking into account the dynamics of the patient's condition, which eliminates the development of complications and makes it possible to achieve the expected result.

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

• the main task is to tone the muscles, they must be elastic;
• it is important to perform the movements smoothly, because 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 respect regularity and frequency. If discomfort occurs, it is necessary to 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 enables the mobility of the neck vertebrae.
• Exercise no. 2 – Lower your head down, pressing your chin to your chest so you can feel your ribcage. This exercise improves neck mobility and relieves muscle stiffness.
• Exercise no. 3 – Move your head back, tucking your chin in. Exercise improves posture in the cervical spine.

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

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

conclusions

Between 30 and 70% of the population has 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.