Neck pain: why and what to do?

According to current statistics, one in three people have had neck pain at some point. Due to the emergence of new "sedentary" jobs and computers, neck injuries are becoming more and more common. As a rule, discomfort can be of a painful nature if it constantly bothers you. When the cervical spine hurts, the following symptoms sometimes appear: reduced vision, dizziness, limited mobility, loss of sensitivity. In some cases, especially when working in an uncomfortable position, the neck pain spreads to the arms and the heart area. Patients with neck problems complain of nausea, crunching when turning the head and tinnitus. Sometimes the symptoms are accompanied by a feeling of numbnessin the back of the mind. Neck pain is a very common symptom these days because many people don't exercise, are overweight and often suffer from stress. Neck pain can also occur for other reasons, such as serious illnesses that require urgent treatment. For example, meningitis, Vascular infections and cancer, rheumatoid arthritis, ankylosing spondylitis, arthritis due to inflammation of the intestines and other internal organs.

Cervical radiculitis ("pinched nerve")

In the cervical spine, radiculitis most commonly occurs when the roots of the spinal nerves are compressed.
This usually occurs due to spondylosis or hernia and bulging of the disc when the fibrous ring ruptures and its nucleus pulposus leaks into the spinal canal. The consequences of a lack of treatment are irreversible complications and even paralysis. Sciatica in the neck sometimes occurs due to the herpes virus and Lyme disease.

The pain occurs in the neck and often radiates to the arm, causing the arm to become numb and weak. This diagnosis can usually be made after an examination by a neurologist. However, in some cases it may be necessary to perform electromyography or computed tomography to assess the damage.

Ankylosing spondylitis

A systemic inflammatory disease that affects almost all joints in the body and leads to severe limitations in mobility due to the fusion of individual vertebrae into strong and immobile conglomerates.

Diffuse skeletal hyperostosis (Forestier disease)

People over 50 years of age usually suffer from Forestier disease. It has been established that the accumulation of calcium salts in the ligamentous and musculoskeletal system of the spine is the most likely cause of the development of this disease.

Forestier's disease may not manifest itself in any way, but in some cases a person feels pain and neck mobility decreases. To confirm the diagnosis, a doctor from a clinic of the highest category requires 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 common cause of neck pain. The syndrome arises as a result of degenerative changes in the structure between the intervertebral discs of the spine due to uneven loading between the endplates and facet joints. With this disease, the pain can spread to the arm or shoulder, and sometimes even to the hands and fingers. The neck hurts when you turn or tilt your head. Keeping your head in one position for a long time also aggravates the condition in your neck.

Due to degenerative changes in the neck area,Spondylosisin the cervical spine. The destruction of the intervertebral discs leads to a gradual reduction in the distance between the vertebrae, bone deformation and the formation of osteophytes during growth; This deformation has an enormous impact on the functioning of the entire body. With age, these changes in most cases do not cause unpleasant sensations. However, they sometimes cause pressure on the spinal nerve, causing numbness and pain in the neck and, in some cases, pain in the arm or shoulder. Numbness, reduced sensitivity and mobility, and attacks of unconsciousness are often observed, which indicates the development of neurological disorders.

Cervical spondylogenic myelopathy. Degenerative changes in the cervical spine, which lead to a narrowing of the central spinal canal, lead to damage to the spinal cord and functional disorders. The result is acute pain in the neck that constantly increases, mobility is difficult, coordination of movements is impaired, urination and bowel movements are not controlled, and general weakness and problems in the sexual area can also be observed. The disease most commonly develops after age 55 and often requires surgical intervention.

Cervical spine injuries

The consequences of an injury can be pain in the neck and shoulder area, migraines, cramps in the neck muscles and limited mobility. In car accidents, people usually suffer neck injuries due to the sudden back and forth movement of the head. This can damage intervertebral discs, soft tissue, nerve fibers, the posterior longitudinal ligament, the facet joint (facet syndrome), etc. After an injury, muscle spasms occur and it becomes difficult to move the neck. Over time, the pain symptoms disappear on their own, but sometimes chronic pain develops.

Muscle aches

Muscle spasms in the upper back and neck occur due to physical overexertion, poor posture, emotional stress during the workday, or spinal injuries. The wrong pillow can also lead to muscle tension. The symptoms usually lead to limited mobility, but this pain disappears within six weeks. To speed up the process, doctors recommend eliminating the cause of the muscle strain if possible and also performing special exercises.

Myofascial pain syndrome

With myofascial syndrome, it is important to identify the most sensitive pain points that can occur after overexertion, hypothermia, emotional trauma or stress. These pressure points cause muscle tension and pain that often becomes chronic.

