Neck pain(cervicalgia) is pain of various nature and intensity occurring in the cervical region.The symptom is accompanied by dizziness, in the back of the head or arm, local redness and swelling of the skin.The neck can be damaged due to infectious and inflammatory diseases of this area, due to injuries and degenerative processes in the spine, harmful and non-spiritual processes after staying in a forced uncomfortable position.To determine the cause of neck pain, CT, MRI, ultrasound and laboratory tests are prescribed.Analgesics, NSAIDS and physiotherapy methods are used to relieve symptoms.
General features
Neck pain occurs periodically in 70% of the adult population.These emotions can be of different intensity and duration: from short-term discomfort to severe pain that complicates daily activities.More often, neck pain is localized in the cervical spine or anterolateral surfaces.Typically, patients feel a sudden "lumbago" that is replaced by persistent pain.Pain varies in nature - throbbing, tingling, squeezing.They can light up the shoulder, scapula and occipital region.
Unpleasant sensations intensify when turning and bending, so the person has to turn his whole body.Often, the neck begins to hurt after being in an uncomfortable position for a long time: patients note that the discomfort appeared after a working day at the computer or sewing machine.Many patients associate the development of cervicalgia with the effects of hypothermia and drafts.If you have severe neck pain, or the pain is accompanied by dizziness, numbness in the back of the head or tinnitus, you should seek qualified medical attention as soon as possible.
Classification
Depending on the duration of the neck pain, there is an acute form lasting up to 10 days and constant or repeated chronic cervicalgia.According to etiopathogenetic classification, two forms of cervicalgia are distinguished:
- Onebrogenic neck pain.It develops as a result of primary damage to the osteochondral structures of the cervical spine.This group includes spondylogenic cervicalgia associated with bone damage and compression of the spinal cord caused by deformation of the intervertebral discs.
- Non-debilitating neck pain.It includes all other causes of neck pain.Unpleasant sensations can occur due to inflammatory processes in the musculo-ligamentous apparatus, pathologies of internal organs - pharynx, thyroid gland, lymph nodes and salivary glands.
According to the localization, the pain syndrome differs in the front or in the area of the spine, in the neck or in the side.Also, sore throat is isolated.Cervicalgia, which radiates to adjacent anatomical areas, is divided into cervicocracia (skin spread of pain) and cervicobrachialgia (Cervicobrachial syndrome).
Why does my neck hurt?
Causes of sore throat
A scratchy, scratchy feeling in the throat is associated with a cold, but unpleasant sensations can be caused by other reasons (excessively dry indoor air, exposure to atmospheric pollutants).Sometimes the pain syndrome is felt so strongly that the whole neck of patients hurts.Conditions such as:
- Laryngitis: atrophic, hemorrhagic, hyperplastic.
- Viral diseasesARVI, infectious mononucleosis, flu, etc.
- Bacterial infections: tonsillitis, diphtheria, scarlet fever.
- Allergic inflammation: laryngotrachitis, pharyngitis.
- Foreign bodies in the throatOpen Meat and fish bones, for children - parts of toys.
- Disadvantages:Lack of vitamins B12 and B2, ascorbic acid, lack of iron.
- Gastroesophageal reflux.
- It is a rare cause: Long styloid process, Itsenko-Cushing syndrome, malignant neoplasms of the throat or vocal apparatus.
Causes of frontal neck pain
Disturbing sensations can be localized directly under the chin, in a limited area, but more disturbing is severe, diffuse pain.The pain worsens when 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.
- Injury: sprays and tears of muscle fibers, strikes the neck area.
- Inflammatory processes:myositis, neuritis, tendonitis.
- Screening diseases: presumed cervical cyst, peritonsillar abscess.
- Damage to lymphoid forms: 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 along the back surface.Painful sensations are intense;Due to constant "lumbago", the person is forced to keep the head and shoulder girdle still.Pain in the cervical spine can be a symptom of the following pathological conditions:
- Degenerative diseases of the spine: cervical osteochondrosis, osteoarthritis, prolapse or herniated disc.
- Bone injuries: compression fractures of cervical vertebrae, spinal cord, compression fractures of vertebral arches and processes.
- Damage to other structures: Tearing of the supraspinatus and cruciate ligaments of the spine, causing damage to the paraspinal muscles.
- Systemic connective tissue diseases: Ankylosing spondylitis (ankylosing spondylitis), arthritis (rheumatoid, psoriatic), repeated syndrome.
- Infectious processes: osteomyelitis, vertebral tuberculosis.
- It is a rare cause: There are pathological bilateral cervical ribs, Klippel-Feil syndrome.
Causes of lateral neck pain
Intense pain in the side of the neck, usually spreading to the shoulder or ear.A person may feel tingling, burning or pulsation in this area.With severe anxiety, secondary torticollis occurs, the head is constantly directed to the painful side, and the chin is directed to the healthy side.The most common causes of lateral neck pain are:
- Pathologies of blood vessels: Varicose veins in the neck, atherosclerosis of the large cervical vessels that supply the brain.
