Neck pain(cervical pain) is pain of different nature and intensity that occurs in the cervical region.This symptom is accompanied by dizziness, numbness in the back of the head or arms, local skin redness and swelling.The neck can hurt due to infectious and inflammatory diseases in this area, injuries and degenerative processes in the spine, after a long time in an uncomfortable position.To determine the cause of neck pain, CT, MRI, ultrasound and laboratory tests are prescribed.Pain relievers, NSAIDs, and physical therapy are used to relieve symptoms.
General characteristics
Neck pain occurs periodically in 70% of the adult population.These feelings can vary in intensity and duration: from short-term discomfort to severe pain that makes daily activities difficult.Typically, neck pain is localized to the cervical spine or along the anterolateral surface.Often, patients experience sudden “low back pain,” which is then replaced by persistent pain.The pain is of different nature - sharp, tingling, squeezing.They can spread to the shoulders, scapula, and occipital region.
The feeling of discomfort increases when turning or tilting the head, so the patient is forced to turn the whole body.Most often, the neck begins to hurt after a long time in an uncomfortable position: patients note that discomfort appears after a day of work at a computer or sewing machine.Many patients associate the development of neck pain with hypothermia and the effects of drafts.If your neck pain is severe or the pain is combined with dizziness, numbness in the back of the head or ringing in the ears, you should seek qualified medical help as soon as possible.
Classify
Depending on the duration of neck pain, there is an acute form that lasts up to 10 days and a chronic form of neck pain, which can be continuous or recurring.According to the etiological classification, two forms of cervical pain are distinguished:
- Neck pain due to vertebrae.Develops due to primary damage to the bone and cartilage structure of the cervical spine.This group includes vertebral neck pain, which is associated with bone damage and spinal cord compression, and herniated disc, which is caused by deformation of the intervertebral discs.
- Neck pain is not caused by the vertebrae.Includes all other causes of neck pain.Unpleasant sensations can occur due to inflammatory processes in the musculo-ligamentary apparatus, pathology of internal organs - pharynx, thyroid gland, lymph nodes and salivary glands.
According to localization, pain syndrome is distinguished in the front or in the lateral parts of the neck, in the spinal region.Separately, sore throat is isolated.Cervical pain, spreading to neighboring anatomical areas, is divided into cervical pain (pain radiating to the occipital region) and cervical pain (cervical syndrome).
Why does my neck hurt?
Causes of sore throat
An itchy, uncomfortable feeling in the throat is associated with colds, but the discomfort can often be caused by other causes (too dry indoor air, exposure to airborne pollutants).Sometimes the pain syndrome is felt so strongly that the patient feels as if his or her entire neck hurts.Conditions such as:
- Laryngitis: atrophy, hemorrhage, hyperplasia.
- Viral disease: ARVI, infectious mononucleosis, influenza, etc.
- Bacterial infection: tonsillitis, diphtheria, scarlet fever.
- Allergic inflammation: laryngotracheitis, pharyngitis.
- Foreign body in the throat;Meat and fish bones for children - parts of toys.
- Shortage:Vitamin B12 and B2 deficiency, ascorbic acid deficiency, iron deficiency.
- Gastroesophageal reflux.
- Rare cause: long styloid process, Itsenko-Cushing syndrome, malignant tumor of the pharynx or vocal apparatus.
Causes of anterior neck pain
The discomfort may be localized just below the chin, in a limited area, but the discomfort is usually intense, diffuse pain.The pain increases when swallowing, turning the head or strangling with a collar.Neck pain is caused by:
- thyroid disease: acute and subacute thyroiditis, diffuse toxic goiter, Hashimoto's thyroiditis.
- Injury: sprains and tears of muscle fibers, impacts to the neck area.
- Inflammatory processes:myositis, neuritis, tendonitis.
- Pus disease: suppurative cervical cyst, peritonsillar abscess.
- Damage to lymphatic formation: lymphadenitis, lymphadenitis.
- Cervical compression syndrome: radicular artery, vertebral artery.
- Diseases of related organs: esophagitis, tracheitis.
- Angina pectoris.
Causes of pain in the cervical spine
The patient complains of pain in the neck that occurs along the dorsal surface.The pain is very intense;due to constant "back pain", the person is forced to keep his head and shoulder girdle still.Pain in the cervical spine can be a symptom of the following medical conditions:
- Degenerative diseases of the spine: cervical spondylosis, osteoarthritis, disc prolapse or herniation.
- Bone injury: cervical vertebra compression fractures, spinal cord compression, vertebral arch fractures and processes.
- Damage to other structures: rupture of the supraspinous and interspinous ligaments of the spine, damage to paraspinal muscles.
- Systemic connective tissue disease: ankylosing spondylitis (ankylosing spondylitis), arthritis (rheumatism, psoriasis), Reiter syndrome.
- Infectious process: osteomyelitis, vertebral tuberculosis.
- Rare cause: pathological presence of bilateral cervical ribs, Klippel-Feil syndrome.
Causes of one-sided neck pain
Severe pain along the side of the neck often radiates to the shoulder or ear.A person may feel tingling, burning, or pulse in this area.With severe discomfort, secondary torticollis is formed, in which the head is constantly tilted towards the painful side, and the chin turns towards the healthy side.The most common reasons for lateral neck pain are:
- Vascular disease: varicose veins in the neck, atherosclerosis of large arteries in the neck supplying blood to the brain.
