Neck pain(cervical pain) is a pain of various nature and intensity that occurs in the cervical region.The symptom is accompanied by dizziness, numbness sensation 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 of the spine, after a long stay in an uncomfortable and forced position.To determine the cause of neck pain, CT, MRI, ultrasound and laboratory tests are prescribed.Analgesics, NSAIDs and physiotherapeutic methods are used to relieve symptoms.
General characteristics
Neck pain occurs periodically in 70% of the adult population.These sensations can have variable intensity and duration: from short-term discomfort to intense pain that makes daily activities difficult.Most often, neck pain is localized in the cervical spine or along the anterolateral surfaces.Usually, patients experience sudden "low back pain", which is replaced by persistent pain.The pain varies in nature: throbbing, tingling, squeezing.They can radiate to the shoulder, scapula and occipital region.
The 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 working 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 a chronic neck pain, which can be constant or recurrent.In accordance with the etiopathogenetic classification, two forms of neck pain are distinguished:
- Vertebrogenic neck pain.It develops following 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 can occur due to inflammatory processes in the musculo-ligament system, pathologies of internal organs: pharynx, thyroid, lymph nodes and salivary glands.
According to localization, the pain syndrome is distinguished in the front or lateral part of the neck, in the area of the spine.Separately, a sore throat is isolated.Cervical pain, which radiates to nearby anatomical areas, is divided into cervicocranialgia (spread of pain to the occipital region) and cervicobrachialgia (cervicobrachial syndrome).
Why does my neck hurt?
Causes of sore throat
An itchy sensation in the throat is associated with colds, but unpleasant sensations can often be caused by other reasons (excessively dry indoor air, exposure to air pollutants).Sometimes the pain syndrome is so strong that patients have the feeling that the whole 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 - parts of toys.
- 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
Unpleasant sensations can be localized directly under the chin, in a limited area, but more often the discomfort is severe, widespread pain.The pain intensifies when you swallow, turn your head, or squeeze your neck with your shirt collar.Neck pain is caused by:
- Thyroid disorders: 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, tendinitis.
- Purulent diseases: suppurating cervical cyst, peritonsillar abscess.
- Damage to lymphoid formations: lymphadenitis, lymphangitis.
- Cervical compression syndrome: radicular artery, vertebral.
- Related organ diseases: esophagitis, tracheitis.
- Angina attack.
Causes of cervical spine pain
Patients complain of neck pain that occurs along the posterior surface.The painful sensations are intense;due to constant "low back pain", 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, arthrosis, prolapse or herniated disc.
- Bone lesions: 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 down 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, a secondary torticollis is formed, in which the head is constantly tilted towards the painful side, and the chin is turned towards the healthy side.The most common reasons for lateral neck pain are:
- Blood vessel disorders: varicose veins of the neck, atherosclerosis of the large cervical arteries that supply the brain.
- Remain in an uncomfortable position: constantly bowed head when working at the computer, poor pillow for sleeping, peculiarity of gait with the neck tilted in the same direction.
- Muscle spasms: with a sharp rotation of the head, intense physical activity, after hypothermia.
- Retropharyngeal abscess.
- Oncological diseases: tumors of the thyroid and parathyroids, 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.
Diagnostics
A person suffering from neck pain most often turns to an osteopath or neurologist.The exam is long and complex;To make a correct diagnosis it is necessary to exclude many causes of neck pain.Diagnostic research involves the use of laboratory and instrumental methods aimed at visualizing the affected area and looking for signs of concomitant diseases.The most informative ones 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 internal organ pathology that may cause neck pain.A targeted ultrasound of the thyroid and submandibular salivary glands is performed.Duplex scanning helps evaluate the state of blood flow in large vessels.
- X-ray images.Neck x-ray is used to identify deformations of bone structures, displacement of the vertebrae, which always causes neck pain.A more informative method is CT scan of the spine, which allows you to evaluate the nature and extent of spinal disorders.Magnetic resonance imaging is recommended to study the ligament system.
- Functional diagnostics.The appearance of neck pain can be caused by damage to the muscular system, which is why it is advisable to perform electromyography.If radicular pain is suspected, electroneurography is indicated.To detect cervical kyphosis, the Forestier test is necessary.The degree of pain is determined using the McGill questionnaire.
- Laboratory methods.General and biochemical blood tests are needed to exclude acute inflammatory processes, which can cause neck pain.It is necessary to determine the concentration of thyroid hormones.In the presence of a general infectious syndrome, bacteriological culture of sputum or pharyngeal 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 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 condition of the spinal canal.
Treatment
Help before diagnosis
If your neck starts to hurt, you should not delay a visit to the doctor.Neck pain 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 woolen scarf).If the pain is severe, analgesics from the NSAID group can be taken.But these drugs should not be taken for a long time without a prescription, as they can cause ulcers and bleeding from the gastrointestinal tract.
Conservative therapy
Medical tactics for neck pain depend on the cause of the disease and the intensity of the pain.Isolated drug treatment 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.The drugs 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.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 advisable.
- Antibiotics.The drugs are indicated for bacterial and purulent processes in the cervical region that cause pain.In such a situation, discomfort in patients ceases 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 spinal roots and 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 for restoring 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 physical therapy methods.
Surgical treatment
For neck pain caused by spinal pathology, surgery is required.Discectomy, foraminotomy and laminectomy are used to reduce pressure on the 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 lesions of the spine are an indication for spinal fusion.If neck pain is caused by ulcers or cysts, you need to open them, drain them and wash the resulting cavity with antibacterial solutions.