Neck pain: why and what to do?

According to the latest statistics, one in three people has already experienced neck pain. People's necks have become more common due to the emergence of new "sedentary" professions and computing. Discomfort, as a rule, can be painful if it constantly bothers you. Sometimes when the cervical spine hurts, the following symptoms appear: 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. Patients with neck discomfort complain of nausea, cracking noises when turning their heads, and tinnitus. Sometimes the discomfort is accompanied by numbness in the back of the head. Neck pain is a very common symptom today because many people do not exercise, are overweight and often deal with stress. Neck pain can also occur for other reasons, including serious illnesses requiring 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 occurs due to spondylosis or herniation and protrusion of the intervertebral disc, when the annulus fibrosus ruptures and its nucleus pulposus comes out into the spinal cord 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 down the arm, causing numbness and weakness in the arm. 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 CT scan to assess the damage.

Ankylosing spondylitis

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

Diffuse skeletal hyperostosis (Forestier disease)

Most people over the age of 50 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 a person experiences pain and decreased 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 common cause of neck pain. The syndrome develops as a result of degenerative changes in the structure between the discs of the spine due to unequal loading between the vertebral endplates and facet joints. In 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 also worsens.

Due to degenerative changes in the neck region,spondylosisin the cervical spine. The erasure of the intervertebral discs leads to a progressive reduction in the space between the vertebrae, deformation of the bones and the formation of osteophytes as they grow; this deformation has a considerable impact on the functioning of the entire body. With age, these changes in most cases do not bring any unpleasant sensations. However, they sometimes put pressure on the spinal nerve, causing numbness and pain in the neck, and in some cases, arm or shoulder pain. Numbness, impaired 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 becomes damaged and begins to malfunction due to degenerative changes in the cervical spine, which leads to narrowing of the central spinal canal. The result is sharp 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 mayalso be observed. The disease most often develops after age 55 and often requires surgery.

Cervical spine injuries

The consequences of an injury can be pain in the cervical region and shoulders, migraines, neck muscle spasms and reduced mobility. In car accidents, people usually suffer neck injuries due to the sudden movement of the head back and forth. As a result, intervertebral discs, soft tissues, nerve fibers, posterior longitudinal ligament, facet joint (facet syndrome), etc. are damaged. may be damaged. After an injury, muscle spasms occur and it becomes difficult to move the neck. Over time, pain symptoms go away on their own, but sometimes they progress to chronic pain.

Muscle pain

Muscle spasms in the upper back and neck occur due to physical overexertion, uncomfortable posture, emotional stress during the work day, or spinal injuries. Muscles can also spasm, especially from a bad pillow. Usually the discomfort causes limited mobility, but this pain disappears after six weeks. To speed up the process, doctors recommend eliminating, if possible, the cause of muscle tension and also performing special exercises.

Myofascial pain syndrome

With myofascial syndrome, it is important to identify the most sensitive pain points that may appear after overexertion, hypothermia, emotional trauma or stress. These pressure points cause muscle tension and pain that often becomes chronic.

Cervical osteochondrosis

Among the diseases that cause neck pain, osteochondrosis is a diagnosis made in the territory of the former Soviet Union and, in fact, all of the diseases listed above (degenerative-dystrophic lesions of the spine) himwere generally assigned.

Almost all people over the age of 40 suffer from degenerative changes in the spine. This is not a reason to call a completely sick person and actively start treatment. If the neck bothers you, this is just a symptom indicating the need to make a real diagnosis, after which medical treatment is prescribed.

Diagnosing the causes of neck pain is always complex. He understands:

• general and biochemical laboratory blood tests;
• determination of the level of thyroid hormones in the blood;
• Ultrasound with Dopplerography of the vessels of the neck, thyroid gland, salivary glands;
• X-ray of the cervical spine;
• electroneuromyography;
• CT scan;
• 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 you have neck pain, when should you see a doctor?

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

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

• Severe headaches;
• neck injury;
• uncontrolled urination or bowel movements;
• numbness, tingling, weakness in arms and legs;
• I have had neck pain for a week and there is no improvement;
• lack of benefit in painkillers.

See your doctor immediately if:

• Meningitis, if your head hurts from a sharp rise in temperature, and your neck is so stiff that it hurts to turn it and you cannot 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 of neck pain

1. Medicines that relieve pain and tension. For such discomfort, there is generally no specific treatment. In simple situations, the doctor recommends nonsteroidal anti-inflammatory drugs, chondroprotectors (drugs that promote the restoration of cartilage tissue) that relieve pain. If the spasm is severe, the doctor may prescribe an evening medication that relaxes the muscles, such as a muscle relaxant. For chronic pain, the doctor prescribes tricyclic antidepressants, since botulinum blockades are ineffective. With conservative medical treatment, most muscle tension disappears within 2 to 3 weeks.
2. Ice and heat. If your cervical spine bothers you after an injury, it is recommended to apply ice during the first three days to relieve the pain. If it is a muscular problem, use heat, including taking a shower or bath, or placing a damp towel on the 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 practiced carefully and after consulting a specialist. You need to warm up your neck first. 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 soccer.
5. Relaxation techniques. Due to emotional stress, the neck begins 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. Change habits. The position in which a person spends a lot of time during the working day must be corrected so that the neck no longer hurts. To do this, it is important to monitor your posture yourself, 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 up straight with your shoulders back. The head and body should be at the same level while sleeping 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. It should be kept in mind, however, that massage for chronic pain is likely to be ineffective and is rarely practiced.
8. Manual therapy. In some cases, manipulations can completely aggravate the situation, since they do not have proven effectiveness. In combination only with physical exercise, it is recommended to use "gentle" manual therapy, however, manual therapy makes it possible to eliminate the signs of radicular syndrome, improve the functioning of internal organs and in particular 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, 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 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 wear it for 1-3 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, traction of the neck muscles is ineffective, but acupuncture helps relieve chronic neck pain. Electromagnetic and low-frequency therapy also work, as well as electromyostimulation and laser therapy. However, it is not recommended to skip exercise 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 pathology, but also help accelerate regeneration processes.
12. Surgery for neck pain. If you have neck pain, surgery is not necessary in most cases. Initially, only conservative treatment is used. If the cause of the pain is a narrowing of the central spinal canal or a "pinched nerve", that is, pressure on its root in the spinal cord, and conservative treatment does not help, treatmentSurgical treatment is then recommended.