Neck pain: why and what to do?

According to the latest statistics, every third person has experienced neck pain at some point. Due to the new "sedentary" professions and the appearance of computers, people's necks have become more and more common. The discomfort can usually be painful if it bothers you constantly. Sometimes, when the cervical spine hurts, the following symptoms appear: reduced vision, dizziness, limited movement, loss of sensitivity. In some cases, especially due to work in an uncomfortable position, neck pain spreads to the arms and heart. Patients with neck discomfort complain of nausea, crunching when turning the head, and tinnitus. Sometimes the discomfort is accompanied by numbness in the back of the head. Neck painit is a very common symptom nowadays, as many people are sedentary, overweight and often stressed. Neck pain can also occur due to other causes, including serious diseases that require urgent treatment. For example, meningitis, vascular infections and cancer, rheumatoid arthritis, ankylosing spondylitis, arthritis due to inflammation of intestines and other internal organs.

Cervical radiculitis ("trapped nerve")

In the cervical spine, radiculitis most often occurs when the roots of the spinal nerves are compressed.
This is usually due to spondylosis or herniation and protrusion of the intervertebral disc when the annulus fibrosus ruptures and the nucleus pulposus is pushed into the spinal canal. The consequences of lack of treatment are irreversible complications, including paralysis. Sciatica sometimes appears on the neck due to the herpes virus and Lyme disease.

The pain starts in the neck and often radiates to the arm, causing the arm to become numb and weak. Usually, this diagnosis can be established after a neurologist's examination. 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 every joint in the body and causes severe limitation of movement 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 ligaments and musculoskeletal system of the spine is the most likely cause of this disease.

Forestier's disease may not manifest itself in any way, but in some cases a person experiences pain and reduced mobility of the neck. To confirm the diagnosis, the doctor of the highest category clinic needs 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 in the spine as a result of degenerative changes in the intervertebral disc structure due to uneven loading between the endplates and facet joints. With this disease, the pain can spread to the arm or shoulder, sometimes to the hand and fingers. The neck hurts when you turn or tilt your head. If you keep your head in one position for a long time, the condition of your neck will also deteriorate.

Due to degenerative changes in the neck area,spondylosisin the cervical spine. Deletion of the discs leads to a gradual reduction of the space between the vertebrae, the deformation of the bones and the formation of osteophytes during their growth, this deformation has a huge impact on the functioning of the entire body. As we age, these changes do not cause discomfort in most cases. However, they sometimes put pressure on the spinal nerve, causing numbness and pain in the neck and, in some cases, pain in the arm or shoulder. Numbness, loss of sensitivity and mobility, and attacks of unconsciousness are often observed, which indicate the development of neurological disorders.

Cervical spondylogenic myelopathy. The spinal cord is damaged and malfunctions due to degenerative changes in the cervical spine that lead to narrowing of the central spinal canal. The result is acute pain in the neck, which is constantly getting worse, mobility is difficult, movement coordination is disturbed, urination and defecation are not controlled, general weakness, and sexual problems can also be observed. The disease most often develops after the age of 55 and often requires surgical intervention.

Cervical spine injuries

The consequences of the injury may be pains in the neck region and shoulders, migraines, spasms of the neck muscles, and limited mobility. In car accidents, people usually suffer neck injuries due to the sudden forward and backward movement of the head. Because of this, the intervertebral discs, soft tissues, nerve fibers, the posterior longitudinal ligament, the facet joint (facet syndrome), etc. can be damaged. . After an injury, muscle spasms occur, and it becomes difficult to move the neck. Over time, the symptoms of pain go away on their own, but sometimes it turns into chronic pain.

Muscle pain

Muscle spasms in the upper back and neck occur as a result of physical overexertion, uncomfortable posture, emotional stress during the working day or spinal injuries. Muscles can also cramp, especially from an inappropriate pillow. Usually, the discomfort causes limited movement, but this pain goes away within six weeks. In order to speed up the process, doctors recommend eliminating the cause of muscle tension, if possible, and performing special exercises.

Myofascial pain syndrome

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

Cervical osteochondrosis

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

Almost everyone over the age of 40 experiences degenerative changes in the spine. This is not a reason to call a person completely sick and actively start treatment. If the neck bothers you, then this is just a symptom that indicates that a real diagnosis should be made, after which medical therapy will be prescribed.

