Neck pain: why and what to do?

According to recent statistics, one in three people have experienced neck pain at some point. People's necks have become more common due to the emergence of new "sedentary" professions and computers. Discomfort, as a rule, can become pain if it bothers you constantly. Sometimes, when the cervical spine hurts, the following symptoms occur: decreased vision, dizziness, limited mobility, loss of sensitivity. In some cases, especially due to working in an uncomfortable position, neck pain spreads to the arm and heart. Patients with neck discomfort complain of nausea, throbbing when turning the head, and tinnitus. Sometimes the discomfort is accompanied by numbness in the back of the head. Neck pain today is a very common symptom, because 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 root of the spinal cord is compressed.
This usually occurs due to spondylosis or herniation and protrusion in the intervertebral disc, when the fibrous ring breaks and the nucleus pulposus exits into the spinal canal. The consequences of lack of treatment require irreversible complications, including paralysis. Sciatica appears in the neck sometimes due to the herpes virus and Lyme disease.

The pain occurs in the neck and often spreads to the arm, causing the arm to become numb and weak. Usually this diagnosis can be made after examination by a neurologist. However, in some cases it may be necessary to perform an electromyographic or computed tomography scan 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 a strong and immobile conglomerate.

Diffuse skeletal hyperostosis (Forestier's disease)

People over the age of 50 mostly suffer from 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 for the development of this disease.

Forestier's disease may not manifest in any way, but in some cases a person experiences pain and reduced neck mobility. To confirm the diagnosis, a doctor in the highest category clinic will require 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- Probably the most popular cause of neck pain. This 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. With this disease, the pain can be distributed to the arm or shoulder, sometimes down to the hands and fingers. Neck pain when turning or tilting the head. If you keep your head in one position for a long time, the condition of your neck also gets worse.

Due to degenerative changes in the neck area,spondylosisin the cervical spine. Deletion of the spinal disc leads to a gradual reduction in the space between the vertebrae, deformation of the bones and the formation of osteophytes as they grow; This deformation has a major impact on the functioning of the entire body. With age, these changes in most cases do not bring any unpleasant sensations. However, they sometimes lead to pressure on the spinal nerves, causing numbness and pain in the neck, and in some cases, pain in the arm or shoulder. Often, numbness, impaired sensitivity and mobility, and attacks of loss of consciousness are observed, which indicate the development of neurological disorders.

Cervical spondylogenic myelopathy. The spinal cord becomes damaged and begins to malfunction due to degenerative changes in the cervical spine, which leads to narrowing of the central spinal canal. The result is acute pain in the neck, which is constantly increasing, mobility is difficult, movement coordination is disturbed, urination and defecation are uncontrollable, and general weakness and problems in the sexual field can also be observed. This disease most often develops after the age of 55 and often requires surgical intervention.

Cervical spine injury

The result of the injury can be pain in the cervical and shoulder areas, migraines, neck muscle spasms, and impaired movement. In car accidents, people usually suffer neck injuries due to the sudden forward and backward movement of the head. As a result, intervertebral discs, soft tissues, nerve fibers, posterior longitudinal ligaments, facet joints (facet syndrome), etc. can be damaged. After an injury, muscle spasms occur, and it becomes 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 occur due to physical fatigue, awkward posture, emotional stress during the working day, or spinal injury. Muscles can also cramp, especially due to the wrong pillow. Usually, the discomfort causes limited movement, but this pain disappears within six weeks. To speed up the process, doctors recommend eliminating, if possible, the cause of muscle tension, and also doing special exercises.

Myofascial pain syndrome

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

Cervical osteochondrosis

Among the diseases that cause pain in the neck, osteochondrosis is a diagnosis made in the territory of the former Soviet Union and, in fact, all the diseases listed above (degenerative-dystrophic lesions of the spine) are usually associated with it.

Almost everyone over the age of 40 experiences degenerative changes in the spine. This is not a reason to call someone who is completely sick and actively start treatment. If the neck bothers you, then this is only a symptom that indicates the need to make a real diagnosis, after which medical therapy is prescribed.

