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Neck pain (cervicalgia)

severe neck pain

Neck pain(Cervicalgia) is a pain of varying nature and intensity that occurs in the cervical region.These symptoms are accompanied by dizziness, numbness in the back of the head or arms, local redness and swelling of the skin.The neck may be painful due to infectious and inflammatory diseases in this area, injuries and degenerative processes in the spine, after staying for a long time in an uncomfortable position.To determine the cause of neck pain, CT, MRI, ultrasound, and laboratory tests are prescribed.Analgesic methods, NSAIDs, and physiotherapy are used to relieve 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 severe pain that makes daily activities difficult.Often, neck pain is localized in the cervical spine or along the anterolateral surface.Usually, the patient feels a sudden "lumbago", which is replaced by constant pain.Pain varies - throbbing - throbbing, tingling, red.They can radiate to the shoulder, scapula, and occipital region.

Unpleasant sensations increase when turning and tilting the head, so the person has to turn his whole body.Often, the neck begins to hurt after a long stay in an uncomfortable position: Patients note that the discomfort appears after a day of work at the computer or sewing machine.Many patients associate the development of cervicalgia with hypothermia and draft effects.If your neck hurts badly, or the pain is combined with dizziness, numbness in the back of the head, or tinnitus, you need to 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 cervicalgia, which can be permanent or recurring.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 structure of the cervical spine.This group includes spondylogenic cervicalgia, which is associated with bone damage and compression of the spinal cord, and discogenic, due to deformation of the intervertebral disc.
  • Nonvertebrogenic neck pain.Including all other causes of neck pain.Unpleasant sensations can occur due to inflammatory processes in the muscular apparatus -ligaments, pathology of internal organs - glands of the pharynx, thyroid, lymph nodes and salivary glands.

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

Why does my neck hurt?

Causes of sore throat

A scratchy, itchy feeling in the throat is associated with the flu, but unpleasant sensations are often caused by other reasons (too dry indoor air, exposure to atmospheric pollutants).Sometimes the pain syndrome is felt so strongly that the patient feels as if their entire neck hurts.Conditions such as:

  • Laryngitis: Atrophic, hemorrhagic, hyperplastic.
  • Viral disease: Arvi, infectious mononucleosis, influenza, etc.
  • Bacterial infection: Tonsillitis, diphtheria, scarlet fever.
  • Allergic inflammation: Laryngotracheitis, pharyngitis.
  • Foreign body in the throat;Fish meat and bones, for children - toy parts.
  • State Disadvantages:Lack of vitamins B12 and B2, lack of ascorbic acid, iron.
  • Gastroesophageal reflux.
  • Rare reasons: Long styloid process, Itsenko-Cushing syndrome, malignant neoplasm of the throat or vocal apparatus.

Causes of neck pain in the front

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

  • Thyroid pathology: Acute and subacute thyroiditis, diffuse toxic goiter, Hashimoto's thyroiditis.
  • Injury: Sprains and tears of muscle fibers, blows to the neck area.
  • Inflammatory process:Myositis, neuritis, tendonitis.
  • Purulent disease: Suppurating cervical cyst, Peritonsillar abscess.
  • Damage to lymphoid formation: lymphadenitis, lymphangitis.
  • Cervical compression syndrome: radicular, vertebral artery.
  • Related organ diseases: esophagitis, tracheitis.
  • Angina attack.
Causes of neck pain

Causes of pain in the cervical spine

The patient complains of pain in the neck that occurs along the back surface.The painful sensation is intense;Due to the constant "lumbago", the person had to keep the head and shoulders 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 injury: Compression fracture of cervical vertebra, compression of spinal cord, fracture of arch bone and vertebral process.
  • Damage to other structures: Rupture of the supraspinous and interspinous ligaments of the spine, damaging the paraspinal muscles.
  • Systemic connective tissue disease: Ankylosing spondylitis (ankylosing spondylitis), arthritis (rheumatoid, psoriatic), Reiter's syndrome.
  • Infectious process: osteomyelitis, vertebral tuberculosis.
  • Rare reasons: Presence of pathological bilateral cervical ribs, Klippel-Feil syndrome.

