Sore throat

Almost two-thirds of people experience neck pain (cervicalgia). Causes include acute conditions such as muscle strains and whiplash and chronic conditions such as cervical spondylosis and myofascial pain syndrome. Pinched nerves, infections, fractures, and spinal cord problems can also cause neck pain.

For effective treatment, it is necessary to understand the causes of neck pain. For this, a comprehensive examination is conducted. Based on the received diagnostic results, the doctor prescribes therapy. You should not treat yourself, because in many cases it cannot be delayed. Pain that seems harmless at first glance can cause serious complications.

general characteristics

The neck is a sensitive part of the body - the cervical spine consists of seven vertebrae. Muscles, ligaments and nerves provide stability - the muscular framework. Poor posture or excessive strain creates overload, which reduces blood flow, causing muscle pain and myositis (inflammation).

Rarely, neck pain is felt locally. It often spreads to the shoulders, sometimes even to the arms and fingers. It can be felt in the back of the head, causing headaches, dizziness and vision problems. When the neck becomes stiff, it becomes difficult to turn and bend the head and is accompanied by severe discomfort.

Neck pain varies in nature and severity. Numbness of the hands or the back of the head, hyperemia and swelling of the skin may occur. Discomfort can be short-term or long-term and make daily activities difficult.

Acute neck pain usually goes away in a few days to 2 weeks and is not a cause for concern. Neck pain is considered chronic if it lasts for more than three months. If, along with neck pain, symptoms other than those listed appear, such as nausea, vomiting, sensitivity to light, fever, chills, nervous disorders, paralysis symptoms, etc. , you should consult a doctor.

Types of neck pain

Depending on the nature, neck pain can be non-specific and specific. In the first case, we are talking about anxiety without a clear cause. It often occurs due to excessive tension of the trapezius muscle. Specific pain has a specific cause associated with a specific disease.

Depending on the duration, there are:

• Acute cervicalgia - does not last more than 10 days, disappears after the elimination of the provoking factor.
• Chronic cervicalgia - lasts more than three weeks, is recurrent or constant.

According to etiopathogenetic classification, vertebrogenic and non-vertebrogenic pains in the neck area are distinguished. In the first case, we are talking about primary damage to the osteochondral structures of the cervical vertebral region. It develops against the background of spondylogenic and discogenic cervicalgia as a result of compression of the spinal cord, damage to bone structures and deformation of the intervertebral discs.

Depending on the location, the pain syndrome differs in the front, back and sides of the neck. Each of them has its own reasons. Accordingly, an individual treatment plan is required in each case.

Causes of neck pain

Most neck pain is non-specific. This means that doctors cannot assign a specific medical cause for complaints such as damage to intervertebral discs or vertebrae. Often, discomfort is caused by poor posture, which causes muscle-fascial tension.

Neck pain occurs for the following reasons:

• sitting at the computer for a long time;
• excessive work, for example, during sports or physical work;
• underdeveloped muscles;
• increased muscle tone;
• hypothermia, exposure to drafts;
• wrong position during sleep;
• accident (whiplash, cervical spine injury);
• degenerative-dystrophic changes in the spine;
• colds and viral infections;
• changes in hormones during menopause;
• stress, depression and anxiety;
• mineral deficiency.

In very rare cases, pain in the neck is a symptom of inflammation or damage to the cervical spine. The most common cause is excessive muscle tension in the shoulder area. After a few days, complaints usually disappear by themselves. If the discomfort lasts longer, becomes chronic, or additional symptoms appear, a consultation with a specialist is necessary.

Pain in the front of the neck: causes

Discomfort of varying severity is felt on the front surface of the neck. There are many structures here, each of which can cause pain. It is not easy to determine the real cause without a comprehensive diagnosis.

