Neck pain refers to pain in the back of the neck, starting from the occipital region to the upper edges of the shoulder blades, as well as pain in the area from the right to the left shoulder.
Causes of neck pain
Not only already formed diseases of the spine, but also some ordinary situations can lead to neck pain:
- staying in one, especially incorrect, position for a long time: the load on the spine increases, the muscles are in constant tension, which leads to their spasm and pain;
- muscle hypothermia can also cause muscle spasm, which leads to poor circulation;
- incorrectly chosen bed, incorrect position when driving a car, at the computer, etc.;
- excess weight puts a lot of stress on the spine and muscles;
- strong emotional stress causes feelings of fatigue and pain in the neck;
- sudden, excessive movements that lead to muscle strain and pain.
Diseases that cause neck pain
The most common culprits of pain in the neck area are diseases such as:
- intervertebral hernia of the same department,
- damage to intervertebral joints,
- cervical injuries,
- ligaments and muscles.
Less common causes of neck pain are:
- myelopathy,
- polymyalgia rheumatica,
- fibromyalgia,
- ankylosing spondylitis,
- and foreign bodies in it.
Neck pain can occur with some life-threatening diseases: coronary heart disease, subarachnoid hemorrhage, infectious diseases (osteomyelitis), vertebral fractures.
Even mental changes can cause pain in the neck.
Causes of neck pain in children
Most often, neck pain in children appears as a complication of tonsillitis, when the cervical lymph nodes become inflamed and lymphadenitis develops. In addition, the cause of pain in the neck can be infectious diseases, such as:
- meningitis,
- osteomyelitis,
- polio,
- with signs of meningism.
With inflammatory processes in the sternocleidomastoid muscle, pain occurs when turning the head. , due to muscle spasm, is also accompanied by pain, while the head is tilted and turned in the direction opposite to the pain. In children, as in adults, neck pain can occur due to diseases such as neoplasms, abscesses, intracranial hemorrhages, rheumatoid arthritis.
Pain in the neck in children can occur with a contagious (infectious) disease such as mumps. It manifests itself as an increase in temperature and pain. The process can spread to the submandibular and sublingual glands. This may cause swelling of the larynx and soft palate. There are difficulties when chewing, swallowing and even breathing.
Due to the fact that children often suffer from infectious diseases, it is advisable to call a doctor at home.
What symptoms may accompany neck pain?
With osteochondrosis, intervertebral hernia, radiculitis of the cervical spine, pain can spread to the occipital region, one or both arms, and there may be a headache. There is a decrease in sensitivity in the hands and motor disturbances, which in severe cases can turn into paralysis.
Severe neck pain, bruises, and muscle stiffness are characteristic of cervical injuries. If neurological disorders occur, spinal cord damage may be suspected.
Stretching and rupture of ligaments leads to disruption of the functioning of the upper limbs and neck muscles. Accompanied by severe pain, which intensifies at night and with movement. A hematoma is often visible, just under the skin, swelling. Movements may be limited or (if the ligament is torn) have a pathologically large amplitude.
With myelopathy (damage to the spinal cord), pain appears in the cervical spine, limitation of movements in the neck, spastic paresis of the lower extremities with impaired deep sensitivity, and flaccid paresis of the arms. When straightening or bending the neck, a sensation of electric current running along the back, along the spine appears; the sensation can spread to the arms and legs.
Polymyalgia rheumatica can cause cutting, tugging or pulling pain in the neck muscles, which sharply intensifies with movement. In addition to this symptom, the disease is manifested by stiffness in the shoulder girdle, especially in the morning and after a period of immobility. It is difficult for a sick person to get out of bed, put his hands behind his back, and sometimes even lift them, and it is difficult to perform even ordinary manipulations. The pain can spread to other muscles of the body, most often to the muscles of the pelvic girdle. Sometimes the pain intensifies at night, causing sleep disturbance. Despite the fact that patients complain of significant weakness, muscle strength is maintained.
With lymphadenitis of the cervical lymph nodes, the body temperature rises, general malaise appears, enlarged lymph nodes are visible or palpable on the back of the neck, painful when touched, and they may be red.