Diagnosing the causes of neck pain is always complex. Includes:

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

Cervical osteochondrosis can damage cerebral circulation. This causes throbbing headaches, vegetative-vascular dystonia and high blood pressure, cardiovascular and respiratory problems, hearing, vision and coordination problems.

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 for further examination. The following will help determine the cause of neck pain and dystrophic condition, treat and restore its function: surgeon, neurologist, vertebrologist, rheumatologist, cardiologist, traumatologist, orthopedist, endocrinologist and some other doctors.

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

• severe headache;
• neck injury;
• uncontrolled urination or defecation;
• numbness, tingling, weakness in arms and legs;
• my neck has been hurting for a week and there is no improvement;
• lack of analgesic effect.

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 when you turn it, and you cannot reach your chest with your chin.
• A heart attack if you have chest discomfort, rapid breathing, sweating, nausea, vomiting and pain in the arms or jaw.

Treatment of neck pain

1. Medicines to relieve pain and tension. There is usually no specific treatment for such discomforts. In simple situations, the doctor recommends non-steroidal anti-inflammatory drugs, chondroprotectors (drugs that promote the restoration of cartilage tissue), which relieve pain. If the spasm is severe, the doctor may prescribe a nighttime medicine that relaxes the muscles, such as a muscle relaxant. In case of chronic pain, the doctor prescribes tricyclic antidepressants, since botulinum blockades are ineffective. With conservative medical treatment, most muscle strains disappear within 2-3 weeks.
2. Ice and heat. If the cervical spine bothers you after an injury, it is recommended to use ice for the first three days to relieve the pain. If it's a muscle problem, use heat, including showering or bathing, or putting a wet towel on your neck.
3. Physiotherapy:phonophoresis, carboxytherapy, ozone therapy, pressotherapy, RF currents, ultrasound therapy.
4. Stretching exercises. Stretching exercise therapy is effective, especially for chronic pain. Qigong exercises 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 worth practicing in the morning or before going to bed. Be sure to 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 must be corrected so that the neck does not hurt again. For this, it is important to monitor our own posture, it is advisable to reduce tension to a minimum by changing positions, stretch the neck once an hour, and place the computer at eye level. You should sit straight with your shoulders back. While sleeping, the head and body should be on the same level, and the neck needs support. Sleeping on your back is the ideal position; the worst position for your neck is sleeping on your stomach.
7. Massagerelieves muscle spasms and ensures normal blood supply, and for pressure it is advisable to use a vibration massager. However, it should be noted that massage for chronic pain is likely to be ineffective and infrequent.
8. Manual therapy. In some cases, manipulations can completely worsen the condition, since they have no proven effectiveness. It is recommended to use manual "soft" therapy only in combination with physical exercise, however, manual therapy helps to eliminate the signs of radicular syndrome, improves the functioning of internal organs and especially the brain. It is better not to contact chiropractors if the central spinal canal is narrowed due to spondylotic myelopathy.
9. Biofeedback (BFB). With this method, a person receives "relief of neck muscle tension", the execution of which is monitored with the help of sensors. On the screen, the patient himself sees the cloudy image, which becomes clear as the muscles relax. This is how the person learns to control neck muscle tension.
10. Corset, which fixes the cervical vertebrae, although it is pain-relieving, it is recommended to wear it for 1-3 hours a day, for a maximum of 1-2 weeks, so that the neck muscles do not weaken.
11. There are methods andosteopathic. According to some data, for example, pulling the neck muscles is not effective, but acupuncture helps with chronic neck pain. Electromagnetic and low-frequency therapy also work, as well as electromyostimulation and laser therapy. However, it is not recommended to neglect exercise while using all these methods. Adequate nutrition is also important so that the body receives all the necessary substances and vitamins. This not only slows down the progression of the pathology, but also contributes to faster regeneration processes.
12. Surgery for neck pain. If your neck hurts, in most cases surgery is not necessary. At first, only conservative treatment is used. If the cause of the pain is a narrowing of the central spinal canal or a "pinched nerve", i. e. pressure on the root of the spinal cord, and conservative treatment does not help, then surgical treatment is recommended.