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Neck pain (Cervicalgia)

severe neck pain

Neck pain(cervicalgia) pain of varying nature and intensity that occurs in the neck region.The symptom is accompanied by dizziness, numbness of the back of the head or arm, local redness and swelling.The neck can hurt due to infectious and inflammatory diseases of the area, injuries and degenerative processes of the spine, after staying in an uncomfortable position for a long time.To determine the cause of neck pain, CT, MRI, ultrasound and laboratory tests are prescribed.Painkillers, NSAIDs and physiotherapy methods are used to relieve symptoms.

General characteristics

Neck pain occurs periodically in 70% of the adult population.These feelings can vary in intensity and duration: from short-term discomfort to severe pain that makes daily activities difficult.Neck pain is more often localized in the cervical spine or along the anterolateral surfaces.Typically, patients experience a sudden "lumbar leg" that is replaced by persistent pain.The nature of the pain varies - throbbing, tingling, squeezing.They can radiate to the shoulder, scapula, and occipital region.

Unpleasant sensations intensify when turning and tilting the head, so the person is forced to turn the whole body.The neck often 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 a draft.If your neck hurts badly, 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, which lasts up to 10 days, and chronic cervicalgia, which can be permanent or recurring.According to the etiopathogenetic classification, two forms of cervicalgia are distinguished:

  • Vertebrogenic neck pain.It develops as a result of primary damage to the osteochondral structures of the cervical spine.This group includes spondylogenic cervicalgia, which is related to bone damage and compression of the spinal cord, and discogenic, which is caused by deformation of the intervertebral discs.
  • Non-vertebrogenic neck pain.It includes all other causes of neck pain.Unpleasant sensations may occur due to inflammatory processes of the muscle-ligament apparatus, pathologies of the internal organs - pharynx, thyroid gland, lymph nodes and salivary gland.

According to localization, the pain syndrome can be distinguished in the front or lateral parts of the neck, in the area of the spinal column.Sore throats are isolated separately.Cervicalgia radiating to adjacent 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

Scratchy, scraping sensation in the throat is associated with a cold, but the unpleasant sensations can often be caused by other reasons as well (excessively dry indoor air, exposure to atmospheric pollutants).Sometimes the pain syndrome is felt so strongly 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 bodies in the throat;meat and fish bones, for children - parts of toys.
  • The incomplete states:Vitamin B12 and B2 deficiency, ascorbic acid, iron deficiency.
  • Gastroesophageal reflux.
  • Rare reasons: long styloid process, Itsenko-Cushing syndrome, malignant tumors in the throat or vocal apparatus.

Causes of anterior neck pain

Discomfort can be localized directly under the chin in a limited area, but more often the discomfort is severe, diffuse pain.The pain intensifies when swallowing, turning the head or squeezing the neck with a shirt collar.Neck pain is caused by:

  • Thyroid pathologies: acute and subacute thyroiditis, diffuse toxic goiter, Hashimoto's thyroiditis.
  • Injuries: muscle fibers sprains and tears, blows in the neck area.
  • Inflammatory processes:myositis, neuritis, tendinitis.
  • Purulent diseases: festering neck cyst, peritonsillar abscess.
  • Damage to lymphoid formations: lymphadenitis, lymphangitis.
  • Cervical compression syndrome: radicular, vertebral artery.
  • Diseases of related organs: esophagitis, tracheitis.
  • Angina attack.
causes of neck pain

Causes of cervical spine pain

Patients complain of neck pain that occurs along the back surface.The painful sensations are intense;due to the constant "lumbago", one 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, osteoarthritis, prolapse or herniated disc.
  • Bone injuries: compression fractures of cervical vertebrae, spinal cord compressions, fractures of 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, arthritis (rheumatoid, psoriasis), Reiter's syndrome.
  • Infectious processes: osteomyelitis, vertebral tuberculosis.
  • Rare reasons: presence of abnormal bilateral cervical ribs, Klippel-Feil syndrome.

Causes of lateral neck pain

Intense pain on the side of the neck usually radiates to the shoulder or ear.A person may feel tingling, burning or throbbing in this area.In case of severe discomfort, secondary torticollis is formed, in which the head constantly tilts towards the painful side and the chin turns towards the healthy side.The most common causes of lateral neck pain are:

  • Pathologies of blood vessels: jugular vein, atherosclerosis of the large carotid arteries that supply the brain.
  • To remain in an awkward position: constantly bowed head while working on the computer, wrong pillow for sleeping, peculiarities of walking with the neck tilted in the same direction.
  • Muscle cramps: with a sharp turn of the head, intense physical activity, after hypothermia.
  • Retropharyngeal abscess.
  • Oncological diseases: tumors of the thyroid gland and parathyroid gland, tumors of the lateral surface of the pharynx and larynx.
  • Congenital diseases: Grisel syndrome, pterygoid neck with Shereshevsky-Turner anomaly.
  • Rare reasons: complications after subarachnoid hemorrhage, meningitis.