What to do if your neck hurts
To begin with, you need to at least somewhat determine what caused the neck pain. If the situation is similar to the symptoms of osteochondrosis, it is necessary to change position more often, move more, use special physical exercises, use spinal stretching methods, massage, and physiotherapy. The complex must include the use of non-steroidal anti-inflammatory drugs.
For pain caused by prolonged stay in one position or hypothermia, it is necessary to rub the neck area with an anesthetic or warming cream, and take an anti-inflammatory drug tablet orally. You can wrap a warm scarf around your neck. It is recommended to use warm compresses.
If the pain is a consequence of a disease, you should not self-medicate; consult a doctor as soon as possible, especially if the neck pain occurs in a child.
If you have neck pain, you can consult the following doctors:
First, it is more advisable to contact a therapist who will conduct a full examination and decide whether it is necessary to involve qualified specialists, such as
- surgeon;
- traumatologist;
- orthopedist;
- rheumatologist;
- otolaryngologist;
- physiotherapist;
- masseur.
Neck pain is a very common complaint. It occurs at any age in both men and women. Its main causes are osteochondrosis and osteoarthrosis of the cervical spine. Sources of pain in these diseases can be intervertebral joints and discs, as well as spinal ligaments and back muscles (Fig. 1).
Rice. 1. Structure of the cervical spine
The pain is usually localized in the back of the neck and may radiate to the head, shoulders and chest wall. In addition to pain, osteochondrosis and osteoarthritis of the spine are manifested by tension in the neck muscles and limitation of head movements. More details about the causes of neck pain are given in table. 1.
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Basic information
- At any given time, one in ten adults has neck pain.
- Neck pain is usually caused by damage to the intervertebral joints, and somewhat less commonly, to the intervertebral discs.
- Most often, the intervertebral discs of the lower cervical spine are affected, and unilateral neck pain and sensory disturbances in the arm on the affected side usually occur.
- The prevalence of osteochondrosis and osteoarthritis increases with age. Thus, radiological signs of osteochondrosis of the cervical spine are found in 50% of people over 50 years of age and in 75% of people over 65 years of age.
- According to the results of a study conducted in the UK, radiological signs of osteochondrosis are found in 40% of men and 28% of women aged 55-64 years.
- Whiplash injury to the spine is characterized by damage to the ligaments of the intervertebral joints and fractures of the articular processes of the vertebrae. These injuries are often undiagnosed and can cause long-term neck pain.
- Osteophytes in osteochondrosis can compress the spinal roots (radiculopathy) and the spinal cord (myelopathy).
- The main causes of radiculopathy are herniated discs, space-occupying lesions and osteophytes.
- Neck pain is often worsened by shaking, such as while driving a car.
- The examination of the cervical spine begins with the identification of anatomical landmarks - the spinous processes of the vertebrae C2, C6 and C7.
- The main method of physical examination for neck pain is careful (but gentle) palpation.
- In most cases, neck pain lasts 2-10 days, and within a month it goes away in 70% of patients.
- For degenerative diseases of the spine, the main thing is to restore joint mobility.
- If there is no tumor, injury or radiculopathy, then the most effective methods for neck pain are manual therapy and physical therapy.
Diagnostics
Differential diagnosis for neck pain is presented in table. 2.
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Most likely reason
The main causes of neck pain are osteochondrosis and osteoarthritis of the cervical spine, as well as damage to the neck muscles and spinal ligaments. The prevalence of spinal osteoarthritis increases with age. The main source of pain in osteoarthritis is the intervertebral joints. It is believed that damage to the intervertebral joints is the cause of myofascial pain and acute torticollis. Herniated discs usually occur in the lower cervical spine: the intervertebral discs C5-C6 and C6-C7 are usually affected.
The most dangerous diseases
Neck pain and limitation of head movement are observed with meningitis, subarachnoid hemorrhage, brain tumors and retropharyngeal abscess. If pain is localized along the anterior surface of the neck, coronary artery disease (IHD) - angina pectoris and myocardial infarction - are excluded.
