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Neck pain (cervicalgia)

severe neck pain

Neck pain(cervicalgia) is pain of varying nature and intensity that occurs in the cervical region.The symptom is accompanied by dizziness, a feeling of numbness in the back of the neck or arm, local redness and swelling of the skin.The neck can hurt due to infectious and inflammatory diseases in this region, injuries and degenerative processes in the spine, after a long stay in a forced and uncomfortable position.To determine the cause of neck pain, computed tomography, magnetic resonance imaging, ultrasound and laboratory tests are prescribed.Pain relievers, NSAIDs and physical therapy methods are used to alleviate symptoms.

General characteristics

Neck pain occurs periodically in 70% of the adult population.These sensations can vary in intensity and duration: from short-term discomfort to intense pain that makes daily activities difficult.Most often, neck pain is located in the cervical spine or along the anterolateral surfaces.Typically, patients feel a sudden “low back pain”, which is replaced by persistent pain.The pain varies in nature - throbbing, tingling, squeezing.They can radiate to the shoulder, scapula and occipital region.

The unpleasant sensations intensify when turning and tilting the head, causing the person to be forced to turn the entire body.Often, the neck begins to hurt after a long stay in an uncomfortable position: patients note that discomfort appeared after a day of work at the computer or sewing machine.Many patients associate the development of neck pain with hypothermia and the effects of drafts.If your neck hurts a lot or if the pain is combined with dizziness, numbness in the back of the head or tinnitus, 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 neck pain, which can be constant or recurrent.According to the etiopathogenetic classification, two forms of neck pain 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 neck pain, associated with bone damage and spinal cord compression, and discogenic neck pain, caused by deformation of the intervertebral discs.
  • Non-vertebrogenic neck pain.Includes all other causes of neck pain.Unpleasant sensations can occur due to inflammatory processes in the musculo-ligamentous apparatus, pathologies of internal organs - pharynx, thyroid gland, lymph nodes and salivary glands.

According to the location, the pain syndrome is distinguished in the anterior or lateral part of the neck, in the region of the spine.Separately, sore throat is isolated.Neck pain, which radiates to neighboring anatomical areas, is divided into cervicocranialgia (dissemination of pain to the occipital region) and cervicobrachialgia (cervicobrachial syndrome).

Why does my neck hurt?

Causes of sore throat

An itchy sensation in the throat is associated with colds, but unpleasant sensations can often be caused by other reasons (excessively dry indoor air, exposure to air pollutants).Sometimes the pain syndrome is felt so strongly that patients feel as if their entire 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 bodies in the throat;meat and fish bones, for children - parts of toys.
  • Disability states:deficiency 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

The discomfort may be localized directly under the chin in a limited area, but more often the discomfort is intense, diffuse pain.The pain intensifies when swallowing, turning the head or squeezing the neck with the shirt collar.Neck pain is caused by:

  • Thyroid pathologies: acute and subacute thyroiditis, diffuse toxic goiter, Hashimoto's thyroiditis.
  • Injuries: sprains and ruptures of muscle fibers, blows to the neck area.
  • Inflammatory processes:myositis, neuritis, tendonitis.
  • Purulent diseases: suppurating cervical cyst, peritonsillar abscess.
  • Damage to lymphoid formations: lymphadenitis, lymphangitis.
  • Cervical compression syndrome: radicular artery, vertebral.
  • Related organ diseases: esophagitis, tracheitis.
  • Angina attack.
causes of neck pain

Causes of cervical spine pain

Patients complain of neck pain that occurs along the posterior surface.The painful sensations are intense;Due to the constant “lumbago”, the person is forced to keep the head girdle and shoulder blades still.Pain in the cervical spine can be a symptom of the following pathological conditions:

  • Degenerative diseases of the spine: cervical osteochondrosis, osteoarthritis, prolapse or herniated disc.
  • Bone injuries: compression fractures of the cervical vertebrae, compression of the spinal cord, fractures of the arches and vertebral 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 side neck pain

Severe pain on the side of the neck often radiates to the shoulder or ear.A person may feel tingling, burning, or pulsing in this area.With severe discomfort, secondary torticollis forms, in which the head is constantly tilted to the painful side and the chin is turned to the healthy side.The most common reasons for side neck pain are:

  • Blood vessel pathologies: varicose veins of the neck, atherosclerosis of the large cervical arteries that supply the brain.
  • Being in an awkward position: head constantly lowered when working at the computer, bad pillow for sleeping, peculiarities of gait with a neck tilted in the same direction.
  • Muscle spasms: 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: Grisel syndrome, pterygoid neck with Shereshevsky-Turner anomaly.
  • Rare causes: complications after subarachnoid hemorrhage, meningitis.