Causes of front neck pain:

• Diseases of the thyroid gland (toxic goiter, Hashimoto's thyroiditis) - anxiety arises due to inflammatory processes and endocrine pathologies. Increased pain is observed when bending forward and during movement. It is accompanied by an increase in temperature, an increase in heart rate, a feeling of heat and increased sweating.
• Sialadenitis is damage to the salivary glands of the jaw. The pain progresses with swallowing, chewing movements and turning the head. It is accompanied by the formation of swelling and compression. It is characterized by dry mouth and difficulty eating. This is accompanied by weakness, chills and fever.
• Purulent inflammation in the pharynx - the inflammatory process spreads to the adjacent tissue, which leads to the formation of a retropharyngeal abscess. Discomfort is accompanied by redness of the skin on the front of the neck, which becomes bright pink and warm to the touch. The pain is throbbing and severe, so the patient may refuse to eat. Associated with febrile fever. It is the result of an extensive paratonsillar abscess.
• Cervical plexitis - the intensity of clinical manifestations depends on the number of damaged nerve structures. Often, sharp pain occurs from the anterolateral part of the neck. Coughing and difficulty speaking. Discomfort spreads to the ear, chest and back of the head. There is a feeling of "creeping" and paresthesia. Occurs after injury, hypothermia or vaccination.
• Rheumatic diseases are systemic disorders of connective tissue (collagenosis) accompanied by skin and muscle damage. Dermatomyositis and scleroderma are characterized by constant aching and nagging pain. Swelling and thickening of the skin occurs. Shooting pain spreads to the front of the neck and spine.
• Lymphadenitis - discomfort is localized in the upper neck. Lymphoid tissue is affected. Discomfort is localized in the submandibular region, usually on one side. Symptoms progress with head tilt and talking. The skin is hyperemic and swollen. It is accompanied by inflammation of the lymph nodes, general weakness and fever.

Pain in the front of the neck can also occur with atypical attacks of angina. The pain becomes more prominent and is accompanied by shortness of breath. Difficulty speaking and difficulty swallowing.

The pain is also localized in the front with inflammation of the mucous membrane of the trachea and esophagus. Discomfort is the result of a painful cough and tracheitis. Rare causes include cervical compression syndrome and spinal lesions.

Pain in the back of the neck: causes

Discomfort in the back of the neck is the result of prolonged work at the computer and low physical activity. Pain occurs due to pathological changes in the spine.

Pain in the back of the neck has the following causes:

• Osteochondrosis is accompanied by degenerative-dystrophic disorders of the intervertebral discs, a decrease in their strength and a decrease in height.
• Protrusions are a complication of osteochondrosis accompanied by protrusion of the intervertebral disc. Protrusions are caused by disruption of the vertebral artery and nerve structures.
• Intervertebral tears occur when the protrusions are pushed forward. The internal contents of the intervertebral disc squeeze the nerve endings and exit the spinal canal.
• Spondylosis – bony protrusions (osteophytes) are formed on the edges of the vertebral bodies, the intervertebral discs are reduced in size, adjacent vertebrae are fused, and neck mobility is limited.

Pain in the back of the neck is characteristic of myofascial syndrome, which is a spasm of individual muscles. It is accompanied by sharp pain when pressing on the back of the neck, as well as during physical activity.

Among the systemic diseases, one can distinguish ankylosing spondylitis, which affects the articular structures and is characterized by limited mobility. It is accompanied by the formation of stable and durable conglomerates due to the fusion of individual vertebrae. Less commonly, pain in the back of the neck is associated with spinal tuberculosis, Reiter's syndrome, and osteomyelitis.

A more serious cause requiring emergency medical attention is a compression fracture of the spine. It occurs due to a whiplash injury on the neck.

Lateral neck pain: causes

Pain in the side of the neck can be throbbing, tingling or burning. It radiates to the shoulder or ear. It is accompanied by the formation of secondary torticollis. This causes the head to tilt to the affected side. It is characteristic of atherosclerosis and other blood vessel disorders.

The reason is muscle spasm that occurs during sudden movements, extreme stress and hypothermia. Pain in the neck is observed with malignant processes in the larynx, pharynx and thyroid gland. You should not leave things to chance. If the initial symptoms appear, you should consult a doctor. This approach makes it possible to take timely treatment measures and eliminate the development of complications.

Diagnosing the causes of neck pain

The examination includes laboratory examinations and instrumental diagnostics aimed at visualizing the affected areas and identifying signs of pathology:

• Ultrasound of the submandibular salivary glands and thyroid gland is prescribed for quick visualization of neck structures and identification of diseases of internal organs that cause neck pain. A duplex scan is performed to scan the large vessels and determine the state of blood flow.
• X-ray examination or CT (computed tomography) - determines the displacement of the vertebra and bone deformations. It allows to determine the degree of vertebral disorders and the nature of disorders.
• Functional diagnostics - damage to the muscular system is determined using MRI of the cervical spine.