Tumors of the cervical spine are usually metastatic. A tumor should be excluded if there is prolonged, constant pain that bothers the patient day and night. Metastases from malignant neoplasms in 5-10% of cases are localized in the spine, while damage to the cervical spine is observed in 15% of cases. Cancers of the breast, prostate and lung most often metastasize to the spine, and melanoma, kidney cancer and thyroid cancer are somewhat less common.
Sources of misdiagnosis
Difficulties most often arise in the diagnosis of rheumatoid arthritis and spondyloarthropathies, especially ankylosing spondylitis, psoriatic arthritis and arthritis in inflammatory bowel diseases. Pain in the lower part of the neck can be observed with polymyalgia rheumatica, although many people mistakenly believe that with this disease the pain is localized only in the shoulders.
Diffuse neck pain is observed in fibromyalgia. When examining a patient with fibromyalgia, pain points of a certain localization are identified. The disease is difficult to treat.
Causes of errors
- Ignorance of how common osteochondrosis of the cervical spine is.
- Ignorance of the fact that when a herniated disc occurs, only one spinal root is affected; if several roots are affected at once, then a malignant neoplasm should be suspected (metastases to the spine, lymphoma, etc.).
- Late diagnosis of myelopathy: it is characterized by a gradual onset, which leads to diagnostic errors; myelopathy is also observed in rheumatoid arthritis, osteochondrosis and osteoarthritis of the spine.
Seven main pretenders
Among the pretend diseases, the main cause of neck pain is osteochondrosis of the cervical spine. Severe neck pain is also observed in acute thyroiditis. Acute thyroiditis is a rare disease; it can be purulent; it is also observed in syphilis. Less intense pain, enlargement of the thyroid gland and dysphagia are observed with subacute granulomatous thyroiditis. Depression can also be a cause of neck pain.
Mental disorders and malingering
After an injury, the neck very often becomes a zone of psychological fixation. Depression, anxiety and conversion disorders, and malingering can be both a cause and a consequence of neck pain. Constant neck pain, such as after whiplash or osteochondrosis, often provokes depression.
Survey
Anamnesis
During the collection of anamnesis, the nature of the pain, the circumstances of its occurrence, localization and irradiation, and accompanying symptoms are clarified in detail. Information about the daily rhythm of pain plays an important role in diagnosis.
Main questions
- Show the place of greatest pain.
- Is there pain early in the morning? Do you wake up in pain?
- Does pain occur when you throw your head back?
- Is it easy for you to turn your head?
- Were there any head or neck injuries?
- Are there any restrictions in head movements, is there any crunching during movements?
- Do you have headaches or dizziness?
- Is the pain paroxysmal or constant?
- Is there any pain, tingling, numbness, or weakness in your hands?
- Does the pain get worse with movement?
- Do your shoulders hurt?
Physical examination
The study is carried out in the following sequence - inspection, palpation, assessment of active movements (including measurement of their volume), physical tests. Research objectives:
- reproduce symptoms
- determine the level of damage,
- determine the cause of the pain.
For radicular pain, disturbances in sensitivity and movement in the arms, as well as for pain in the arm below the level of the elbow, a neurological examination is indicated.
Inspection
During the examination, the patient should sit on the couch with his hands on his hips. Rate:
- voluntary movements in the cervical spine,
- shoulder position,
- head position,
- contours of the neck when viewed from the side.
In acute torticollis, the head is tilted to the side and slightly turned in the direction opposite to the pain. After a whiplash injury and with severe osteochondrosis, the head is fixed and motionless: when it is necessary to turn the head, the patient turns his entire body.
Palpation
First of all, the main anatomical landmarks are determined. During palpation, the patient lies on his stomach, his shoulders are relaxed, his forehead is on his palms, his head is slightly tilted.
Palpation of the spinous processes:
- the spinous process of the C2 vertebra is palpated immediately under the back of the head,
- due to cervical lordosis, the spinous processes of the vertebrae C3, C4 and C5 are difficult to palpate, their location is estimated approximately (Fig. 2),
- the spinous process of the C6 vertebra is accessible to palpation only when the neck is flexed,
- The spinous process of the C7 vertebra is the largest and most prominent, located at the base of the neck.
