Recommend
Official site Hondrogel

Neck pain (cervicalgia)

severe neck pain

Neck pain(Cervicalgia) is pain of varying nature and intensity that occurs in the neck area.The symptom is accompanied by dizziness, numbness in the back of the head or arm, local redness and swelling of the skin.The neck may hurt after a long stay in a forced uncomfortable position due to infectious and inflammatory diseases of this area, injuries and degenerative processes in the spine.To determine the cause of neck pain, CT, MRI, ultrasound and laboratory tests are prescribed.To relieve symptoms, analgesics, NSAIDs and physiotherapeutic methods are used.

General characteristics

Neck pain occurs periodically in 70% of the adult population.These sensations can vary in intensity and duration: from short-term discomfort to severe pain that makes everyday activities difficult.More often, neck pain is localized in the cervical spine or along the anterolateral surfaces.Typically, patients experience a sudden “lumbago” that is replaced by persistent pain.The pain is of different nature – throbbing, tingling, pressing.They can radiate into the shoulder, shoulder blade and back of the head area.

Unpleasant sensations increase when turning and tilting the head, forcing the person to turn his entire 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 drafts.If your neck hurts severely or the pain is accompanied by 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 cervicalgia, which can be constant or recurring.According to the etiopathogenetic classification, two forms of cervicalgia are distinguished:

  • Vertebrogenic neck pain.Arises as a result of primary damage to the osteochondral structures of the cervical spine.This group includes spondylogenic cervicalgia, which is associated with bone damage and compression of the spinal cord, and discogenic cervicalgia, which is caused by deformation of the intervertebral discs.
  • Nonvertebral 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 - throat, thyroid, lymph nodes and salivary glands.

Depending on the localization, a pain syndrome is distinguished in the front or side part of the neck, in the spine area.Separately, a sore throat is isolated.Cervicalgia that radiates to adjacent anatomical areas is divided into cervicocranialgia (pain spread to the back of the head) and cervicobrachialgia (cervicobrachial syndrome).

Why does my neck hurt?

Causes of a sore throat

A scratchy, scratchy feeling in the throat is associated with colds, but unpleasant sensations can often have other causes (room air that is too dry, exposure to air pollutants).Sometimes the pain syndrome is so severe 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 body in the throat;Meat and fish bones, for children - parts of toys.
  • Deficiencies:Vitamin deficiency B12 and B2, deficiency of ascorbic acid, iron.
  • Gastroesophageal reflux.
  • Rare causes: long styloid process, Itsenko-Cushing syndrome, malignant neoplasms of the pharynx or vocal tract.

Causes of front neck pain

Unpleasant sensations can be localized in a limited area just under the chin, but more often it is severe, diffuse pain.The pain increases when swallowing, turning the head, or pressing the neck with a shirt collar.Neck pain is caused by:

  • Thyroid diseases: 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: festering cervical cyst, peritonsillar abscess.
  • Damage to lymphoid formations: lymphadenitis, lymphangitis.
  • Cervical compression syndrome: radicular artery, vertebral artery.
  • Diseases of related organs: esophagitis, tracheitis.
  • Angina pectoris attack.
Causes of neck pain

Causes of pain in the cervical spine

Patients complain of pain in the neck that occurs along the back.The painful sensations are intense;Due to the constant “lumbago” 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 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 supraspinal and interspinal ligaments of the spine, damage to the paraspinal muscles.
  • Systemic connective tissue diseases: Bechterew's disease (Bechterew's disease), arthritis (rheumatoid, psoriatic arthritis), Reiter's syndrome.
  • Infectious processes: Osteomyelitis, vertebral tuberculosis.
  • Rare causes: Presence of pathological bilateral cervical ribs, Klippel-Feil syndrome.