Cervical osteochondrosis

Among the diseases that cause pain in the neck, osteochondrosis is a diagnosis made in the territory of the former Soviet Union and, in fact, all of the diseases listed above (degenerative-dystrophic lesions of the spine) were 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 the neck bothers you, this is just a symptom that indicates the need for a real diagnosis and then prescribe medical therapy.

Diagnosing the causes of neck pain is always complex. It contains:

• general and biochemical laboratory blood test;
• Determination of thyroid hormone levels in the blood;
• Ultrasound with Dopplerography of the neck vessels, thyroid, salivary glands;
• X-ray of the cervical spine;
• electroneuromyography;
• CT;
• MRI.

Cervical osteochondrosis can affect cerebral circulation. This leads to throbbing pain in the head, vegetative-vascular dystonia and hypertension, problems with the cardiovascular and respiratory systems, hearing, vision and coordination systems.

If your neck hurts, when should you see a doctor?

If the neck causes discomfort, you must first contact a therapist who will refer you for further examination. The following people help to identify the causes of neck pain and dystrophic diseases, treat and restore their function: a surgeon, a neurologist, a vertebrologist, a rheumatologist, a cardiologist, a traumatologist, an orthopedist, an endocrinologist and some other doctors.

The main reasons why a consultation of 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 painkillers.

Consult your doctor immediately if:

• Meningitis, when your head hurts when the temperature rises sharply and your neck is so stiff that it hurts to turn it and you cannot reach your chest with your chin.
• A heart attack occurs when chest discomfort, rapid breathing, sweating, nausea, vomiting, and pain in the arms or jaw occur.

Neck pain treatment

1. Medications that relieve pain and tension. There is usually no specific treatment for such complaints. In simple situations, the doctor recommends non-steroidal anti-inflammatory drugs, chondroprotectors (drugs that promote the restoration of cartilage tissue), which relieve pain. If you have severe cramps, your doctor may prescribe a medication at night that relaxes the muscles, such as a muscle relaxant. For chronic pain, the doctor prescribes tricyclic antidepressants because botulinum blockades are ineffective. With conservative medication, most muscle strains resolve within 2 to 3 weeks.
2. Ice and heat. If you are suffering from a cervical spine injury, it is recommended to use ice for the first three days to relieve pain. If it is a muscle problem, use heat, including showering or bathing, or placing a wet towel on the neck.
3. Physical therapy:Phonophoresis, carboxytherapy, ozone therapy, pressotherapy, HF currents, ultrasound therapy.
4. stretching. Stretching exercise therapy is particularly effective for chronic pain. Qigong gymnastics is useful and should be carried out carefully and after consultation with a specialist. First you need to warm up your neck. However, it is better to exercise in the morning or before bed. You should definitely consult your doctor about more frequent physical activities such as yoga, running and soccer.
5. Relaxation techniques. Due to emotional stress, the neck begins to hurt more, so treatment cannot be delayed. Relaxation techniques such as breathing exercises, self-hypnosis, meditation and psychotherapy can help reduce muscle tension.
6. Change 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. To do this, it is important to monitor your posture yourself, minimize tension by changing positions, stretch your neck once an hour and place the computer at eye level. You need to sit straight with your shoulders back. Head and body should be at the same height when sleeping; the neck needs support. The ideal position is sleeping on your back; The worst position for your neck is sleeping on your stomach.
7. massagerelieves muscle spasms and ensures normal blood supply. When pressing, it makes sense to use a vibration massager. However, it should be noted that massage is likely to be ineffective for chronic pain and is rarely performed.
8. Manual therapy. In some cases, manipulations can completely worsen the condition because their effectiveness has not been proven. Only in combination with physical exercise is it recommended to resort to manual "gentle" therapy. However, manual therapy helps to eliminate the signs of root syndrome and improve the functioning of internal organs and especially the brain. It is better not to visit a chiropractor, 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 implementation of which is monitored using sensors. The patient himself sees a cloudy image on the screen, which becomes clear due to the relaxation of his muscles. This is how he learnsman to control the muscle tension in the neck.
10. corset, which fixes the neck vertebrae, although it relieves pain, it is recommended to wear it for 1 to 3 hours a day, no longer than 1-2 weeks, so as not to weaken the neck muscles.
11. There are methods andosteopathic. For example, according to some data, traction on the neck muscles is ineffective, but acupuncture helps with chronic neck pain. Electromagnetic and low frequency therapy work as well as electromyostimulation and laser therapy. However, it is not recommended to avoid exercise when using all of these methods. Proper nutrition is also important so that the body receives all the substances and vitamins it needs. This will not only slow down the progression of the pathology, but also contribute to faster regeneration processes.
12. Surgery for neck pain. In most cases, if your neck hurts, surgery is not necessary. Initially, 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 its root in the spinal cord, and conservative treatment does not help, surgical treatment is recommended.