Neck pain: why and what to do?

According to the most 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" professions and computers. Discomfort, as a rule, can be painful 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 region. Patients with neck discomfort complain of nausea, clicking sounds when turning the head and tinnitus. Sometimes the discomfort is accompanied by numbness in the back of the neck. 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 intestines 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 hernia and protrusion in the intervertebral disc, when the fibrous ring ruptures and its nucleus pulposus exits into the spinal canal. The consequence of lack of treatment leads to irreversible complications, including paralysis. Sciatica sometimes appears in the neck due to the herpes virus and Lyme disease.

The pain occurs in the neck and often radiates into the arm, causing it to feel numb and weak. This diagnosis can normally be made after examination by a neurologist. However, in some cases it may be necessary to perform electromyography or computed tomography to assess the damage.

Ankylosing spondylitis

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

Diffuse skeletal hyperostosis (Forestier's disease)

People over 50 mainly develop Forestier's 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 the person feels pain and reduced mobility in 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 as a result of degenerative changes in the structure between the spinal discs due to unequal loading between the endplates and facet joints. With this disease, 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 the same position for a long time, the condition of your neck will also worsen.

Due to degenerative changes in the neck area,spondylosisin the cervical spine. Erasure of the 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 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, decreased sensitivity and mobility, and 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 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 most often develops after the age of 55 and often requires surgical intervention.

Cervical spine injuries

The consequences of the injury can be pain in the cervical region and shoulders, migraines, spasms of the neck muscles and difficulty with mobility. In car accidents, people often 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. become damaged. , 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 it develops into chronic pain.

Muscle pain

Muscle spasms in the upper back and neck occur due to excessive physical exertion, poor posture, emotional stress during the workday, or spinal injuries. Muscles can also spasm, mainly due to the wrong pillow. Typically, the discomfort causes limited mobility, but this pain disappears 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

In myofascial syndrome, it is important to identify the most sensitive pain points that may arise after excessive exertion, 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) used to be attributed to it.

Almost everyone over the age of 40 has degenerative changes in the spine. This is not a reason to call a person completely sick and actively begin treatment. If the neck bothers, 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 test;
• determination of the level of thyroid hormones in the blood;
• Doppler ultrasound of the neck vessels, thyroid gland, salivary glands;
• Radiography of the cervical spine;
• electroneuromyography;
• TC;
• 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, you first need to contact a therapist, who will refer you for additional examinations. The following will help determine the causes of neck pain and dystrophic condition, treat and restore its function: surgeon, neurologist, vertebrologist, rheumatologist, cardiologist, traumatologist, orthopedist, endocrinologist and some other doctors.

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

• severe 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 from pain medications.

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.

Neck pain treatment

1. Medicines that relieve pain and tension. For this discomfort, there is generally no specific treatment. In simple situations, the doctor recommends non-steroidal anti-inflammatory drugs, chondroprotectors (medicines that promote the restoration of cartilaginous tissue) that relieve pain. If the spasm is severe, your 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, for 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 bath or shower, or placing a damp towel on your 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 must be done carefully and after consultation with a specialist. First you need to warm up your neck. However, it is best 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 postponed. 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 workday 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 position, stretching your neck once an hour and placing the computer at eye level. You need to sit up straight and 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 borne in mind, however, 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, as they have no proven effectiveness. In combination with physical exercise alone, 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 as a result of spondylotic myelopathy.
9. Biofeedback (BFB). With this method, the person is given the task of "relieving neck muscle tension", the execution 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 neck vertebrae, although it relieves pain, it is recommended to use it for 1 to 3 hours a day, no more than 1 to 2 weeks, so that the neck muscles do not weaken.
11. There are methods andosteopathic. According to some data, for example, traction of the neck muscles is ineffective, but acupuncture helps in the treatment of chronic neck pain. Electromagnetic and low-frequency therapy also work, as do electromyostimulation and laser therapy. It is not recommended, however, to skip exercise when using all of these methods. It is also important to eat well 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, surgery in most cases is not necessary. 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 "pinched nerve", i. e. pressure at its root in the spinal cord, and conservative treatment does not help, then surgical treatment is recommended.