Neck pain: why and what to do?

According to the latest statistics, one in three people 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 aching in nature if it bothers you constantly. Sometimes, when the cervical spine hurts, the following symptoms occur: decreased 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 tinnitus. Sometimes the discomfort is accompanied by numbness in the back of the head. Neck pain today is a very common symptom, since many people do not exercise, are overweight, and often face stress. Neck pain can also occur for other reasons, including 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 often occurs when the roots of the spinal cord nerves are compressed.
This usually happens due to spondylosis or hernia and protrusion in the intervertebral disc, when the fibrous ring ruptures and its nucleus pulposus exits into the spinal cord canal. The consequence of lack of treatment entails irreversible complications, including paralysis. Sciatica appears in the neck sometimes 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. Usually this diagnosis can already be made after examination by a neurologist. However, in some cases it may be necessary to perform an electromyography or computed tomography 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 strong and immobile conglomerates.

Diffuse skeletal hyperostosis (Forestier disease)

People over 50 years of age mostly develop 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 experiences pain and neck mobility decreases. To confirm the diagnosis, a doctor at a clinic of the highest category will need 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 as a result of degenerative changes in the structure between the discs in the spine due to uneven load between the endplates and facet joints. With this disease, pain can be distributed 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 in your neck also worsens.

Due to degenerative changes in the neck area,spondylosisin the cervical spine. Erasure of spinal discs leads to a gradual reduction in the space between the vertebrae, bone deformation and the formation of osteophytes as they grow; this deformation has a tremendous impact on the functioning of the entire body. With age, these changes in most cases do not bring any unpleasant sensations. However, they sometimes lead to pressure on the spinal nerve, causing numbness and pain in the neck, and in some cases, pain in the arm or shoulder. Often, numbness, impaired sensitivity and mobility, and attacks of loss of consciousness are observed, which indicates the development of neurological disorders.

Cervical spondylogenic myelopathy. The spinal cord becomes damaged and begins to malfunction due to degenerative changes in the cervical spine, which lead to a narrowing of the central spinal canal. The result is acute pain in the neck, which constantly intensifies, its mobility is difficult, coordination of movements is impaired, urination and defecation are not controlled, and general weakness and problems in the sexual sphere may also be observed. The disease develops most often after 55 years of age and often requires surgical intervention.

Cervical spine injuries

The consequences of injury can be pain in the cervical region and shoulders, migraines, spasms of the neck muscles, and impaired mobility. In car accidents, people usually suffer neck injuries due to the sudden movement of the head back and forth. As a result, intervertebral discs, soft tissues, nerve fibers, the posterior longitudinal ligament, the facet joint (facet syndrome), etc. can be damaged. After an injury, muscle spasm occurs, and it becomes difficult to move the neck. Over time, the symptoms of pain go away 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, awkward posture, emotional stress during the workday, or spinal injuries. Muscles can also spasm, in particular due to the wrong pillow. Usually, discomfort causes limited mobility, but this pain goes away within six weeks. To speed up the process, doctors recommend eliminating, if possible, the cause of muscle strain, and also doing special exercises.

Myofascial pain syndrome

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

Cervical osteochondrosis

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

Almost all people over 40 years old experience degenerative changes in the spine. This is not a reason to call a person completely sick and actively begin treatment. If the neck bothers you, then this is only a symptom indicating the need to make a real diagnosis, after which medical therapy is prescribed.

Diagnosis of the causes of neck pain is always complex. It includes:

• general and biochemical laboratory blood test;
• determination of 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 spine;
• electroneuromyography;
• CT;
• MRI.

Cervical osteochondrosis can impair 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 your neck hurts, when should you see a doctor?

If the neck causes discomfort, then first of all you need to 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: a surgeon, neurologist, vertebrologist, rheumatologist, cardiologist, traumatologist, orthopedist, endocrinologist and some other doctors.

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

• severe headache;
• neck injury;
• uncontrolled urination or bowel movements;
• numbness, tingling, weakness in the arms and legs;
• my neck hurts for a week and there is no improvement;
• lack of benefit in pain medications.

Consult your doctor immediately if:

• Meningitis, if your head hurts with a strong increase in 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 discomfort in the chest, rapid breathing, sweating, nausea, vomiting, and pain in the arms or jaw.

Treatment for neck pain

1. Medicines that relieve pain and tension. For such discomfort, there is usually no specific treatment. In simple situations, the doctor recommends non-steroidal anti-inflammatory drugs, chondroprotectors (drugs that promote the restoration of cartilage tissue) that relieve pain. If the spasm is severe, the doctor may prescribe a drug to take at night that relaxes the muscles, for example, 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 is bothering you after an injury, then in the first three days it is recommended to apply ice to relieve pain. If it is a muscle problem, use heat, including taking a shower or bath, or placing a damp towel on the 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 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 better to exercise in the morning or before bed. You should definitely consult your doctor about more common physical activities, including yoga, running, and football.
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. Changing habits. The position in which a person spends a lot of time during the working day needs to be corrected so that the neck does not hurt again. To do this, it is important to monitor your posture yourself, it is advisable to 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. The head and body should be at 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 taken into account, however, that massage for chronic pain is likely to be ineffective and is rarely performed.
8. Manual therapy. In some cases, manipulations can completely worsen the condition, since they have no proven effectiveness. In combination only with physical exercise, it is recommended to resort to manual "soft" therapy, however, manual therapy helps 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 implementation of which is monitored using sensors. On the screen, the patient himself sees a cloudy image, which becomes clear as his muscles relax. This is how a person learns to control muscle tension in the neck.
10. Corset, which fixes the vertebrae of the neck, although it relieves pain, it is recommended to wear it for 1 to 3 hours a day, no more than 1–2 weeks, so that the neck muscles cannot weaken.
11. There are methods andosteopathic. According to some data, for example, traction of the neck muscles is ineffective, but acupuncture helps with chronic neck pain. Electromagnetic and low-frequency therapy also works, as well as electromyostimulation and laser therapy. It is not recommended, however, to ignore exercise while using all these methods. It is also important to eat properly so that the body receives all the substances and vitamins it needs. This will not only slow down the progression of pathology, but will also contribute to faster regeneration processes.
12. Surgery for neck pain. If your neck hurts, then surgery, in most cases, is not required. At first, only conservative treatment is used. If the cause of pain is a narrowing of the central spinal canal or 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.