Neck pain(cervicalgia) is pain of varying nature and intensity that occurs in the cervical region.The symptom is accompanied by dizziness, a feeling of numbness in the back of the head or arm, local redness and swelling of the skin.The neck may hurt due to infectious and inflammatory diseases of this area, injuries and degenerative processes in the spine, after a long stay in a forced and uncomfortable position.To determine the cause of neck pain, CT, MRI, ultrasound and laboratory tests are prescribed.Painkillers, NSAIDs and physiotherapy methods are used to relieve symptoms.
General characteristics
Neck pain occurs periodically in 70% of the adult population.These sensations can vary in intensity and duration: from short-term discomfort to intense pain that makes daily activities difficult.Most often, neck pain is localized in the cervical spine or along the anterolateral surfaces.Typically, patients experience a sudden “lumbago,” which is replaced by persistent pain.The nature of the pain varies: throbbing, tingling, pressing.They can radiate to the shoulder, scapula and occipital region.
Unpleasant sensations are intensified by turning and tilting the head, so the person is forced to turn their entire body.Often the neck begins to hurt after a long stay in an uncomfortable position: patients note that the discomfort appeared after a day of work at the computer or at the sewing machine.Many patients associate the development of neck pain with hypothermia and the effects of drafts.If your neck hurts very much or the pain is associated with dizziness, numbness in the back of the head, or tinnitus, you should see a qualified doctor as soon as possible.
Classification
Depending on the duration of neck pain, we distinguish between an acute form which can last up to 10 days, and chronic neck pain, which can be constant or recurrent.In accordance with the etiopathogenetic classification, there are two forms of neck pain:
- Vertebrogenic neck pain.Develops as a result of primary damage to the osteochondral structures of the cervical spine.This group includes spondylogenic neck pain, associated with bone lesions and compression of the spinal cord, and discogenic neck pain, caused by deformation of the intervertebral discs.
- Non-vertebrogenic neck pain.Includes all other causes of neck pain.Unpleasant sensations may occur due to inflammatory processes in the musculo-ligamentous apparatus, pathologies of internal organs - the pharynx, thyroid gland, lymph nodes and salivary glands.
Depending on the localization, the pain syndrome is distinguished in the front or in the lateral parts of the neck, at the level of the spine.Separately, a sore throat is isolated.Neck pain, which radiates to neighboring anatomical areas, is divided into cervicocranialgia (spread of pain to the occipital region) and cervicobrachialgia (cervicobrachial syndrome).
Why does my neck hurt?
Causes of sore throat
A scratchy, scratchy feeling in the throat is associated with the common cold, but the unpleasant sensations can often be caused by other reasons (excessively dry indoor air, exposure to air pollutants).Sometimes the pain syndrome is so strong that patients feel as if their whole neck hurts.Conditions such as:
- Laryngitis: atrophic, hemorrhagic, hyperplastic.
- Viral diseases: ARVI, infectious mononucleosis, flu, etc.
- Bacterial infections: tonsillitis, diphtheria, scarlet fever.
- Allergic inflammation: laryngotracheitis, pharyngitis.
- Foreign bodies in the throat;meat and fish bones, for children - toy parts.
- Deficiency states:deficiency of vitamins B12 and B2, lack of ascorbic acid, iron.
- Gastroesophageal reflux.
- Rare causes: long styloid process, Itsenko-Cushing syndrome, malignant tumors of the throat or vocal tract.
Causes of neck pain in the front
Uncomfortable sensations can be localized directly under the chin, in a limited area, but most often the discomfort results in intense, diffuse pain.The pain intensifies when swallowing, turning the head, or squeezing the neck with a shirt collar.Neck pain is caused by:
- Thyroid pathologies: acute and subacute thyroiditis, diffuse toxic goiter, Hashimoto's thyroiditis.
- Injuries: sprains and tears of muscle fibers, blows to the neck.
- Inflammatory processes:myositis, neuritis, tendonitis.
- Purulent diseases: suppurating cervical cyst, peritonsillar abscess.
- Damage to lymphoid formations: lymphadenitis, lymphangitis.
- Cervical compression syndrome: radicular, vertebral artery.
- Diseases of related organs: esophagitis, tracheitis.
- Angina attack.
Causes of pain in the cervical spine
Patients complain of neck pain that occurs along the back surface.The painful sensations are intense;due to constant "lumbago", the person is forced to keep the head and shoulder girdle immobile.Pain in the cervical spine can be a symptom of the following pathological conditions:
- Degenerative diseases of the spine: cervical osteochondrosis, osteoarthritis, disc prolapse or herniation.
- Bone injuries: compression fractures of the cervical vertebrae, compression of the spinal cord, fractures of the vertebral arches and processes.
- Damage to other structures: ruptures of the supraspinous and interspinous ligaments of the spine, damage to the paraspinal muscles.
- Systemic connective tissue diseases: ankylosing spondylitis (ankylosing spondylitis), arthritis (rheumatoid, psoriatic), Reiter syndrome.
- Infectious process: osteomyelitis, spinal tuberculosis.
- Rare causes: presence of pathological bilateral cervical ribs, Klippel-Feil syndrome.
Causes of side neck pain
Severe pain along the neck usually radiates to the shoulder or ear.A person may feel tingling, burning, or throbbing in this area.In case of severe discomfort, a secondary torticollis is formed, in which the head is constantly tilted to the painful side, and the chin is turned to the healthy side.The most common reasons for side neck pain are:
- Blood vessel pathologies: varicose veins of the neck, atherosclerosis of the large cervical arteries which supply blood to the brain.