Rice. 2. Cervical spine: side view
Palpation is carried out with the thumbs of both hands. The fingers are placed opposite each other along the midline, palpation is carried out from top to bottom - from the C2 vertebra to the C7 vertebra. During palpation, your arms should be kept straight. Place your fingers on the spinous process and press on it 3-4 times; In this way, pain and trigger points are identified.
Palpation of the articular processes:
- projections of the articular processes are located on the same line 2-3 cm lateral to the posterior midline,
- Palpation is carried out from top to bottom with thumbs facing each other.
- Palpation of lymph nodes, thyroid gland, neck muscles.
Assessment of active movements
During the examination, the patient sits on the couch. The range of motion in the cervical spine is normal:
- bending - 45 0,
- extension - 50 0,
- bending to the sides (abduction and adduction) - 45 0 in each direction,
- rotation (twisting) - 75 0 in each direction.
If there is no restriction of movement and pain, then at the end of each active movement a short-term additional effort is applied in the same direction and asked if pain has appeared. Based on the results of the study, fill out the form (Fig. 3).
Rice. 3. Range of motion in the cervical spine: crossed out lines mean limitation and pain when tilting and turning the head to the right
Neurological examination
A neurological examination is carried out for pain, paresthesia, movement disorders and sensitivity in the hand, i.e. in the area of innervation of the C5-Th1 roots. Signs of spinal root compression include:
- pain and paresthesia in the area of its innervation,
- sensory disturbances,
- decreased muscle strength,
- hyporeflexia.
Symptoms of compression of individual roots are presented in Table. 3. They need to be known in order to accurately determine the level of damage.
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The cutaneous innervation from the cervical and upper thoracic segments of the spinal cord is shown in Fig. 4.
Rice. 4. Cutaneous innervation of the head, neck and arm
Laboratory and instrumental studies
Additional research methods are used to clarify the cause of neck pain and exclude organic diseases of the spine.
The prescription of CT must be justified. A CT scan should not be performed for neck pain on everyone. Thus, CT is absolutely indicated before a neurosurgical operation and if an organic disease of the spine is suspected, which is not detected by radiography.
For neck pain, the following research methods are used:
- general blood analysis,
- ESR study,
- blood test for rheumatoid factor,
- HLA B27 determination,
- radiography of the spine,
- CT scan of the spine,
- CT scan with myelography (before surgery for a herniated disc),
- bone scintigraphy,
- MRI of the spine.
Neck pain in children
In children and adolescents, neck pain and limitation of head movements are often a manifestation of cervical lymphadenitis (a complication of tonsillitis).
A stiff neck occurs with meningitis and other severe infections, such as pneumonia (meningismus). Poliomyelitis, a currently rare disease, can also be accompanied by neck pain.
Some causes of neck pain in children are the same as in adults: intracranial hemorrhages, abscesses and tumors. In children, in addition, acute torticollis is often observed (see below). Neck pain can also be a symptom of juvenile rheumatoid arthritis.
Neck pain in the elderly
If you have neck pain in the elderly, you should first suspect the following diseases:
- osteochondrosis of the cervical spine, complicated by radiculopathy or myelopathy,
- polymyalgia rheumatica,
- subluxation of the atlantoaxial joint in rheumatoid arthritis,
- metastatic tumors of the spine,
- pancoast cancer,
- abscess or tumor of the pharynx or retropharyngeal space.
The main causes of neck pain in the elderly are osteochondrosis and osteoarthritis of the spine. Neck pain is also observed with damage to the brain and its membranes, rheumatoid arthritis and spondyloarthropathy, such as ankylosing spondylitis.
Acute torticollis often occurs in the elderly, and it is more often caused by damage to the intervertebral joints and less often by a herniated disc.
A herniated disc usually presents with radicular pain. Radicular pain also occurs with osteoarthritis of the spine due to compression of the spinal nerves in the intervertebral foramina.
