Neck pain(cervicalgia) is pain of different nature and intensity that appears 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 forced 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 characteristics
Neck pain occurs periodically in 70% of the adult population.These sensations can have different intensity and duration: from short-term discomfort to severe pain that makes daily activities difficult.Most often, neck pain is localized in the cervical spine or along the anterolateral surfaces.Typically, patients feel a sudden "lumbago", which is replaced by constant pain.The pain varies in nature - throbbing, 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 whole 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 sewing machine.Many patients associate the development of cervicalgia with hypothermia and the effects of currents.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.
Distribution
Depending on the duration of neck pain, there is an acute form that lasts up to 10 days, and chronic cervicalgia, which can be constant or repeated.According to the etiopathogenetic classification, two forms of cervicalgia 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 cervicalgia, caused by deformation of the intervertebral discs.
- Non-vertebral neck pain.Includes all other causes of neck pain.Unpleasant sensations can occur due to inflammatory processes in the muscular-ligamentous apparatus, pathologies of internal organs - pharynx, thyroid gland, lymph nodes and salivary glands.
According to the localization, the pain syndrome is distinguished in the front or lateral parts of the neck, in the area of the spine.Separately, a sore throat is isolated.Cervicalgia, which radiates to adjacent anatomical areas, is divided into cervicocranialgia (spreading pain in the occipital region) and cervicobrachialgia (cervicobrachial syndrome).
Why does my neck hurt?
Causes of sore throat
The scratchy and scratchy feeling in the throat is associated with a cold, but the unpleasant sensations can often be caused by other reasons (too dry indoor air, exposure to atmospheric pollutants).Sometimes the pain syndrome is felt so strongly that patients feel as if the 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 - parts of toys.
- Deficiency says:lack of vitamins B12 and B2, lack of ascorbic acid, iron.
- Gastroesophageal reflux.
- Rare causes: long styloid process, Itsenko-Cushing syndrome, malignant neoplasm of the throat or vocal apparatus.
Causes of neck pain in the front
Unpleasant sensations can be localized directly under the chin, in a limited area, but more often the discomfort is strong, 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.
- INJURY: sprains and tears of muscle fibers, impact in the neck area.
- Inflammatory processes:myositis, neuritis, tendonitis.
- Purulent diseases: suffocating cervical cyst, peritonsillar abscess.
- Damage to lymphoid formations: lymphadenitis, lymphangitis.
- Cervical compression syndrome: radicular artery, vertebral.
- Diseases of related organs: esophagitis, tracheitis.
- Angina attack.
Causes of pain in the cervical spine
Patients complain of pain in the neck that occurs along its back surface.Painful sensations are intense;due to constant "lumbago", the person is forced to keep his 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, disc prolapse or hernia.
- Bone injuries: compression fracture of the cervical vertebrae, compression of the spinal cord, fracture of the vertebral arches and processes.
- Damage to other structures: rupture 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
Sharp 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 causes of lateral neck pain are:
- Pathologies of blood vessels: varicose veins of the neck, atherosclerosis of the large cervical arteries that supply the brain.
- Standing in a difficult position: constantly bent head when working on the computer, poor pillow for sleeping, peculiarity of walking with the neck tilted in the same direction.
- Muscle spasms: with a sharp turn of the head, intense physical activity, after hypothermia.
- Retropharyngeal abscess.
- Oncological diseases: neoplasia 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.
Diagnosing
A person who has neck pain is most often referred to an osteopath or neurologist.The examination is long and complex;to make an accurate 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 associated 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 to assess the state of blood flow in the large vessels.
- X-ray imaging.Survey radiography of the neck is used to identify deformations of bone structures, displacement of vertebrae, which always causes pain in the neck.A more informative method is a CT scan of the spine, which allows you to assess the nature and extent of vertebral 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 recommended to perform 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 rule out acute inflammatory processes, which can cause neck pain.The concentration of thyroid hormones should be determined.In the presence of a general infectious syndrome, a bacteriological culture of sputum or throat smear 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 otolaryngologist is necessary.In case of intense pain, especially in elderly patients or with a history of heart disease, an ECG is recorded to rule out atypical forms of angina pectoris and myocardial infarction.For severe spinal injuries accompanied by sensory disturbances or paresis, myelography is performed to assess the condition of the spinal canal.
Treatment
Help before diagnosis
If the neck starts to hurt, you should not delay the visit to the doctor.Cervicalgia requires careful diagnosis to determine the causes of unpleasant symptoms.It is necessary to avoid sudden movements in the cervical region, drafts and hypothermia.Before the diagnosis is verified, neck pain is relieved with the help of warming procedures (wrapping the cervical area with a wool 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 from the gastrointestinal tract.
Conservative therapy
Medical tactics for cervicalgia depend on the cause of the disease and the intensity of the pain.Treatment with isolated drugs is rarely used;its combinations with modern physiotherapeutic methods are more effective.To relieve neck pain and eliminate the underlying pathology that caused cervicalgia, 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 relaxants.Medicines quickly eliminate muscle spasms, and after muscle relaxation, 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.Medicines are administered to the affected area in the form of injections (blocks).Long-term administration of local anesthetics is not advised.
- Antibiotics.Medicines are indicated for bacterial and purulent processes in the cervical region that cause pain.In such a situation, discomfort in patients stops after the cause is eliminated.
- Vitamins.Preparations of B vitamins, especially thiamine, are actively used in cases where pain in the neck area is chronic.Medicines improve the nutrition of the roots and nerves of the spine.
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 to restore 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 spine pathology, surgical intervention is necessary.Discectomy, foraminotomy, and laminectomy are used to reduce pressure on nerve roots.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 spinal lesions are an indication for spinal fusion.If the neck pain is caused by ulcers or cysts, it is necessary to open them and drain them and wash the resulting cavity with antibacterial solutions.