Neck pain: why and what to do?

According to the latest statistics, every third person has experienced neck pain at some point. Human necks have become more common due to the emergence of new "sedentary" professions and computers. Discomfort, as a rule, can be of a painful nature if it constantly bothers you. Sometimes, when the cervical spine hurts, the following symptoms appear: reduced vision, dizziness, limited mobility, losssensitivity. In some cases, especially due to working in an uncomfortable position, the pain in the neck spreads to the arms and heart area. Patients with neck discomfort complain of nausea, creaking when turning the head and ringing in the ears. Sometimes the discomfort is accompanied by numbness in the back of the headNeck pain is a very common symptom today, as many people do not exercise, are overweight and often face stress. Neck pain can also occur for other reasons, including serious illnesses that require immediate treatment. For example, meningitis, vascular infections and cancer, rheumatoid arthritis, ankylosing spondylitis, arthritis due to inflammation of the intestines and other internal organs.

cervical radiculitis ("pinched nerve")

In the cervical spine, radiculitis most often occurs when the nerve roots of the spinal cord are compressed.
This usually occurs due to spondylosis or herniation and protrusion in the intervertebral disc, when the annulus fibrosus ruptures and its nucleus pulposus protrudes into the canal of the spinal cord. The consequence of the lack of treatment entails irreversible complications, including paralysis. Sciatica sometimes occurs in the neck due to the herpes virus and Lyme disease.

The pain occurs in the neck and often radiates to the arm, causing the arm to become numb and weak. Usually, this diagnosis can be made already after an examination by a neurologist. However, in some cases, an electromyography or computed tomography scan may be needed to assess the damage.

Ankylosing spondylitis

A systemic inflammatory disease that affects almost all joints of the body and causes severe limitations in mobility due to the fusion of individual vertebrae, forming strong and immobile conglomerates.

Diffuse skeletal hyperostosis (Forestier's disease)

People over the age of 50 mostly develop Forestier's disease. It has been established that the accumulation of calcium salts in the ligamentous and musculoskeletal system of the spine is the most likely cause of the development of this disease.

Forestier's disease may not manifest itself in any way, but in some cases a person feels pain and the mobility of the neck decreases. To confirm the diagnosis, the doctor in the clinic of the highest category will need an X-ray examination, in some cases diagnostic procedures are also prescribed: computed tomography (CT) or magnetic resonance imaging (MRI). There is no specific treatment for this disease.

Degenerative diseases

Discogenic syndrome- Perhaps the most popular cause of neck pain. The syndrome develops as a result of degenerative changes in the structure between the discs in the spine due to uneven loading between the end plates and facet joints. In this disease, the pain can spread to the arm or shoulder, sometimes to the hands and fingers. The neck hurts when turning or tilting the head. If you keep your head in one position for a long time, the condition of your neck also worsens.

Due to degenerative changes in the neck area,spondylosisin the cervical spine. Deletion of the spinal discs leads to a gradual reduction of the space between the vertebrae, deformation of the bones and the formation of osteophytes as they grow, and this deformation has a huge impact on the functioning of the whole body. Over the years, these changes in most cases do not bring any unpleasant sensations. However, they sometimes put pressure on a spinal nerve, causing numbness and pain in the neck, and in some cases pain in the arm or shoulder. Numbness, reduced sensitivity and mobility and attacks of loss of consciousness are often observed, which indicates the development of neurological disorders.

Cervical spondylogenic myelopathy. The spinal cord is damaged and begins to deteriorate due to degenerative changes in the cervical spine, which lead to a narrowing of the central spinal canal. The result is an acute pain in the neck that is constantly increasing, its mobility is hindered, coordination of movements is disturbed, uncontrolled urination and defecation, and general weakness and problems in the sexual sphere can also be observed. The disease most often develops after the age of 55 and often requires surgical intervention.

Injuries of the cervical spine

The consequences of the injury can be pain in the cervical region and shoulders, migraines, neck muscle spasms and reduced mobility. In car accidents, people usually suffer neck injuries due to the sudden movement of their head back and forth. As a result, there may be damage to intervertebral discs, soft tissues, nerve fibers, posterior longitudinal ligament, facet joint (facet syndrome), etc. After the injury, the muscles spasm and it is difficult to move the neck. Over time, the pain symptoms disappear on their own, but sometimes they develop into chronic pain.

Muscle pain

Muscle spasms in the upper back and neck are caused by physical overexertion, awkward posture, emotional stress during the working day, or spinal injuries. Muscles can also cramp, especially from the wrong pillow. Usually the discomfort causes limited mobility, but this pain disappears within six weeks. In order to speed up the process, doctors recommend removing, if possible, the cause of muscle strain, as well as special exercises.

Myofascial pain syndrome

In myofascial syndrome, it is important to identify the most sensitive pain points that can appear after overexertion, hypothermia, emotional trauma or stress. These pressure points cause muscle tension and pain, which often becomes chronic.

Cervical osteochondrosis

Among the diseases that cause neck pain, osteochondrosis is a diagnosis that was established in the territory of the former Soviet Union, and in fact all the above-mentioned diseases (degenerative-dystrophic lesions of the spine) were usually attributed to it.

