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Neck pain (cervicalgia)

severe neck pain

Pain in the neck(cervicalgia) is a pain of different nature and intensity that occurs in the cervical region.The symptom is accompanied by dizziness, a feeling of numbness in the back of the head or hand, 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 physiotherapy methods are used to relieve symptoms.

General characteristics

Neck pain periodically occurs in 70% of the adult population.These feelings can have 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 spine or along the anterolateral surfaces.Usually, patients feel a sudden "lumbago", which is replaced by persistent pain.The pain is of different nature - throbbing, burning, tightening.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.Often, the neck begins to hurt after a long stay in an uncomfortable position: patients note that the discomfort appeared after a day of working at the computer or sewing machine.Many patients associate the development of cervicalgia with hypothermia and draft effects.If you have severe neck pain, or the pain is combined with dizziness, numbness in the back of the head, or ringing in the ears, you should seek qualified medical help as soon as possible.

Classification

Depending on the duration of neck pain, there is an acute form that lasts up to 10 days and chronic cervicalgia, which can be constant or repeated.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 spine.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-vertebrogenic neck pain.It includes all other causes of neck pain.Unpleasant sensations can arise due to inflammatory processes in the muscular-ligamentous apparatus, pathologies of internal organs - pharynx, thyroid gland, lymph nodes and salivary glands.

According to the localization, the pain syndrome differs in the front or side parts of the neck, in the region of the spinal column.Separately, sore throat is isolated.Cervicalgia, which radiates to adjacent anatomical areas, is divided into cervicocranialgia (spreading pain to the occipital region) and cervicobrachialgia (cervicobrachial syndrome).

Why does my neck hurt?

Causes of sore throat

The sensation of scratching and scratching in the throat is associated with a cold, but unpleasant sensations can often be caused by other reasons (too dry indoor air, exposure to atmospheric pollutants).Sometimes the pain syndrome is felt so strongly that patients feel as if their whole 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 body in throat;meat and fish bones, for children - parts of toys.
  • Deficiency states:lack of vitamins B12 and B2, lack of ascorbic acid, iron.
  • Gastroesophageal reflux.
  • Rare causes: long styloid process, Itsenko-Cushing syndrome, malignant neoplasms of the throat or vocal apparatus.

Causes of front neck pain

Unpleasant 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 squeezing the neck with a shirt collar.Neck pain is caused by:

  • Thyroid pathologies: acute and subacute thyroiditis, diffuse toxic goiter, Hashimoto thyroiditis.
  • Injuries: sprains and tearing of muscle fibers, blows in the neck area.
  • Inflammatory processes:myositis, neuritis, tendonitis.
  • 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 spine

Patients complain of pain in the neck that occurs along its back surface.Painful sensations are intense;due to constant "lumbago" the person is forced to keep his head and shoulder girdle still.Pain in the cervical spine can be a symptom of the following pathological conditions:

  • Degenerative diseases of the spinal column: 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 causes: presence of pathological bilateral cervical ribs, Klippel-Feil syndrome.

Causes of neck pain

Intense pain on the side of the neck usually spreads to the shoulder or ear.The person may feel tingling, burning or throbbing in this area.With strong discomfort, secondary torticollis occurs, in which the head is constantly tilted towards the painful side, and the chin is turned towards the healthy side.The most common causes of neck pain are:

  • Pathologies of blood vessels: varicose veins of the neck, atherosclerosis of the large cervical arteries that supply the brain.
  • Stay in an awkward position: constantly bent head when working at the computer, bad sleeping pillow, peculiarities of walking with the neck bent in the same direction.
  • Muscle cramps: with sudden turning 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: Grizel syndrome, pterygoid neck with Shereshevsky-Turner anomaly.
  • Rare causes: complications after subarachnoid hemorrhage, meningitis.

Diagnostics

A person who has neck pain usually turns to an osteopath or a neurologist.The review is long and complex;in order to make a correct diagnosis, it is necessary to rule out many causes of neck pain.Diagnostic examination includes the use of laboratory and instrumental methods aimed at visualizing the affected area and looking for signs of accompanying 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, identifying 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 large vessels.
  • X-ray imaging.A comprehensive radiograph of the neck is used to identify deformations of bone structures, displacement of vertebrae, which always causes neck pain.A more informative method is CT of the spine, which enables the assessment of the nature and extent of vertebral disorders.MRI is recommended to study the ligamentous apparatus.
  • Functional diagnostics.The appearance of pain in the neck can be caused by damage to the muscular system, so it is recommended to do an electromyography.If radicular pain is suspected, electroneurography is indicated.To detect cervical kyphosis, the Forestier test is needed.The degree of pain is 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.Thyroid hormone concentration must 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 has pain not only in the neck, but also in the throat, an examination by an otorhinolaryngologist is necessary.In case of severe pain, especially in elderly patients or those with a history of heart disease, an ECG is recorded to rule out atypical forms of angina pectoris and myocardial infarction.For serious spinal injuries 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, don't delay a visit to the doctor.Cervicalgia requires careful diagnosis to determine the causes of unpleasant symptoms.Sudden movements in the cervical region, drafts and hypothermia should be avoided.Before confirming the diagnosis, pain in the neck is alleviated 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, because they can cause ulcers and bleeding from the gastrointestinal tract.

taping for neck pain

Conservative therapy

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

  • NSAIDs.Medicines effectively remove 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 relaxing the muscles, 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 tolerate.Medicines are given to the affected area in the form of injections (blockade).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, the patient's discomfort stops after the cause is removed.
  • Vitamins.Vitamin B preparations, especially thiamine, are actively used in cases where pain in the neck area is chronic.Medicines improve nutrition of spinal roots and nerves.

Physiotherapy

To remove muscle tension that causes neck pain, use the 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 for restoring the anatomical position of the vertebrae and discs.Magnetic therapy and acupuncture help reduce chronic neck pain.After the cessation of acute pain, massage sessions begin, and physiotherapy must be supplemented with exercise therapy methods.

Surgical treatment

In the case of neck pain caused by pathology of the spinal column, 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 detected in the cervical part of the body, they are surgically removed.Severe degenerative spinal lesions are an indication for spinal fusion.If the pain in the neck is caused by ulcers or cysts, they should be opened and drained, and the cavity should be washed with antibacterial solutions.