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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 head or arm, local redness and swelling of the skin.The neck may 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 occurs periodically in 70% of the adult population.These sensations can have varying intensity and duration: from short-term discomfort to severe pain that makes everyday activities difficult.More often, neck pain is localized in the cervical spine or along the anterolateral surfaces.Typically, patients feel a sudden “lumbago”, which is replaced by persistent pain.The pain varies in nature - throbbing, tingling, squeezing.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 his 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 the effects of drafts.If your neck hurts severely, or 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 lasting up to 10 days, and chronic cervicalgia, which can be constant or recurrent.In accordance with the etiopathogenetic classification, two forms of cervicalgia are distinguished:

  • Vertebrogenic neck pain.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.
  • Nonvertebrogenic neck pain.Includes all other causes of neck pain.Unpleasant sensations can occur due to inflammatory processes in the muscular-ligamentous apparatus, pathologies of internal organs - the pharynx, thyroid gland, lymph nodes and salivary glands.

According to localization, pain syndrome is distinguished in the front or in the lateral parts of the neck, in the area of the spinal column.Separately, a sore throat is isolated.Cervicalgia, which radiates to neighboring anatomical areas, is divided into cervicocranialgia (spread of pain to the occipital region) and cervicobrachialgia (cervicobrachial syndrome).

Why does my neck hurt?

Causes of sore throat

A scratchy, scratchy feeling in the throat is associated with colds, but unpleasant sensations can often be caused by other reasons (excessively dry indoor air, exposure to atmospheric 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, influenza, 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.
  • Deficiency states:vitamin deficiency 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 neck pain in the front

Discomfortable sensations can be localized directly under the chin, in a limited area, but more often the discomfort is severe, 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's thyroiditis.
  • Injuries: sprains and tears 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, 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.The painful sensations are intense; due to constant “lumbago”, the person is forced to keep the head and shoulder girdle 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 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 side neck pain

Intense pain along the side of the neck usually radiates to the shoulder or ear.A person may feel tingling, burning, or pulsation in this area.With severe discomfort, secondary torticollis is formed, in which the head is constantly tilted towards the painful side, and the chin is turned towards the healthy side.The most common reasons for side neck pain are:

  • Pathologies of blood vessels: varicose veins of the neck, atherosclerosis of the large cervical arteries that supply the brain.
  • Staying in an awkward position: constantly bowed head when working at the computer, poor pillow for sleeping, peculiarities of gait with the neck tilted in the same direction.
  • Muscle spasms: with a sharp turn 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.

Diagnostics

A person who has neck pain most often turns to an osteopath or neurologist.The examination is long and complex; to make a correct diagnosis, it is necessary to exclude many causes of neck pain.A diagnostic search involves the use of laboratory and instrumental methods aimed at visualizing the affected area and searching for signs of concomitant diseases.The most informative ones are:

  • Sonography.Ultrasound of the neck and other parts of the body is used for rapid 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 assess the state of blood flow in large vessels.
  • X-ray imaging.Survey radiography of the neck is used to identify deformations of bone structures, displacement of the vertebrae, which always causes neck pain.A more informative method is a CT scan of the spine, which allows one to assess the nature and extent of vertebral disorders.MRI is recommended to study the ligamentous apparatus.
  • Functional diagnostics.The appearance of neck pain can be caused by damage to the muscular system, so it is advisable to perform electromyography.If radicular pain is suspected, electroneurography is indicated.To detect cervical kyphosis, a Forestier test is required.The degree of pain is determined using the McGill questionnaire.
  • Laboratory methods.General and biochemical blood tests are required to exclude acute inflammatory processes, which may 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 smear and serological reactions (RIF, ELISA, PCR) are carried out.

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 intense pain, especially in elderly patients or with a history of heart disease, an ECG is recorded to exclude 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, you shouldn’t delay visiting a doctor.Cervicalgia 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 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, as they can cause ulcers and bleeding from the gastrointestinal tract.

taping for neck pain

Conservative therapy

Medical tactics for cervicalgia depend on the cause of the disease and the intensity of 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 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.The drugs 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.The drugs are administered to the affected area in the form of injections (blockades).Long-term administration of local anesthetics is not advisable.
  • Antibiotics.The drugs are indicated for bacterial and purulent processes in the cervical region that cause pain.In such a situation, the discomfort in patients stops after the cause is eliminated.
  • Vitamins.Preparations of B vitamins, 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 eliminate muscle tension that causes neck pain, use a 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 to restore the anatomical position of the vertebrae and discs.Magnetic therapy and acupuncture help reduce chronic neck pain.After acute pain subsides, massage sessions begin, and physiotherapy must be supplemented with exercise therapy methods.

Surgical treatment

For neck pain caused by pathology of the spinal column, surgical intervention is necessary.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 surgically removed.Severe degenerative lesions of the spine are an indication for spinal fusion.If neck pain is caused by ulcers or cysts, it is necessary to open them and drain them, and wash the resulting cavity with antibacterial solutions.