A blood test is performed to confirm inflammatory processes. The level of thyroid hormones is also determined. If there are general infectious symptoms, a bacteriological culture or a throat swab is prescribed. Serological tests (PCR, ELISA, RIF) are also required.

Treatment of neck pain

For neck pain, non-surgical, conservative treatment methods are prescribed. Drug treatment aims to relieve pain, eliminate the cause of anxiety and restore the body. Therapy is prescribed depending on the stage of the pathology, the cause of the disorders, the age of the patient and the characteristics of the body.

Physiotherapy and physiotherapy are prescribed to increase the effectiveness of the drugs used. Manual methods are effective. In some cases, if the expected result is not obtained, surgery is performed.

Help before diagnosis

Bending and rotating the head, as well as light massage, will help relieve acute neck pain. The tension gradually decreases, which helps to improve the situation. There are muscle knots or trigger points in the neck muscles that cause discomfort when irritated. Gentle rubbing and kneading helps relieve pain.

You can use cool or warm compresses for the first 24 hours after the discomfort. Warming your neck with a heating pad is only allowed from the side or back.

Tablets and ointments for neck pain

It is recommended to take any analgesic drug that temporarily improves the condition. An NSAID that not only relieves pain, but also has an anti-inflammatory effect is prescribed.

For local effects, you can apply a warming patch or ointment. They eliminate hyperemia and swelling, which reduces pressure on nerve endings and reduces spasm.

Exercises for neck pain

For moderately painful pain, you can do light gymnastic exercises yourself. It is important to monitor your well-being to avoid harm.

Smooth and non-abrupt movements will help reduce anxiety:

• lie on your back, press your head on a flat but not soft pillow for up to 5 (5 to 7 approaches);
• lie on your side, raise your head and hold for 5 counts (at least 5 approaches);
• lie on your stomach, cross your arms behind your head, raise your head, provide light resistance (4 to 6 approaches).

In case of acute and severe pain, any exercise is contraindicated. If you feel dizzy or weak, you should stop exercising. In this case, Shants collar will help reduce pain. The period of immobilization should not be extended. Otherwise, the muscle corset will weaken and the condition will worsen.

What not to do if you have neck pain

If discomfort in the cervical spine occurs often, it is unacceptable:

1. Maintain a forced body position for a long time in which the neck is in a tense position.
2. Lift heavy objects and do physical labor.
3. Exposure to severe stress, which causes vasospasm, which negatively affects blood circulation.
4. Frequent drinking of alcohol and smoking, which contribute to the continuous narrowing of vascular structures.
5. Dress inappropriately for the weather, stay in drafts, don't wear a hat or scarf in the cold season.

Sleeping on a soft mattress and a high pillow is unacceptable. Sudden turns of the head should be avoided, which can cause sudden pinching of the nerve.

When you need to see an emergency doctor

If the pain does not decrease or intensifies after 5-7 days, the help of a specialist is needed. If you have severe pain that prevents you from falling asleep and does not go away when you change your body position, you should see a doctor.

An absolute indication for a visit to the clinic is the deterioration of general health - the appearance of nausea, dizziness and weakness. Numbness of the hands also requires professional help.

Drug treatment

Combination therapy is usually prescribed, which includes:

• non-steroidal anti-inflammatory drugs - relieve discomfort and swelling, eliminate residual inflammation;
• analgesics - relieve pain and improve the general condition, but do not eliminate the cause;
• corticosteroids - reduce inflammation, affect muscle excitability;
• muscle relaxant - relieves painful muscle tension, improves motor activity.

In case of severe pain, injections to trigger points are indicated. Antioxidants, anticonvulsants and antidepressants are also prescribed.

Chondroprotectors stop inflammation and degenerative processes in the spine. Vitamins improve blood circulation and have a healing effect.

Surgery

The operation is performed to restore the functionality of the cervical spine. The most commonly used decompression tactic is indicated for compression syndrome, when the nerve roots are compressed by a pathological defect. Microsurgical discectomy, laminectomy and nucleoplasty are used. Also, stabilizing methods for cervical back pain are popular - arthrodesis, vertebroplasty, implantation of a piece of bone tissue and installation of stable metal structures.