- Being in an awkward position: frequent bowing of the head when working in front of the computer, bad pillow when sleeping, peculiar gait with the neck tilted in the same direction.
- Muscle spasms: sudden head turning, intense physical activity, after hypothermia.
- Retropharyngeal abscess.
- Cancer: tumors of the thyroid and parathyroid glands, tumors of the lateral surface of the pharynx and larynx.
- Congenital disease: Grisel syndrome, pterygium with Shereshevsky-Turner malformation.
- Rare cause: complications after subarachnoid hemorrhage, meningitis.
Diagnose
A person with neck pain often sees a chiropractor or neurologist.The examination is long and complicated;To make an accurate diagnosis, many causes of neck pain need to be ruled out.Seeking a diagnosis involves the use of laboratory methods and instruments aimed at visualizing the affected area and looking for signs of concurrent diseases.The most useful information is:
- Supersonic.Ultrasound of the neck and other parts of the body is used to quickly non-invasively visualize all cervical structures, identify signs of pathology of internal organs that can cause neck pain.Targeted ultrasound of the thyroid and submandibular salivary glands was performed.Duplex scanning helps evaluate blood flow status in large vessels.
- Take X-ray images.X-rays of the neck are used to determine deformations of the bone structure, and displacement of the vertebrae always causes neck pain.A more informative method is a CT scan of the spine, which allows assessment of the nature and extent of vertebral disorders.MRI is recommended to study the ligamentous apparatus.
- Functional diagnosis.Symptoms of neck pain may be due to damage to the musculature, so electromyography should be performed.If nerve root pain is suspected, electroneurography is indicated.To detect cervical kyphosis, it is necessary to perform the Forestier test.Pain severity was determined using the McGill questionnaire.
- Experimental methods.General blood and biochemical tests are necessary to rule out acute inflammatory processes that can cause neck pain.Thyroid hormone levels must be determined.When there is a general infectious syndrome, bacterial culture of sputum or throat swab and serological reactions (RIF, ELISA, PCR) are performed.
If the patient has pain not only in the neck, but also in the throat, it is necessary to be examined by an otolaryngologist.In cases of severe pain, especially in elderly patients or with a history of heart disease, an ECG is recorded to rule out atypical forms of angina and myocardial infarction.For severe spinal injuries with sensory disturbances or paralysis, a myelogram is performed to evaluate the condition of the spinal canal.
Treatment
Help before diagnosis
If your neck starts to hurt, you should not delay seeing a doctor.Cervical pain requires careful diagnosis to determine the cause of the bothersome symptoms.It is necessary to avoid sudden movements in the cervical area, drafts and hypothermia.Before confirming the diagnosis, neck pain is relieved with the help of warming procedures (wrapping the cervical area with a woolen scarf).If the pain is severe, NSAID pain relievers can be used.But these drugs should not be used long-term without a doctor's prescription because they can cause ulcers and gastrointestinal bleeding.
Conservation therapy
The treatment strategy for cervical pain depends on the cause of the disease and the intensity of the pain.Treatment with drugs alone is rarely used;Its combination with modern physiotherapy methods will be more effective.To relieve neck pain and eliminate the underlying pathology causing neck pain, the following groups of drugs are used:
- NSAIDs.The drug effectively eliminates the inflammatory process and relieves pain.To reduce side effects, selective COX-2 inhibitors, which do not affect the gastrointestinal mucosa, should be used.
- Muscle relaxants.The drug quickly eliminates muscle spasms, and after relaxing the muscles, the pain in the neck becomes much less.The effect is observed after the first injection;To strengthen the effect, the product is used in procedures.
- Anesthesia.Used for cases of severe neck pain that the patient cannot tolerate.The medicine is given into the affected area as an injection (block).Long-term use of local anesthetics is not recommended.
- Antibiotics.The drug is indicated for bacterial and purulent processes in the cervical area that cause pain.In such a situation, the patient's discomfort will stop after eliminating the cause.
- Vitamin.Vitamin B preparations, especially thiamine, are actively used in cases of chronic neck pain.The drug improves the nutrition of spinal roots and nerves.
Physical therapy
To eliminate muscle tension that causes neck pain, use a Shants necklace, which is recommended to be worn for 2-3 weeks.The neck hurts less after local heat therapies - mud baths and compresses, electrophoresis with anesthetics.Manual therapy techniques are useful for restoring the anatomical position of the vertebrae and intervertebral discs.Magnetic therapy and acupuncture help relieve chronic neck pain.After the acute pain subsides, massage sessions begin and physiotherapy must be supplemented with exercise methods.
Surgical treatment
For neck pain caused by spinal disease, surgical intervention is required.To relieve pressure on the nerve roots, discectomy, foraminectomy, and laminectomy are used.When a hernia is detected, appropriate actions will be taken;When tumors are detected in the cervical part of the body, they will be surgically removed.Severe degenerative spinal lesions are a sign of spinal fusion.If neck pain is caused by ulcers or cysts, it is necessary to open them and drain them, and wash the resulting cavity with an antibacterial solution.