neck pain(cervicalgia) is a 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 can hurt due to infectious and inflammatory diseases of this area, injuries and degenerative processes in the spine, after a long stay in an uncomfortable and forced position.To determine the cause of neck pain, CT scans, MRIs, ultrasounds and laboratory tests are prescribed.Pain relievers, NSAIDs and physiotherapy methods are used to relieve symptoms.
General characteristics
Neck pain occurs periodically in 70% of the adult population.These sensations can have different intensity and duration: from brief discomfort to intense pain that makes daily activities difficult.Most often, neck pain is located in the cervical spine or anterolateral surfaces.Typically, patients feel a sudden "lumbago", which is replaced by persistent pain.The pain varies in nature: stabbing, tingling, squeezing.They can radiate to the shoulder, scapula, and occipital region.
Unpleasant sensations intensify when turning and tilting the head, so the person is forced to turn the entire body.Often the neck begins to hurt after a long stay in an uncomfortable position: patients notice that the discomfort appeared after a day of work at the computer or sewing machine.Many patients associate the development of neck pain with hypothermia and the effects of drafts.If your neck hurts a lot or the pain is combined with dizziness, numbness in the back of the head or tinnitus, you should seek qualified medical help as soon as possible.
Classification
Depending on the duration of neck pain, there is an acute form that lasts up to 10 days and chronic neck pain, which can be constant or recurrent.According to the etiopathogenetic classification, two forms of neck pain are distinguished:
- Vertebrogenic 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, and discogenic, caused by deformation of the intervertebral discs.
- Non-vertebrogenic neck pain.Includes all other causes of neck pain.Unpleasant sensations may arise due to inflammatory processes in the musculo-ligamentous apparatus, pathologies of internal organs: pharynx, thyroid gland, lymph nodes and salivary glands.
Depending on the localization, the pain syndrome is distinguished in the front or side of the neck, in the area of the spine.Separately, sore throat is isolated.Cervicalgia, which radiates to neighboring anatomical areas, is divided into cervicocranialgia (extension of pain to the occipital region) and cervicobrachialgia (cervicobrachial syndrome).
Why does my neck hurt?
Causes of sore throat
An itchy, itchy feeling in the throat is associated with colds, but unpleasant sensations can often be due to other reasons (excessively dry indoor air, exposure to atmospheric pollutants).Sometimes the pain syndrome is felt so strongly that patients feel as if their entire neck hurts.Conditions such as:
- Laryngitis: atrophic, hemorrhagic, hyperplastic.
- viral diseases: ARVI, infectious mononucleosis, influenza, 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 neoplasms of the throat or vocal apparatus.
Causes of neck pain in the front.
Uncomfortable sensations can be localized directly under the chin, in a limited area, but more often the discomfort is intense, diffuse pain.The pain intensifies when swallowing, turning the head, or pressing 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 area.
- 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 posterior surface.The painful sensations are intense;Due to the constant “lumbago”, the person is forced to keep the shoulder girdle and head 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 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's syndrome.
- infectious processes: osteomyelitis, vertebral tuberculosis.
- rare causes: presence of pathological bilateral cervical ribs, Klippel-Feil syndrome.
Causes of lateral neck pain.
Severe pain along the side of the neck usually radiates to the shoulder or ear.A person may feel tingling, burning, or throbbing in this area.With severe discomfort, 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 lateral neck pain are:
- Pathologies of blood vessels.: varicose veins of the neck, atherosclerosis of the large cervical arteries that supply the brain.
- Staying in an uncomfortable position: constantly tilted head when working at the computer, poor pillow for sleeping, peculiarities of walking with the neck tilted in the same direction.
- muscle spasms: with sudden turning of the head, intense physical activity, after hypothermia.
- Retropharyngeal abscess.
- Oncological diseases: neoplasms of the thyroid and parathyroid glands, tumors of the lateral surface 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 has neck pain usually goes 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 search involves the use of instrumental and laboratory methods aimed at visualizing the affected area and looking for signs of concomitant diseases.The most informative are:
- Sonography.Ultrasound of the neck and other parts of the body is used for rapid, non-invasive visualization of all cervical structures, identifying signs of pathology of internal organs that can cause neck pain.A targeted ultrasound of the thyroid gland and submandibular salivary glands is performed.Duplex scanning helps evaluate the status of blood flow in the large vessels.
- x-ray images.Study x-ray of the neck is used to identify deformations of bone structures, displacement of the vertebrae, which always causes neck pain.A more informative method is computed tomography of the spine, which makes it possible to assess the nature and extent of spinal disorders.Magnetic resonance imaging is recommended to study the ligamentous apparatus.
- Functional diagnosis.The appearance of neck pain may be due to damage to the muscular system, so it is advisable to perform an electromyography.If radicular pain is suspected, electroneurography is indicated.To detect cervical kyphosis, a Forestier test is required.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 must be determined.In the presence of a general infectious syndrome, bacteriological 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, an examination by an otorhinolaryngologist 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 pectoris and myocardial infarction.For severe spinal injuries accompanied by sensory disturbances or paresis, myelography is performed to evaluate the status of the spinal canal.
Treatment
Help before diagnosis
If your neck starts to hurt, you should not delay visiting the doctor.Cervicalgia requires careful diagnosis to determine the causes of the unpleasant symptoms.It is necessary to avoid sudden movements in the cervical region, drafts and hypothermia.Before confirming the diagnosis, neck pain is relieved by warming procedures (wrapping the cervical area with a woolen scarf).If the pain is severe, it is possible to take analgesics from the NSAID group.But these drugs 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 pharmacological treatment is rarely used;Their combinations with modern physiotherapy methods are more effective.To relieve neck pain and eliminate the underlying pathology that caused cervicalgia, the following groups of drugs are used:
- NSAIDs.The drugs 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 relaxants.Medications quickly eliminate muscle spasms, and after relaxing the muscles, the neck hurts much less.The effect is observed after the first injection;To consolidate the effect, the product is used in courses.
- anesthetics.It is used for severe neck pain that the patient cannot tolerate.Medications are given to the affected area in the form of injections (blocks).Prolonged administration of local anesthetics is not advisable.
- antibiotics.The drugs are indicated for bacterial and purulent processes in the cervical region that cause pain.In such a situation, the patients' discomfort ceases once the cause is eliminated.
- vitamins.Vitamin B preparations, especially thiamine, are actively used in cases where pain in the neck area is chronic.Medicines improve the nutrition of the roots and spinal 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.Magnetotherapy and acupuncture help reduce chronic neck pain.After the acute pain disappears, massage sessions begin, and physiotherapy should be supplemented with exercise therapy methods.
Surgical treatment
For neck pain caused by spinal pathology, surgical intervention 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 surgically removed.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.