Causes of lateral neck pain

Intense pain along the neck usually radiates to the shoulder or ear.A person may feel tingling, burning, or throbbing in this area.With severe discomfort, secondary torticollis is formed, where the head is always tilted in the painful direction, and the chin is turned in the healthy direction.The most common causes of lateral neck pain are:

  • Pathology of blood vessels: varicose veins of the neck, atherosclerosis of the large cervical artery that supplies the brain.
  • Stay in an awkward position: Always bowing your head while working on the computer, a bad pillow for sleeping, peculiarity of gait with the neck leaning in the same direction.
  • Muscle spasms: With a sharp turn of the head, intense physical activity, after hypothermia.
  • Retropharyngeal abscess.
  • Oncological diseases: Thyroid and parathyroid gland neoplasms, lateral surface tumors of the pharynx and larynx.
  • Congenital disease: Grisel syndrome, pterygoid neck with Shereshevsky-Turner anomaly.
  • Rare reasons: Complications after subarachnoid hemorrhage, meningitis.

Diagnostics

A person with neck pain most often turns to an osteopath or neurologist.Long and complex exams;To make a correct diagnosis, it is necessary to exclude many causes of neck pain.Diagnostic search involves the use of laboratory and instrumental methods aimed at describing the affected area and looking for signs of concomitant diseases.The most informative are:

  • Sonography.Ultrasound of the neck and other parts of the body is used for rapid non-invasive visualization of all cervical structures, identifying pathological signs of internal organs that can cause neck pain.Targeted ultrasound of the thyroid gland and submandibular salivary gland is performed.Duplex scanning helps assess the state of blood flow in large vessels.
  • X-ray imaging.Radiography of the neck survey is used to identify deformation of the bone structure, 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 degree of vertebral disorders.MRI is recommended to study the ligament apparatus.
  • Functional Diagnostics.The appearance of neck pain can be caused by damage to the muscular system, so it is recommended to perform electromyography.If radicular pain is suspected, electroneurography is indicated.To detect cervical kyphosis, a forest test is required.Pain levels were determined using the McGill questionnaire.
  • Laboratory methods.General blood and biochemical tests are needed to exclude an acute inflammatory process, which can cause neck pain.The concentration of thyroid hormone must be determined.In the presence of a general infectious syndrome, bacteriological culture of sputum or throat and serological reactions (RIF, ELISA, PCR) are carried out.

If the patient experiences pain not only in the neck, but also in the throat, an examination by an otolaryngologist is required.In case of intense pain, especially in elderly patients or with a history of heart disease, 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 should not delay visiting the doctor.Cervicalgia requires careful diagnosis to determine the cause of unpleasant symptoms.It is necessary to avoid sudden movements in the cervical region, drafts and hypothermia.Before the diagnosis is confirmed, neck pain is relieved with the help of a warming procedure (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, because they can cause ulcers and bleeding from the gastrointestinal tract.

recording neck pain

Conservative Therapy

Medical tactics for cervicalgia depend on the cause of the disease and the intensity of the pain.Isolated drug treatment is rarely used;Its combination with modern physiotherapy methods is more effective.To relieve neck pain and eliminate the underlying pathology that causes 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.Medicines quickly remove muscle spasms, and after relaxing the muscles, the neck hurts less.The effect is observed after the first injection;To consolidate the effect, this product is used in courses.
  • Anesthetic.Used for severe neck pain that the patient cannot tolerate.Medicines are administered to the affected area in the form of injections (blockade).Long-term administration of local anesthetics is not recommended.
  • Antibiotics.These drugs are indicated for bacterial and purulent processes in the cervical region that cause pain.In such a situation, discomfort in the patient stops after the cause is eliminated.
  • Vitamins.Vitamin B preparations, especially thiamine, are actively used in cases where pain in the neck area is chronic.The medicine improves the nutrition of spinal roots and nerves.

Physiotherapy

To relieve 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 heat procedures - mud baths and compresses, electrophoresis with anesthetics.Manual therapy techniques are useful for restoring the anatomical position of vertebrae and discs.Magnetic therapy and acupuncture help reduce chronic neck pain.After the acute pain subsides, massage sessions begin, and physiotherapy must be supplemented with exercise therapy methods.

Surgical treatment

For neck pain caused by spinal column pathology, surgical intervention is required.To reduce pressure on the nerve root, discectomy, foraminotomy and laminectomy are used.When a hernia is detected, the appropriate operation is 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 the neck pain is caused by an ulcer or cyst, it is necessary to open it and drain it, and wash the resulting cavity with an antibacterial solution.