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Neck pain (cervicalgia)

severe neck pain

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

General characteristic

Neck pain occurs periodically in 70% of the adult population.These sensations can be of different intensity and duration: from short-term discomfort to severe pain that makes daily activities difficult.More often, neck pain is localized in the cervical vertebrae or on the front-lateral surfaces.Usually, patients feel a sudden "lumbago", which is replaced by constant pain.The pain is different in character - 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 his whole 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 cervical pain with hypothermia and the effects of current.If your neck hurts a lot or the pain is combined with vertigo, tingling in the back of the head, tinnitus, you should seek qualified medical help as soon as possible.

Classification

Depending on the duration of the pain in the neck, there is an acute form lasting up to 10 days and chronic cervicalgia, which can be permanent or recurring.In accordance with 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 vertebrae.This group includes spondylogenic cervicalgia, associated with bone damage and compression of the spinal cord, and discogenic, caused by deformation of the intervertebral discs.
  • Non-vertebral neck pain.Includes all other causes of neck pain.Unpleasant sensations can occur due to inflammatory processes in the musculo-ligamentous apparatus, pathologies of the internal organs - pharynx, thyroid gland, lymph nodes and salivary glands.

According to the localization, a pain syndrome is distinguished in the front or in the lateral parts of the neck, in the region of the spine.A sore throat is isolated separately.Cervicalgia, which spreads to adjacent anatomical areas, is divided into cervicocranialgia (spread of pain in the occipital region) and cervicobrachialgia (cervicobrachial syndrome).

Why does my neck hurt?

Causes of sore throat

A scratchy sensation in the throat is associated with colds, but unpleasant sensations can often be caused by other reasons (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, flu, etc.
  • Bacterial infections: tonsillitis, diphtheria, scarlet fever.
  • Allergic inflammation: laryngotracheitis, pharyngitis.
  • Foreign bodies in the throat;meat and fish bones, children's - parts of toys.
  • Deficiency states:deficiency of vitamin B12 and B2, lack of ascorbic acid, iron.
  • Gastroesophageal reflux.
  • Rare reasons: long styloid process, Itsenko-Cushing syndrome, malignant neoplasms of the throat or vocal apparatus.

Causes of front neck pain

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

  • Pathologies of the thyroid gland: acute and subacute thyroiditis, diffuse toxic goiter, Hashimoto's thyroiditis.
  • Injuries: sprains and tears of muscle fibers, blows in the neck area.
  • Inflammatory processes:myositis, neuritis, tendinitis.
  • Purulent diseases: purulent cervical 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 pain in the cervical vertebrae

Patients complain of pain in the neck, which appears on its back surface.The painful sensations are intense;due to 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, osteoarthritis, prolapse or disc herniation.
  • 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 supraspinous and interspinous ligaments of the spine, damage to the paraspinal muscles.
  • Systemic connective tissue diseases: ankylosing spondylitis (ankylosing spondylitis), arthritis (rheumatoid, psoriatic), Reiter's syndrome.
  • Infectious processes: osteomyelitis, vertebral tuberculosis.
  • Rare reasons: presence of pathological bilateral cervical ribs, Klippel-Feil syndrome.

Causes of lateral neck pain

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

  • Pathologies of blood vessels: varicose veins of the neck, atherosclerosis of the large cervical arteries that supply the brain.
  • To be left in an awkward position: constantly bowed head when working on a computer, bad pillow for sleeping, gait characteristics with the neck inclined in the same direction.
  • Muscle spasms: with a sharp turn 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 reasons: complications after subarachnoid hemorrhage, meningitis.

Diagnosis

A person who has neck pain most often turns to an osteopath or a neurologist.Research is lengthy and complex;in order to make a correct diagnosis, it is necessary to rule out many causes of neck pain.Diagnostic search includes the use of laboratory and instrumental methods aimed at visualizing the affected area and looking for signs of concomitant 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 cervical structures, identification of signs of pathology of internal organs that can cause neck pain.A targeted ultrasound of the thyroid gland and submandibular salivary glands is performed.A duplex scan helps assess the state of blood flow in the great vessels.
  • X-ray image.Exploratory radiography of the neck is used to identify deformations of bone structures, displacement of the vertebrae, which always causes neck pain.A more informative method is a computed tomography of the spine, which allows assessing the nature and extent of vertebral disorders.MRI is recommended for examination of the ligament apparatus.
  • Functional diagnostics.The appearance of pain in the neck can be caused by damage to the muscular system, so it is recommended to perform an electromyography.If radicular pain is suspected, electroneurography is indicated.A Forestier test is needed to detect cervical kyphosis.The degree of pain was determined using the McGill questionnaire.
  • Laboratory methods.General and biochemical blood tests are needed 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, a bacteriological culture of sputum or throat smear and serological reactions (RIF, ELISA, PCR) are performed.

If the patient has pain not only in the neck, but also in the throat, an examination by an otolaryngologist is necessary.In case of intense pain, especially in elderly patients or with a history of heart disease, an ECG is recorded to rule out atypical forms of angina pectoris and myocardial infarction.In case of serious damage to the spine, accompanied by 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, you should not delay visiting a doctor.Cervicalgia requires a careful diagnosis to determine the causes of the unpleasant symptoms.It is necessary to avoid sudden movements in the cervical area, currents and hypothermia.Before the diagnosis is confirmed, the pain in the neck is relieved with the help of warming procedures (wrapping the cervical area with a woolen scarf).If the pain is severe, it is possible to take analgesics 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.

paste for neck pain

Conservative therapy

Medical tactics for cervical pain depend on the cause of the disease and the intensity of the pain.Isolated drug treatment is rarely used;its combinations with modern physiotherapy methods are more effective.To relieve pain in the neck and eliminate the main pathology that caused cervicalgia, the following groups of drugs are used:

  • NSAIDs.Medicines effectively eliminate the inflammatory process and relieve pain.To reduce side effects, it is recommended to use selective COX-2 inhibitors that do not affect the gastrointestinal mucosa.
  • Muscle relaxants.Medicines quickly remove muscle spasms, and after the muscles relax, the neck hurts much less.The effect is observed after the first injection;to consolidate the effect, the product is used in courses.
  • Anesthetics.It is used for severe pain in the neck that the patient cannot bear.Medicines are applied to the affected area in the form of injections (blockades).Long-term use of local anesthetics is not recommended.
  • antibiotics.Medicines are indicated for bacterial and purulent processes in the cervical region that cause pain.In such a situation, discomfort in patients stops after removing the cause.
  • vitamins.Preparations of B vitamins, especially thiamine, are actively used in cases where pain in the neck area is chronic.Medicines improve the nutrition of spinal 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 heat treatments - mud baths and compresses, electrophoresis with anesthetics.Manual therapy techniques are helpful in restoring the anatomical position of the vertebrae and discs.Magnetic therapy and acupuncture help reduce chronic neck pain.After the acute pain subsides, massage sessions begin, and physical therapy should be supplemented with exercise therapy methods.

Surgical treatment

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