Diagnosing the cause of neck pain is always complicated. It includes:

• general laboratory and biochemical blood tests;
• determination of thyroid hormone levels in the blood;
• Ultrasound with Dopplerography of neck canal, thyroid gland, salivary gland;
• X-ray of the cervical spine;
• electroneuromyography;
• CT;
• MRI.

Cervical osteochondrosis can affect cerebral circulation. This causes throbbing pain in the head, vegetative-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 need to contact a therapist, who will refer you for further examination. The following will help determine the cause of neck pain and dystrophic conditions, treat and restore its function: surgeons, neurologists, vertebrologists, rheumatologists, cardiologists, traumatologists, orthopedists, endocrinologists and several other doctors.

The main reasons for consultation with a rheumatologist and a neurologist are necessary:

• severe headache;
• neck injury;
• uncontrollable urination or defecation;
• numbness, tingling, weakness in arms and legs;
• my neck hurt for a week and no improvement;
• lack of benefit in pain medication.

Consult your doctor immediately if:

• Meningitis, if your head hurts with a strong increase in temperature, and your neck is so stiff that it hurts to turn it 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 for neck pain

1. Medicines that relieve pain and tension. For such discomfort, there is usually no specific treatment. In simple situations, doctors recommend non-steroidal anti-inflammatory drugs, chondroprotectors (drugs that promote cartilage tissue recovery) that relieve pain. If the cramps are severe, the doctor may prescribe a medicine to take at night that relaxes the muscles, for example, a muscle relaxant. For chronic pain, doctors prescribe tricyclic antidepressants, because botulinum blockade is ineffective. With conservative medical treatment, most muscle strains resolve within 2 to 3 weeks.
2. Ice and heat. If the cervical spine bothers you after the injury, then in the first three days it is recommended to apply ice to relieve the pain. If it's a muscle problem, use heat, including a shower or bath, or place a damp towel around the neck.
3. Physiotherapy:phonophoresis, carboxytherapy, ozone therapy, pressotherapy, RF current, 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 regular physical activities, including yoga, running and soccer.
5. Relaxation techniques. Due to emotional stress, the neck starts to hurt more, so treatment should not be delayed. Relaxation techniques such as breathing exercises, self-hypnosis, meditation and psychotherapy can help reduce muscle tension.
6. Change 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 anymore. To do this, it is important to monitor your own posture, it is advisable to minimize tension by changing positions, stretching your neck once an hour, and placing the computer at eye level. You need to 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 your 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 taken into account that massage for chronic pain may not be effective and is rarely performed.
8. Manual therapy. In some cases, manipulation can worsen the situation completely, because it has no proven effectiveness. In combination only with physical exercises, it is recommended to use manual "gentle" therapy, however, manual therapy helps eliminate the signs of radicular syndrome, improves the function of internal organs and especially the brain. It is best not to contact a chiropractor if the central spinal canal is narrowed due to spondylotic myelopathy.
9. Bio feedback (BFB). With this method, a person is given the task of "relaxing muscle tension in the neck, " the execution of which is monitored using sensors. On the screen, the patient himself sees a cloudy image, which becomes clear when his muscles relax. This is how one learns to control muscle tension in the neck.
10. Corset, which corrects the neck vertebrae, although it relieves pain, it is recommended to wear it for 1 to 3 hours a day, no more than 1-2 weeks, so that the neck muscles cannot be weakened.
11. There are methods andosteopathic. According to some data, for example, neck muscle traction is not effective, but acupuncture helps with chronic neck pain. Electromagnetic and low frequency therapy also works, as well as electromyostimulation and laser therapy. However, it is not recommended to neglect exercise while using all these methods. It is also important to eat properly so that the body receives all the necessary substances and vitamins. This will not only slow down the development of pathology, but will also contribute to a faster regeneration process.
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 is due to a "pinched nerve, " i. e. pressure on its root in the spinal cord, and conservative treatment does not help, then surgical treatment is recommended.