Neck pain: why and what to do?

According to recent statistics, every third person has 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 be painful in nature if it bothers you constantly. Sometimes when the cervical spine hurts, the following symptoms appear: reduced vision, dizziness, limited mobility, loss of sensitivity. In some cases, especially due to working in an uncomfortable position, neck pain spreads to the arms and heart area. Patients with neck discomfort complain of nausea, crunching when turning the head and noise inears. Sometimes the discomfort is accompanied by a tingling in the back of the head. Neck pain is a very common symptom today, as many people do not exercise, are overweight and often face stress. Neck pain can also occur due to othercauses, including serious illnesses requiring urgent treatment, such as meningitis, vascular infections and cancer, rheumatoid arthritis, ankylosing spondylitis, arthritis due to inflammation of the bowels and other internal organs.

Cervical radiculitis ("pinched nerve")

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

The pain occurs in the neck and often radiates to the arm, resulting in numbness and weakness of the arm. Usually, this diagnosis can already be made after an examination by a neurologist. In some cases, however, it may be necessary to have an electromyography or CT 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 solid 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 reason for the development of this disease.

Forestier's disease may not manifest itself in any way, but in some cases a person experiences pain and the mobility of the neck decreases. To confirm the diagnosis, the doctor in a clinic of the highest category will need an X-ray examination, in some cases diagnostic procedures are also prescribed: computed tomography (CT) or nuclear magnetic resonance (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 into the arm or shoulder, sometimes down 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 the neck also worsens.

Due to degenerative changes in the neck area,spondylosisin the cervical spine. The erosion of the spinal discs leads to a gradual reduction of the space between the vertebrae, deformation of the bones and the formation of osteophytes during their growth, this deformation has a huge impact on the functioning of the whole body. With age, these changes in most cases do not bring any unpleasant sensations. 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, impaired sensitivity and mobility, bouts 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 malfunction due to degenerative changes in the cervical spine, which leads to a narrowing of the central spinal canal. The result is a sharp pain in the neck that constantly increases, mobility is difficult, coordination of movements is impaired, urination and defecation are not controlled, general weakness and problems in the sexual sphere can be observed. The disease develops most often after the age of 55 and often requires surgical intervention.

Injuries of the cervical vertebrae

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

Muscle pain

Muscle spasms in the upper back and neck occur due to physical overexertion, uncomfortable posture, emotional stress during the working day or spinal injuries. Muscles can also spasm, especially due to an improper pillow. Usually, the discomfort causes limited mobility, but this pain disappears within six weeks. To speed up the process, doctors recommend eliminating, if possible, the cause of muscle tension, as well as doing 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 provoke muscle tension and pain that often becomes chronic.

Cervical osteochondrosis

Among the diseases that cause neck pain, osteochondrosis is a diagnosis made on the territory of the former Soviet Union, and in fact, all the diseases listed above (degenerative-dystrophic lesions of the spine) are 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 bothers you, it is only a symptom that indicates the need to make a real diagnosis, after which medical therapy is prescribed.

The diagnosis of the causes of neck pain is always complicated. Includes:

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

Cervical osteochondrosis can disrupt 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 you have neck pain, when should you see a doctor?

If the neck causes discomfort, then you should first contact a therapist who will refer you for further examination. The following will help determine the causes 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 why consultation with a rheumatologist and neurologist is necessary:

• strong 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.

Consult your doctor immediately if:

• Meningitis if your head hurts with a high 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 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 the recovery of cartilage tissue), which relieve pain. If the spasm is severe, the doctor may prescribe an evening medicine that relaxes the muscles, such as a muscle relaxant. For chronic pain, the doctor prescribes tricyclic antidepressants, since botulinum blockades are 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 an injury, then during the first three days it is recommended to apply ice to relieve pain. 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, ozone therapy, pressotherapy, RF currents, ultrasound therapy.
4. Stretching exercises. Stretching exercise therapy is effective, especially for chronic pain. Qigong gymnastics, which should be done carefully and after consultation with a specialist, will be useful. First you need to warm up your neck. However, it is better to do exercises in the morning or before going to bed. You should definitely check with your doctor about the more common physical activities, including yoga, running, and soccer.
5. Relaxation techniques. Due to emotional stress, the neck begins to hurt more, so treatment cannot be postponed. Relaxation techniques such as breathing exercises, self-hypnosis, meditation and psychotherapy can help reduce muscle tension.
6. Changing habits. The posture in which a person spends a lot of time during the working day must be corrected so that the neck does not hurt again. To do this, it is important to monitor your posture yourself, it is recommended to minimize the tension by changing your positions, stretch your neck once an hour and place the computer at eye level. You should sit up straight with your shoulders back. The head and body should be on 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. It should be kept in mind, however, that massage for chronic pain is probably ineffective and rarely applied.
8. Manual therapy. In some cases, manipulations can completely worsen the condition, since they have no proven effectiveness. In combination with only physical exercises, it is recommended to resort to manual "soft" therapy, but manual therapy helps to eliminate the signs of radicular syndrome, improve the functioning 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 spondylotic myelopathy.
9. Biofeedback (BFB). With this method, a person is given the task of "relieving muscle tension in the neck", the performance of which is monitored with the help of sensors. On the screen, the patient himself sees a blurry image, which becomes clear when his muscles relax. Thus, a person learns to controlneck muscle tension.
10. A corset, which fixes the vertebrae of the neck, although it relieves pain, it is recommended to wear it from 1 to 3 hours a day, no more than 1-2 weeks, so as not to weaken the neck muscles.
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 also work, as do 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 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 is due to a "pinched nerve", that is, pressure on its root in the spinal cord, and conservative treatment does not help, then surgical treatment is recommended.