Almost all people over the age of 40 experience degenerative changes in the spine. This is not a reason to call a person completely sick and actively start treatment. If your neck is bothering you, then it is only a symptom that indicates the need for a proper diagnosis, after which medical therapy is prescribed.

The diagnosis of the cause of neck pain is always complex. This includes:

• general and biochemical laboratory blood test;
• determining the level of thyroid hormone in the blood;
• Ultrasound with dopplerography of neck vessels, thyroid gland, salivary glands;
• x-ray of the cervical spine;
• electroneuromyography;
• CT;
• MRI.

Cervical osteochondrosis can disrupt cerebral circulation. This causes throbbing headaches, vegeto-vascular dystonia and hypertension, problems with the cardiovascular and respiratory systems, hearing, vision and coordination.

If your neck hurts, when should you see a doctor?

If the neck causes discomfort, then first of all you should contact a therapist who will refer you to a further examination. Determining the causes of neck pain and dystrophic condition, treating and restoring its function will help: surgeon, neurologist, vertebrologist, rheumatologist, cardiologist, traumatologist, orthopedist, endocrinologist and some other doctors.

The main reasons why consultations with a rheumatologist and neurologist are necessary:

• severe headache;
• neck injury;
• uncontrolled urination or bowel movements;
• numbness, tingling, weakness in arms and legs;
• my neck hurts for a week and there is no improvement;
• lack of benefit from pain medication.

Contact your doctor immediately if:

• Meningitis, if you have a headache with a strong rise in temperature, and your neck is so stiff that it hurts to turn and you can't reach your chest with your chin.
• A heart attack if there is chest discomfort, rapid breathing, sweating, nausea, vomiting and pain in the arms or jaw.

Treatment of neck pain

1. Medicines that relieve pain and tension. There is usually no specific treatment for such discomfort. In simple situations, the doctor recommends non-steroidal anti-inflammatory drugs, chondroprotectors (drugs that promote cartilage tissue regeneration) that relieve pain. If the spasm is severe, the doctor may prescribe a medicine to drink at night that relaxes the muscles, for example, a muscle relaxant. For chronic pain, the doctor prescribes tricyclic antidepressants, because botulinum blockades are ineffective. With conservative medical treatment, most muscle strains resolve within 2 to 3 weeks.
2. Ice and heat. If you suffer from cervical spine after an injury, it is recommended to apply ice for pain relief in the first three days. If it's a muscle problem, use heat, including taking a shower or bath, or placing a damp towel on your neck.
3. physiotherapy:phonophoresis, carboxytherapy, ozonotherapy, pressotherapy, RF currents, ultrasound therapy.
4. Stretching exercises. Stretching exercise therapy is effective, especially for chronic pain. Qigong gymnastics will be useful, which should be done carefully and after consultation with a specialist. First you need to warm up your neck. However, it is better to exercise in the morning or before going to bed. You should definitely consult your doctor about more frequent physical activities, including yoga, running, and soccer.
5. Relaxation techniques. Due to emotional stress, the neck starts to hurt more, so the treatment cannot be postponed. Relaxation techniques such as breathing exercises, self-hypnosis, meditation and psychotherapy can help reduce muscle tension.
6. Changing habits. The position in which a person spends a lot of time during the working day needs to be corrected so that the neck does not hurt again. To do this, it is important to monitor your own posture, it is recommended to minimize tension by changing your position, stretch your neck once an hour and place the computer at eye level. You must sit up straight with your shoulders back. The head and body should be at the same level during sleep, and the neck needs support. Sleeping on your back is the ideal position; the worst position for the neck is if you sleep on your stomach.
7. Massagerelieves muscle spasms and ensures normal blood supply, and when pressing, it is useful to use a vibrating massager. However, it should be considered that massage for chronic pain is probably ineffective and rarely performed.
8. Manual therapy. In some cases, manipulations can completely worsen the condition, because they have no proven effectiveness. In combination with only physical exercises, it is recommended to resort to manual "soft" therapy, however, manual therapy helps to eliminate signs of radicular syndrome, improve the work of internal organs, and especially the brain. It is better not to contact chiropractors if the central spinal canal is narrowed as a result of spondyloticmyelopathy.
9. biofeedback (BFB). With this method, a person is given the task of "releasing the tension of the muscles in the neck", the implementation of which is monitored using sensors. On the screen, the patient himself sees a blurry image, which becomes clear as his muscles relax. This is how a person learns to control the tension of the muscles in the neck.
10. Corset, which fixes the neck vertebrae, although it relieves pain, it is recommended to wear it for 1 to 3 hours a day, no longer than 1-2 weeks, so that the neck muscles do not weaken.
11. There are methods andosteopathic. According to some data, for example, neck muscle traction is ineffective, but acupuncture helps with chronic neck pain. Electromagnetic and low-frequency therapy, as well as electromyostimulation and laser therapy, also work. However, it is not recommended to neglect exercise while using all these methods. It is also important to eat properly so that the body gets all the necessary substances and vitamins. This will not only slow down the progression of the pathology, but also contribute to faster regeneration processes.
12. Surgery for neck pain. If your neck hurts, then surgery, in most cases, is not necessary. Initially, only conservative treatment is used. If the cause of the pain is a narrowing of the central spinal canal or due to a "pinched nerve", that is, pressure on its root in the spinal cord, and conservative treatment does not help, surgical treatment is recommended.