Diagnostics

A person who has neck pain most often consults an osteopath or a neurologist.The investigation is long and complex;many causes of neck pain must be ruled out to make the correct diagnosis.During the diagnostic search, laboratory and instrumental methods are used, the purpose of which is to display the affected area and look for signs of simultaneous diseases.The most informative are:

  • Sonography.Ultrasound of the neck and other parts of the body is used for quick, non-invasive visualization of all neck structures, identifying signs of pathology of internal organs that can cause neck pain.A targeted ultrasound of the thyroid and submandibular salivary glands is performed.Duplex scanning helps assess the state of blood flow in the large vessels.
  • x-ray imaging.With survey radiography of the neck, deformations of the bone structures and displacement of the vertebrae are identified, which always causes neck pain.A more informative method is a CT scan of the spine, which allows assessing the nature and extent of vertebral abnormalities.An MRI is recommended to examine the ligament apparatus.
  • Functional diagnostics.The appearance of neck pain can be caused by damage to the muscular system, so it is advisable to perform an electromyography.If radicular pain is suspected, electroneurography is indicated.The Forestier test is required to detect cervical kyphosis.The degree of pain is determined using the McGill questionnaire.
  • Laboratory methods.A general and biochemical blood test is necessary to rule out acute inflammatory processes that can cause neck pain.The concentration of thyroid hormones should be determined.In the presence of a general infectious syndrome, bacteriological culture of sputum or throat smear and serological reactions (RIF, ELISA, PCR) are performed.

If the patient not only has a sore throat, but also a sore throat, an ear, nose and throat examination is necessary.In case of severe pain, especially in elderly patients or patients with heart disease, an ECG is recorded to rule out atypical forms of angina pectoris and myocardial infarction.In severe spinal injuries with sensory disturbances or paresis, myelography is performed to assess the condition of the spinal canal.

Treatment

Help before diagnosis

If your neck starts to hurt, don't delay seeing a doctor.Cervicalgia requires careful diagnosis to determine the causes of unpleasant symptoms.Avoid sudden movements of the neck region, drafts and hypothermia.Before the diagnosis is confirmed, neck pain is alleviated with the help of warming procedures (wrapping the neck area with a wool chin).In case of severe pain, it is possible to take painkillers from the NSAID group.But these drugs should not be taken for a long time without a doctor's prescription, as they can cause ulcers and bleeding from the gastrointestinal tract.

taping for neck pain

Conservative therapy

The medical tactics of cervicalgia depends on the cause of the disease and the intensity of the pain.Isolated drug treatment is rarely used;combinations with modern physiotherapy methods are more effective.The following drug groups are used to relieve neck pain and eliminate the underlying pathology that causes cervicalgia:

  • NSAIDs.Medicines effectively eliminate the inflammatory process and relieve pain.In order to reduce side effects, it is advisable to use selective COX-2 inhibitors that do not affect the mucosa of the gastrointestinal tract.
  • Muscle relaxants.Medicines quickly eliminate muscle spasms, and after relaxing the muscles, the neck hurts much less.The effect is observed after the first injection;in order to consolidate the effect, the product is used in courses.
  • Anesthetics.It is used for severe neck pain that the patient cannot tolerate.Medicines are administered in the form of injections (blockades) to the affected area.Long-term use of local anesthetics is not advisable.
  • Antibiotics.Medicines are prescribed for bacterial and purulent processes in the neck region that cause pain.In such a situation, the patients' discomfort disappears after the cause is eliminated.
  • Vitamins.Preparations of B vitamins, especially thiamine, are actively used in cases where neck pain is chronic.Medicines improve the nutrition of the spinal cord 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 in restoring the anatomical position of the vertebrae and discs.Magnetic therapy and acupuncture reduce chronic neck pain.After the acute pain subsides, massage treatments begin, and physiotherapy must be supplemented with exercise therapy methods.

Surgical treatment

In case of neck pain caused by spinal column pathology, surgical intervention is required.Discectomy, foraminotomy, and laminectomy are used to reduce pressure on the nerve roots.Appropriate operations are performed when hernias are detected;if tumors are detected in the cervical part of the body, they are surgically removed.Severe degenerative changes in the spine indicate spinal fusion.If the neck pain is caused by ulcers or cysts, they should be opened and drained, and the resulting cavity should be washed with antibacterial solutions.