Neck pain: why and what to do?

According to the most recent statistics, one in three people has felt neck pain at least once. People's necks have become more common due to the emergence of new "sedentary" professions and computers. Discomfort, as a rule, can be of a painful nature if it constantly bothers you. 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 awkward position, neck pain extends to the arms and heart area. Patients with neck discomfort complain of nausea, crackling sounds 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, as 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 intestine and other internal organs.

Cervical radiculitis ("pinched nerve")

In the cervical spine, radiculitis most often occurs when the nerve roots of the spinal cord are compressed.
This usually happens due to spondylosis or herniation and protrusion of the intervertebral disc, when the fibrous ring ruptures and its nucleus pulposus leaks into the spinal cord canal. The consequence of lack of treatment leads to irreversible complications, including paralysis. Sciatica appears in the neck sometimes due to herpes virus and Lyme disease.

The pain occurs in the neck and often radiates to the arm, making it 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 evaluate the damage.

Ankylosing spondylitis

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

Diffuse skeletal hyperostosis (Forestier's disease)

People over the age of 50 mainly develop Forestier's disease. It has been established that the accumulation of calcium salts in the ligament 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 decreases the mobility of the neck. To confirm the diagnosis, a doctor from 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 due to degenerative changes in the structure between the discs of the spine due to uneven loading between the endplates and facet joints. With this disease, the pain may be distributed to the arm or shoulder, sometimes down to the hands and fingers. The neck hurts when you turn or tilt your head. If you keep your head in the same position for a long time, the condition of your neck also worsens.

Due to degenerative changes in the neck area,spondylosisin the cervical spine. The erasure of the vertebral discs leads to a progressive reduction of the space between the vertebrae, the deformation of the bones and the formation of osteophytes as they grow; this deformation has a huge impact on the functioning of the entire body. With age, these changes in most cases do not bring 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 loss of consciousness are often observed, indicating the development of neurological disorders.

Cervical spondylogenic myelopathy. The spinal cord becomes damaged and begins to function poorly due to degenerative changes in the cervical spine, which leads 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 can also be observed. The disease most often develops after age 55 and often requires surgery.

Cervical spine injuries

The consequences of an injury can be pain in the neck and shoulders, migraines, spasms of the neck muscles and reduced 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, posterior longitudinal ligament, facet joint (facet syndrome), etc. may be damaged. . After an injury, muscle spasm occurs and it becomes difficult to move the neck. Over time, pain symptoms disappear on their own, but sometimes they turn into chronic pain.

Muscular pain

Muscle spasms in the upper back and neck occur due to excessive physical exertion, awkward posture, emotional stress during the workday, or spinal injury. Muscles can also spasm, especially due to the wrong pillow. Usually, the discomfort causes limited mobility, but the pain goes away within six weeks. To speed up the process, doctors recommend eliminating, if possible, the cause of muscle strain, and also performing special exercises.

Myofascial pain syndrome

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

Cervical osteochondrosis

Among the diseases that cause neck pain, 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 the age of 40 experience degenerative changes in the spine. This is not a reason to call a completely sick person and actively start treatment. If your neck bothers you, then this is just a symptom that indicates the need to make a real diagnosis, after which medical therapy is prescribed.

Diagnosing the causes of neck pain is always complex. Includes:

• general and biochemical laboratory blood tests;
• determination of the level of thyroid hormones in the blood;
• Ultrasound with Dopplerography of the vessels of the neck, thyroid, salivary glands;
• X-ray of the cervical spine;
• electroneuromyography;
• CT;
• magnetic resonance imaging.

Cervical osteochondrosis can compromise cerebral circulation. This causes shooting 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, 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, a neurologist, a vertebrologist, a rheumatologist, a cardiologist, a traumatologist, an orthopedist, an endocrinologist and some others doctors.

The main reasons why consultation with a rheumatologist and neurologist is necessary:

• bad headache;
• neck injury;
• uncontrolled urination or bowel movements;
• numbness, tingling, weakness in the arms and legs;
• my neck has been hurting for a week and there is no improvement;
• lack of benefit in painkillers.

See your doctor immediately if:

• Meningitis, if your head hurts with a sharp 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 you feel chest discomfort, rapid breathing, sweating, nausea, vomiting, and pain in your 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 nonsteroidal anti-inflammatory drugs, chondroprotectors (drugs that promote the restoration of cartilage tissue) that relieve pain. If the spasm is severe, your doctor may prescribe a medication to take at night that relaxes the muscles, such as a muscle relaxant. For chronic pain, the doctor prescribes tricyclic antidepressants, since botulinum blocks 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, in the first three days it is recommended to apply ice to relieve the pain. If it is 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 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 best to practice in the morning or before going to bed. You should definitely consult your doctor for 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 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 no longer hurts. To do this, it is important to monitor your posture yourself, it is advisable to minimize tension by changing position, 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 sleeping 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 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 "gentle" manual therapy, however, manual therapy helps to eliminate the signs of radicular syndrome, improve the functioning of internal organs and especially the brain. It is best not to contact chiropractors if the central spinal canal is narrowed due to spondylotic myelopathy.
9. Biofeedback (BFB). With this method, a person is given the task of "relieving neck muscle tension", the implementation of which is monitored using sensors. On the screen the patient himself sees a blurred 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 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 work, as do electromyostimulation and laser therapy. It is not recommended, however, to skip exercise while using all of these methods. It is also important to eat correctly so that the body receives all the substances and vitamins it needs. This will not only slow down the progression of the pathology, but will also contribute to faster regeneration processes.
12. Surgery for neck pain. If your neck hurts, in most cases 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 is due to a "pinched nerve", that is, pressure on its root in the spinal cord, and conservative treatment does not help, surgical treatment is recommended.