Clinical picture of lesions of the cervical spine
When the cervical spine is affected, the following may be observed:
- pain in the neck,
- restriction of head movements,
- headache, including migraine-like,
- facial pain,
- pain in the arm (referred and radicular),
- myelopathy (manifested by motor and sensory disturbances in the arms and legs),
- impaired sensitivity of the scalp on the affected side,
- earache,
- pain in the scapula area,
- pain in the upper chest wall,
- torticollis,
- dizziness,
- visual impairment.
In Fig. Figure 5 shows the possible localization of referred pain in diseases of the cervical spine. It should be noted that pain in diseases of the cervical spine often occurs in the shoulder and arm.
Rice. 5. Referred pain in diseases of the cervical spine
Microdamages of intervertebral joints and osteoarthritis of the cervical spine
Damage to the intervertebral joints of the spine is the main cause of neck pain. Microdamages of these joints occur at any age; frequent microdamages lead to osteoarthritis in old age.
Damage to the intervertebral joints may be primary, or may occur as a result of damage to the intervertebral discs, as a result of a single injury, such as a blow to the head, or minor but frequent injuries, for example, when painting the ceiling or wrestling.
Intervertebral joints are richly innervated, so their damage almost always causes pain, often this pain is myofascial in nature. Damage to intervertebral joints is characterized by the following:
- dull (less often acute) pain in the neck, often in the morning, after sleeping in an uncomfortable position (patients often say that they are “blown away”),
- irradiation of pain to the back of the head, ear, face and temple (if the upper cervical spine is affected) or to the shoulder, especially in the suprascapular region (if the lower cervical spine is affected),
- pain increases with movement and decreases with rest,
- limitation of head movements (most often limited turns) and tension in the neck muscles,
- unilateral pain on palpation in the projection of the affected joint,
- no changes on radiographs.
Irradiation of pain into the arms is not typical for microdamages of the intervertebral joints.
Treatment
The causes of his illness are explained to the patient, and it is emphasized that if you follow the doctor’s recommendations, a complete recovery will occur.
- sit up straight while reading, writing, working on the computer,
- watch your posture,
- sleep on a small elastic or special orthopedic pillow,
- sleep on the losing side,
- Rub your neck with a cream containing analgesics 3 times a day: heat and massage reduce pain.
- throw your head back for a long time,
- often turn your head in the direction of pain,
- tilt your head when lifting weights,
- read or write for a long time while bending over,
- wear a collar splint for a long time,
- sleep on a high pillow.
The patient is examined regularly.
The condition usually improves slowly, so it takes some time to evaluate the effectiveness of treatment.
Analgesics such as paracetamol are prescribed.
As soon as the pain subsides, physical therapy exercises begin. Its combination with manual therapy (the latter should be carried out by a specialist) is very effective.
For prolonged pain, additionally use:
- antidepressants,
- transcutaneous nerve stimulation, especially in case of drug intolerance,
- hydrotherapy,
- acupuncture,
- injections of corticosteroids into the intervertebral joints (after CT or MRI),
- denervation of intervertebral joints.
Osteochondrosis of the cervical spine
Osteochondrosis of the cervical spine is much more common than the lumbar spine. Intervertebral discs C5-C6 and C6-C7 are usually affected. Intervertebral disc degeneration causes secondary changes in the intervertebral joints, which in turn leads to narrowing of the intervertebral foramina and compression of the spinal roots (usually C6 and C7).
Osteochondrosis is a chronic disease with periodic exacerbations, which, however, can remain asymptomatic for a long time. In some patients with osteochondrosis, all manifestations decrease with age, when movements in the spine are limited.
Clinical picture
- Dull, aching, often one-sided pain just below the back of the head (Fig. 6), which often wakes patients up in the morning.
- Limitation of head movements.
- Increased pain in the morning, with sharp flexion or extension of the neck, as well as with prolonged constant stress on the cervical spine, for example, when repairing a car or painting the ceiling.
- Reduce pain when warm, such as during a warm shower.
- Radiation of pain to the head, shoulder blade or arm.
- Paresthesia in the hands.
- Dizziness.
- Upon examination, there is limitation and pain in movements in the cervical spine, especially turns and bends to the side, pain in the intervertebral joints on palpation.
- X-rays show a decrease in the height of the intervertebral discs, osteophytes, degenerative changes in the intervertebral joints.