Causes of side neck pain

Severe pain in the side of the neck usually radiates to the shoulder or ear.A person may feel a tingling, burning, or pulsating sensation in this area.If the symptoms are severe, a secondary torticollis forms, 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 side neck pain are:

  • Pathologies of blood vessels: Varicose veins in the neck, arteriosclerosis of the large neck arteries that supply the brain.
  • Staying in an awkward position: Constantly bowed head when working at the computer, poor pillow for sleeping, walking with neck tilted in the same direction.
  • Muscle cramps: with sharp 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

Those who have neck pain most often turn to an osteopath or neurologist.The exam is lengthy and complex;In order to make a correct diagnosis, many causes of neck pain must be ruled out.A diagnostic search uses laboratory and instrumental methods to visualize the affected area and look for signs of comorbidities.The most informative are:

  • Sonography.Ultrasound of the neck and other parts of the body is used for rapid, non-invasive visualization of all structures of the cervix to detect signs of pathology of internal organs that can cause neck pain.A targeted ultrasound examination of the thyroid and submandibular salivary glands is carried out.Duplex scans help assess blood flow status in large vessels.
  • X-ray imaging.Survey radiography of the neck is used to detect deformations of bone structures and displacements of the vertebrae, which always cause neck pain.A more informative method is a CT scan of the spine, which makes it possible to assess the type and extent of vertebral diseases.An MRI is recommended to examine the ligamentous system.
  • Functional diagnostics.The appearance of neck pain can be caused by damage to the muscles, so it is advisable to do 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 that can cause neck pain.The concentration of thyroid hormones must be determined.In the presence of a general infectious syndrome, a bacteriological sputum culture or a throat swab and serological reactions (RIF, ELISA, PCR) are carried out.

If the patient has pain not only in the neck, but also in the throat, an examination by an otolaryngologist is necessary.If pain is severe, especially in elderly patients or with a history of heart disease, an ECG is recorded to rule out atypical forms of angina and a heart attack.In severe spinal injuries accompanied by sensory impairment or paresis, myelography is performed to assess the condition of the spinal canal.

Treatment

Help before diagnosis

If your neck starts to hurt, you should not delay seeing a doctor.Cervicalgia requires careful diagnosis to identify the causes of unpleasant symptoms.Sudden movements in the neck area, drafts and hypothermia should be avoided.Before the diagnosis is confirmed, neck pain is relieved with the help of heat treatments (wrapping the neck area with a wool scarf).If the pain is severe, you can take painkillers from the NSAID group.However, without a doctor's prescription, these medications should not be taken for a long time as they can cause ulcers and bleeding in the gastrointestinal tract.

Taping for neck pain

Conservative therapy

Medical tactics for cervicalgia depend on the cause of the disease and the intensity of the pain.Isolated drug treatment is rarely used;its combination with modern physiotherapeutic methods is 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.In order to reduce side effects, it is recommended to use selective COX-2 inhibitors that do not attack 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.The medication is administered in the form of injections (blocks) to the affected area.Long-term administration of local anesthetics is not advisable.
  • Antibiotics.The drugs are indicated for bacterial and purulent processes in the neck area that cause pain.In such a situation, the patient's discomfort stops after the cause is eliminated.
  • Vitamins.Preparations made from B vitamins, especially thiamine, are actively used for chronic pain in the neck area.Medicines improve the nutrition of the spinal roots and nerves.

Physiotherapy

To eliminate muscle tension that causes neck pain, use a Shants collar, which should be worn for 2-3 weeks.After local thermal procedures - mud baths and compresses, electrophoresis with anesthetics - the neck hurts less.Manual therapy techniques are useful to restore the anatomical position of the vertebrae and intervertebral discs.Magnetic therapy and acupuncture help relieve chronic neck pain.After the acute pain subsides, massage sessions begin and physiotherapy must be supplemented by exercise therapy methods.

Surgical treatment

For neck pain caused by spinal pathology, surgical intervention is required.To reduce pressure on the nerve roots, discectomy, foraminotomy and laminectomy are used.If hernias are detected, appropriate operations are performed;If neoplasms are found in the cervical part of the body, they are removed surgically.Severe degenerative lesions of the spine are an indication of spinal fusion.If ulcers or cysts cause neck pain, it is necessary to open and drain them and wash the resulting cavity with antibacterial solutions.