Diagnosis

A person who has neck pain usually turns to an osteopath or neurologist.The exam is long and complex;To make a correct diagnosis, it is necessary to exclude many causes of neck pain.The diagnostic search involves the use of laboratory and instrumental methods that aim to visualize the affected area and look for signs of concomitant diseases.The most informative are:

  • Sonography.Ultrasound of the neck and other parts of the body is used for rapid and 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.Duplex scanning helps to assess the state of blood flow in large vessels.
  • X-ray imaging.Neck survey x-ray is used to identify deformations of bone structures, displacement of vertebrae, which always causes pain in the neck.A more informative method is computed tomography of the spine, which makes it possible to assess the nature and extent of vertebral disorders.Magnetic resonance imaging 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, which is why it is advisable to perform electromyography.If radicular pain is suspected, electroneurography is indicated.To detect cervical kyphosis, a Forestier test is necessary.The degree of pain is determined by the McGill questionnaire.
  • Laboratory methods.General and biochemical blood tests are necessary to exclude acute inflammatory processes, which can cause neck pain.The concentration of thyroid hormones must be determined.In the presence of a general infectious syndrome, bacteriological culture of sputum or throat swabs 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 otolaryngologist is necessary.In case of severe pain, especially in elderly patients or those with a history of heart disease, an ECG is done to exclude atypical forms of angina pectoris and myocardial infarction.For severe 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, you should not delay visiting the doctor.Neck pain requires careful diagnosis to determine the causes of unpleasant symptoms.It is necessary to avoid sudden movements in the cervical region, drafts and hypothermia.Before the diagnosis is verified, neck pain is relieved with the help of warming procedures (wrapping the cervical region with a woolen scarf).If the pain is severe, it is possible to take analgesics from the NSAID group.But these medications should not be taken for a long time without a prescription, as they can cause ulcers and bleeding in the gastrointestinal tract.

tape for neck pain

Conservative therapy

Medical tactics for neck pain depend 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 neck pain, the following groups of medications are used:

  • NSAIDs.Medicines effectively eliminate the inflammatory process and relieve pain.To reduce side effects, it is advisable to use selective COX-2 inhibitors that do not affect the gastrointestinal mucosa.
  • Muscle relaxants.Medicines quickly eliminate 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.Used for severe neck pain that the patient cannot tolerate.Medicines are administered to the affected area in the form of injections (blocks).Prolonged administration of local anesthetics is not advisable.
  • Antibiotics.Medicines are indicated for bacterial and purulent processes in the cervical region that cause pain.In this situation, discomfort in patients stops after eliminating the cause.
  • Vitamins.B vitamin preparations, especially thiamine, are actively used in cases where pain in the neck area is chronic.Medicines improve the nutrition of the roots and nerves of the spine.

Physiotherapy

To eliminate muscle tension that causes neck pain, use a Shants collar, which is recommended for use for 2 to 3 weeks.The neck hurts less after local thermal procedures - mud baths and compresses, electrophoresis with anesthetics.Manual therapy techniques are useful in restoring the anatomical position of vertebrae and discs.Magnetic therapy and acupuncture help reduce chronic neck pain.After the acute pain disappears, massage sessions begin and physiotherapy should be supplemented with exercise therapy methods.

Surgical treatment

For neck pain caused by spinal pathology, surgical intervention is required.To reduce pressure on the nerve roots, discectomy, foraminotomy and laminectomy are used.When hernias are detected, appropriate operations are performed;when neoplasms are detected in the cervical part of the body, they are removed surgically.Severe degenerative injuries of the spine are an indication for spinal fusion.If neck pain is caused by ulcers or cysts, it is necessary to open and drain them, as well as wash the resulting cavity with antibacterial solutions.