- Being in an awkward position: Constantly bent head while working on computer, weak pillow for sleeping, neck and light features bent in same direction.
- Muscle spasms: A sharp turn of the head after hypothermia, with intense physical activity.
- Retropharyngeal abscess.
- Oncological diseases: neoplasms of the thyroid and parathyroid glands, tumors of the lateral surface of the pharynx and larynx.
- Congenital diseases: Pterygoid neck with GRISEL syndrome, Shereshevsky-Turner Anomaly.
- It is a rare cause: Complications after subarachnoid hemorrhage, meningitis.
Diagnostics
A person with neck pain most often turns to an osteopath or a neurologist.The exam is long and complicated;To make a correct diagnosis, it is necessary to exclude many causes of neck pain.A diagnostic search involves the use of laboratory and instrumental methods aimed at visualizing the affected area and looking for signs of selected diseases.Most knowledgeable:
- Sonography.Ultrasound of the neck and other parts of the body, rapid non-invasive visualization of all cervical structures, is used to identify signs of pathology of internal organs that may cause neck pain.A targeted ultrasound of the thyroid gland and submandibular salivary glands is performed.Duplex scanning helps to assess the state of blood flow in large vessels.
- X-ray image.Survey radiography of the neck is used to determine the deformation of the bone structures, the deformations of the displacement of the vertebrae, which always cause neck pain.A more informative method is a CT scan of the spine, which allows you to assess the nature and extent of the spine.It is recommended to study MRI, ligament apparatus.
- Functional diagnostics.The appearance of neck pain can damage the muscular system, so it is advisable to perform electromyography.If radicular pain is suspected, electroenurography is indicated.A forester's test is required to detect cervical dysplasia.The degree of pain is determined using the McGill Questionnaire.
- Laboratory methods.General and biochemical blood tests are required to exclude acute inflammatory processes that can cause neck pain.The concentration of thyroid hormones should be determined.In the presence of general infectious syndrome, bacteriological culture of sputum or throat smear and serological reactions (RIF, Elisa, PCR) are carried out.
If the patient has not only the neck, but also the throat, an examination by an otolaryngologist is necessary.Intense pain, especially in elderly patients or with a history of heart disease, an ECG is indicated to rule out atypical forms of angina pectoris and myocardial infarction.Myelography is performed to assess the condition of the spinal canal for sensitive disorders or serious spinal injuries accompanied by paraphyseal injury.
Treatment
Help without diagnosis
If your neck starts to hurt, you should not delay visiting a doctor.Cervicalgia requires careful diagnosis to determine the causes of unpleasant symptoms.Sudden movements in the cervical region, drafts and hypothermia should be avoided.Before the diagnosis is confirmed, neck pain is relieved with the help of warming procedures (wrapping the cervical area with a woolen scarf).If the pain is severe, it is possible to buy analgesics from the NSAID group.But these drugs can cause wounds and bleeding from the gastrointestinal tract for a long time without a doctor's prescription.
Conservative therapy
Medical tactics for cervicalgia depend on the cause of the disease and the intensity of pain.Isolated drug therapy is rarely used;Combinations with modern physiotherapeutic methods are more effective.The following drug groups are used to relieve neck pain and eliminate the main pathology that causes cervicalgia:
- NSAIDs.Medicines effectively eliminate the inflammatory process and relieve pain.To reduce side effects, it is recommended to use selective COX-2 inhibitors that do not affect the gastrointestinal mucosa.
- Muscle streamers.Medicines quickly relieve muscle spasms, and after relaxing the muscles, the neck hurts less.The effect is observed after the first injection;To combine the effect, the product is used in courses.
- Anesthesia.It is used for severe neck pain that the patient cannot tolerate.Medicines are applied in the form of injections (blockades) in the affected area.Long-term administration of local anesthetics is not recommended.
- Antibiotics.Medicines are indicated for bacterial and stinging processes in the cervical region that cause pain.In such a situation, the patient's anxiety stops after the cause is eliminated.
- Vitamin.B vitamins, especially Tidamine preparations, are actively used in cases of chronic pain in the neck region.Medicines increase the nutrition of spinal roots and nerves.
Physiotherapy
To relieve muscle tension that causes neck pain, use a chance collar, which is recommended to be worn for 2-3 weeks.The neck hurts less than local heat procedures - mud baths and compresses, electrophoresis with anesthesia.Manual therapy techniques are useful for restoring the anatomical position of vertebrae and discs.Magnetic therapy and acupuncture help reduce chronic neck pain.After acute pain, massage sessions begin and physiotherapy should be supplemented with exercise therapy methods.
Surgery
Surgical intervention is necessary for neck pain caused by spinal column pathology.Discotomy, foraminotomy, and laminectomy are used to relieve pressure on nerve roots.When a hernia is detected, appropriate operations are performed;When neoplasms are found in the cervical part of the body, they are surgically removed.Severe degenerative lesions of the spine are an indication for spinal fusion.If neck pain is caused by ulcers or cysts, they should be opened and dried, and the resulting cavity should be washed with antibacterial solutions.