- Staying in an uncomfortable position: head constantly lowered when working at the computer, poor pillow for sleeping, gait peculiarities with the neck tilted in the same direction.
- Muscle spasms: with a sudden turn of the head, intense physical activity, after hypothermia.
- Retropharyngeal abscess.
- Oncological diseases: neoplasms of the thyroid and parathyroid glands, tumors of the lateral aspect of the pharynx and larynx.
- Congenital diseases: Grisel syndrome, pterygoid neck with Shereshevsky-Turner anomaly.
- Rare causes: complications after subarachnoid hemorrhage, meningitis.
Diagnosis
A person who suffers from neck pain most often turns to an osteopath or a neurologist.The exam is long and complex;To make a correct diagnosis, it is necessary to exclude many causes of neck pain.A diagnostic research involves the use of laboratory and instrumental methods aimed at visualizing the affected area and looking for signs of concomitant diseases.The most informative are:
- Ultrasound.Ultrasound of the neck and other parts of the body is used for rapid, non-invasive visualization of all cervical structures, thereby identifying signs of internal organ pathology that may cause neck pain.A targeted ultrasound of the thyroid gland and submandibular salivary glands is performed.Double-sided scanning allows you to assess the state of blood flow in large vessels.
- X-ray imaging.Neck examination x-ray is used to identify deformations of bone structures, displacements of the vertebrae, which always cause neck pain.A more informative method is computed tomography of the spine, which allows you to assess the nature and extent of spinal disorders.MRI is recommended to study the ligamentous apparatus.
- Functional diagnosis.The appearance of neck pain can be caused by damage to the muscular system, so it is advisable to perform electromyography.If radicular pain is suspected, electroneurography is indicated.To detect cervical kyphosis, a Forestier test is necessary.The degree of pain is determined using the McGill questionnaire.
- Laboratory methods.General and biochemical blood tests are necessary to exclude acute inflammatory processes, which can cause neck pain.The concentration of thyroid hormones should be determined.In the presence of a general infectious syndrome, bacteriological culture of sputum or throat smears and serological reactions (RIF, ELISA, PCR) are carried out.
If the patient feels pain not only in the neck, but also in the throat, an examination by an otolaryngologist is necessary.In case of severe pain, especially in elderly patients or with a history of heart disease, an ECG is recorded to exclude atypical forms of angina and myocardial infarction.In cases of severe spinal damage accompanied by sensory disturbances or paresis, myelography is performed to assess the condition of the spinal canal.
Treatment
Help before diagnosis
If your neck starts to hurt, you should not delay in seeing a doctor.Neck pain requires careful diagnosis to determine the causes of the unpleasant symptoms.Sudden movements at the cervical level, drafts and hypothermia should be avoided.Before the diagnosis is verified, neck pain is relieved using warming procedures (wrapping the cervical area with a woolen scarf).If the pain is intense, it is possible to take analgesics from the NSAID group.But these medications should not be taken for a long time without a doctor's prescription, as they can cause ulcers and bleeding in the gastrointestinal tract.
Conservative therapy
Medical tactics for neck pain depend on the cause of the disease and the intensity of the pain.Isolated drug treatment is rarely used;its combinations with modern physiotherapeutic methods are more effective.To relieve neck pain and eliminate the underlying pathology that caused neck pain, the following groups of drugs are used:
- NSAIDs.Medicines effectively eliminate the inflammatory process and relieve pain.To reduce side effects, it is advisable to use selective COX-2 inhibitors that do not affect the gastrointestinal mucosa.
- Muscle relaxers.Medicines quickly eliminate muscle spasms and after relaxing the muscles, the neck hurts much less.The effect is observed from the first injection;to consolidate the effect, the product is used in courses.
- Anesthetics.Used for severe neck pain that the patient cannot tolerate.Medicines are given to the affected area in the form of injections (blockages).Long-term administration of local anesthetics is not recommended.
- Antibiotics.The drugs are indicated for bacterial and purulent processes in the cervical region that cause pain.In such a situation, the discomfort in patients ceases after the cause is eliminated.
- Vitamins.B vitamin preparations, especially thiamine, are actively used in cases where pain in the neck area is chronic.Medications improve nutrition of spinal roots and nerves.
Physiotherapy
To eliminate muscle tension that causes neck pain, use a Shants collar, which is recommended to be worn for 2-3 weeks.The neck hurts less after local thermal procedures - mud baths and compresses, electrophoresis with anesthetics.Manual therapy techniques are useful in restoring the anatomical position of the vertebrae and discs.Magnetic therapy and acupuncture help reduce chronic neck pain.After the acute pain subsides, massage sessions begin, and physiotherapy should be supplemented with exercise therapy methods.
Surgical treatment
For neck pain caused by spinal pathology, surgery is necessary.To reduce pressure on the nerve roots, discectomy, foraminotomy and laminectomy are used.When hernias are detected, appropriate operations are performed;when neoplasms are detected in the cervical part of the body, they are removed surgically.Severe degenerative lesions of the spine are an indication for spinal fusion.If neck pain is caused by ulcers or cysts, it is necessary to open them, drain them and wash the resulting cavity with antibacterial solutions.