Neck pain: why and what to do?

According to recent 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" occupations and computers. Embarrassment, as a rule, can be painful in nature if it bothers you constantly. Sometimes, when the cervical spine hurts, the following symptoms appear: decreased vision, dizziness, limited movement, 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, cracking when turning the head, and tinnitus. Sometimes the discomfort is accompanied by numbness in the back of the head. Neck pain is a very common symptom today, as many people do not exercise, are overweight and often deal with stress. Neck pain can also occur for other reasons, including serious illnesses that require emergency 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 ("pressed nerve")

In the cervical spine, radiculitis occurs more often when the nerve roots of the spinal cord are compressed.
This usually occurs due to spondylosis or herniation and protrusion in the intervertebral disc, when the annulus fibrosus ruptures and its nucleus pulposus protrudes into the spinal canal. The consequence of the lack of treatment brings irreversible complications, including paralysis. Sciatica occurs 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 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 hard and immobile conglomerates.

Diffuse skeletal hyperostosis (Forestier's disease)

People over 50 years of age mainly develop Forestier's disease. It has been proven 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 the mobility of the neck decreases. To confirm the diagnosis, a doctor in 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- Probably 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 the unequal load between the end plates and the facet joints. With this disease, the pain can spread to the arm or shoulder, sometimes 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 the neck also worsens.

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

Cervical spondylogenic myelopathy. The spinal cord is 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, the coordination of movements is impaired, urination and defecation are not controlled, and general weakness and problems in the sexual sphere can be observed. The disease develops more often after the age of 55 and often requires surgical intervention.

Cervical back injuries

The consequences of the injury can be pain in the cervical region and shoulders, migraines, neck muscle spasms and impaired mobility. In car accidents, people usually suffer neck injuries due to the sudden forward and backward movement of the head. As a result, the intervertebral discs, soft tissues, nerve fibers, posterior longitudinal ligament, facet joint (facet syndrome) etc. can be damaged. . After an injury, muscle spasm appears 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 working day or spinal injuries. Muscles can also cause spasms, especially due to the wrong pillow. Usually, the 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, as well as performing special exercises.

Myofascial pain syndrome

With myofascial syndrome, it is important to identify the most sensitive points of pain that can appear after overexertion, hypothermia, emotional trauma or stress. These pressure points provoke muscle tension and pain, which often become 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, is usually attributed to all the diseases listed above (degenerative-dystrophic lesions of the spine).

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 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.

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

• general laboratory and biochemical analysis of blood;
• determining the level of thyroid hormones in the blood;
• Doppler ultrasound of neck vessels, 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 go to the doctor?

If the neck causes discomfort, then first of all you should contact a therapist, who will refer you for further examination. The following will help determine the causes of neck pain and dystrophic condition, treatment and restoration of its function: surgeon, neurologist, vertebrologist, rheumatologist, cardiologist, traumatologist, orthopedist, endocrinologist and several other doctors.

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

• severe 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 in pain medication.

Consult your doctor immediately if:

• Meningitis, if your head hurts with a strong rise 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 chest discomfort, 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 a concern, 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 medicine 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 the pain. If it's a muscle problem, use heat, including a shower or bath, or placing a wet towel around your neck.
3. Physiotherapy:phonophoresis, carboxytherapy, ozone therapy, pressotherapy, RF currents, ultrasound therapy.
4. Tightening 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 the neck. However, it is better to exercise in the morning or before going to bed. You should definitely consult your doctor about more common physical activities, including yoga, running, and soccer.
5. Relaxation techniques. Due to emotional stress, the neck starts 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 must be corrected so that the neck does not hurt again. To do this, it is important to monitor your own posture, it is advisable to minimize tension by changing positions, stretch your neck once an hour and place the computer at eye level. You should 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. However, it should be noted that massage for chronic pain is likely to be ineffective and 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 exercises, the use of "soft" manual therapy is recommended, however, manual therapy helps to 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 canal of the spine 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 blurry image, which becomes clear as his muscles relax. This is how a person learns to control the tension of the muscles in the neck.
10. corset, which adjusts 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 do not weaken.
11. There are methods andosteopathic. According to some data, for example, pulling the neck muscles is ineffective, but acupuncture helps with chronic neck pain. Electromagnetic and low-frequency therapy, as well as electromyostimulation and laser therapy, also work. However, it is not recommended 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 the pathology, but 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 the pain is a narrowing of the central spinal canal or due to a "pressed nerve", that is, pressure on its root in the spinal cord and conservative treatment does not help, then surgical treatment is recommended.