Surgical intervention is aimed at eliminating the cause (hernia, tumor, osteophytes, etc. ). The purpose of the operation is to restore the motor support functions of the spine. After surgical treatment, long-term rehabilitation is required, which is necessary to avoid various complications, which are not uncommon. The results of the operation depend on the timeliness of the procedure and compliance with medical recommendations for recovery.

Manual therapy

Minimally invasive technique involves the use of manual techniques. Effectiveness is focused on joints, muscles, ligamentous-articular and bone structures. Manual therapy improves the condition of spinal hernias, bad posture, protrusions and osteochondrosis. It improves the condition of neck pain.

A course of manual therapy restores mobility, restores damaged tissues and relieves dizziness. Pain gradually decreases, back and neck muscles relax. The patient's well-being improves.

Physiotherapy

Physiotherapy treatment is focused on the effect of magnetic field, electric current, temperature and mechanical effects on the body. The procedures are painless, if you follow the doctor's recommendations, they do not cause negative reactions or complications. Physiotherapy is indicated for the treatment of chronic diseases and prescribed for preventive purposes. It is used to strengthen the immune system, treat chronic inflammation and improve posture. Procedures increase the effectiveness of drugs.

Physiotherapy treatment for neck pain includes:

• SMT (sinusoidal modulated currents) - stimulates the production of biologically active substances in the body. Electrophoresis relieves pain and restores mobility, activates your own defenses. The complex of procedures allows to achieve a clear and long-lasting analgesic effect, complemented by anti-inflammatory and anti-edema effects.
• MLT (magnetic field and laser rays) - gives a clear therapeutic effect. The procedure is aimed at activating specific enzymes, changing capillary osmotic pressure and improving blood circulation.
• UVT (shock wave therapy) - processes that improve microcirculation are activated with the help of low-frequency acoustic waves. Inflammation is reduced, swelling is eliminated and pain is reduced.

To achieve a certain effect, it is recommended to undergo a course of physiotherapeutic procedures. Improvements are usually noted after the first session. Physiotherapy is contraindicated in acute inflammation. It is prescribed when the process is chronic and in the recovery phase.

Exercise therapy

Therapeutic physical training is aimed at building the muscular framework of the neck, relieving tension and restoring blood circulation. An individual approach is applied to each patient, taking into account his capabilities and needs.

The physical therapy program is designed by the doctor taking into account the medical history and contraindications. If necessary, adjustments are made taking into account the dynamics of the patient's condition, which eliminates the development of complications and allows to achieve the expected result.

When starting a series of exercises, it is important to consider:

• the main task is to tone the muscles, it is necessary to make them flexible;
• it is important to perform the movements smoothly, because sharp and fast movements will only aggravate the situation;
• Exercises should be performed on a flat surface using special mats and rollers.

It is important to observe regularity and frequency. If there is discomfort, the load should be reduced.

Exercises to restore the plasticity of muscle structures and improve the mobility of the vertebrae:

• Exercise #1 - Turn your head to the extreme right, then to the left. Provides mobility of cervical vertebrae.
• Exercise No. 2 – Lower your head, pressing your chin to your chest, so that you can feel the chest cavity. This exercise improves neck mobility and relieves muscle stiffness.
• Exercise number 3 - pull your head back by pulling your chin back. Exercise improves posture in the cervical spine.

A series of exercises have also been developed to strengthen weak muscles to create a muscle corset and reduce pain. While sitting, place your hand on your forehead and tilt your head forward to create resistance. You can make similar bends to the right and left.

Which doctors should I see for neck pain?

If you are worried, you should consult a therapist. Based on the complaints, the general practitioner will schedule an examination and, if necessary, refer you to a specialist - a neurologist, endocrinologist or oncologist.

results

30-70% of the population suffers from neck pain. This problem lowers the quality of life and often leads to disability. With timely consultation and treatment with a doctor, the prognosis is usually favorable.

Treatment of neck pain includes physical, behavioral and pharmacological methods. The most effective are therapeutic exercises, hand therapy, proper organization of the workplace and compliance with ergonomic rules. NSAIDs, injections and antidepressants are prescribed. In advanced cases and when conservative treatment is ineffective, surgery is performed.