Rice. 6. Osteochondrosis of the cervical spine: localization of pain and results of studies of active movements
Complications
- Unilateral or bilateral radiculopathy.
- Myelopathy.
Treatment
- Psychological support, patient education.
- Physiotherapy, including hydrotherapy.
- Analgesics, such as paracetamol.
- NSAIDs for 3 weeks (then assess their effectiveness and the need for further use).
- A special set of physical exercises.
- Manual therapy.
- Recommendations for daily activities, sleep, etc. etc.
Acute torticollis
Torticollis is a deformity of the neck, manifested by deviation of the head from the midline. Torticollis often occurs as a result of spasm of the neck muscles in diseases of the spine, and it is usually short-lived and accompanied by neck pain. Most often, acute torticollis occurs between the ages of 12 and 30 years.
The causes of acute torticollis are not fully known. It is believed that it is caused by microdamage to the intervertebral discs and especially the intervertebral joints. The level of damage can be any, but most often it is C2-C3, C3-C4 and C4-C5.
Clinical picture
- * The head is tilted and slightly turned in the direction opposite to the pain.
- * Pain is usually localized in the neck and does not radiate
- * Pain most often occurs in the morning, after sleep.
- *Limited head extension.
- * There are usually no neurological symptoms.
Treatment
Manual therapy, including post-isometric relaxation, is very effective.
Postisometric relaxation
The post-isometric relaxation method is based on the fact that when a muscle contracts, its antagonists reflexively relax. To treat torticollis using the post-isometric relaxation method, the head should be tilted and turned in the direction opposite to the pain.
- * The essence of the method is explained to the patient and it is emphasized that it will not hurt.
- * First, carefully turn the patient’s head in the direction of the lesion. If pain occurs, stop immediately.
- * Place one hand on the patient’s head on the side opposite to the pain, and with the other hand fix the neck at the level of the spinal lesion (usually the C3-C4 level).
- * The patient is asked to turn his head in the direction opposite to the pain, overcoming the resistance of the doctor’s hand, while isometric tension of the neck muscles occurs (Fig. 7a). The main condition at this stage is not to turn the patient’s head, but only to resist his movement.
- * After 5-10 seconds the patient is asked to relax. Then carefully turn his head in the direction of pain (Fig. 7b) - an increase in the range of movements is noted.
- * The procedure is repeated 3-5 times until the range of motion is completely restored.
- * The next day the procedure is carried out again, although torticollis may no longer be present.
The patient can be trained to perform post-isometric relaxation independently.
Rice. 7. Postisometric relaxation for left-sided acute torticollis:
a) isometric contraction phase,
b) relaxation phase
Whiplash
Whiplash typically occurs in car accidents. In a rear impact, there is a sudden hyperextension of the neck followed by a sharp flexion; in a frontal collision, there is a sudden flexion followed by extension. Whiplash damages muscles and ligaments, spinal roots, sympathetic trunk, intervertebral joints and discs. Intervertebral joints are especially affected; even microfractures are possible (not noticeable on x-rays).
Symptoms usually appear in the first 6 hours, less often - 1-4 days after injury; their severity may vary.
Whiplash is usually accompanied by pain and limited head movement. The pain is localized in the neck and shoulders, and can radiate to the back of the head, the interscapular area and the arms. First of all, flexion is limited, then extension of the head.
When a whiplash injury occurs, headaches are also common and can last for months. The pain is usually localized in the back of the head, but can radiate to the temple and eye socket. Dizziness and nausea are also observed. Damage to the nerve roots during an injury or their compression by a herniated intervertebral disc is accompanied by radicular pain. Another manifestation of whiplash injury is mood changes (anxiety, depression).
Complications of whiplash are listed in Table. 4.
In case of whiplash injury, an x-ray of the spine is required.
Treatment
The goal of treatment is to restore ability to work as early as possible, stop wearing a collar splint, and achieve complete restoration of range of motion in the cervical spine. In the treatment process, methods of both physical and psychological influence are used.
- Establish a trusting relationship with the patient and provide the necessary psychological support.
- Explain the mechanism of injury to the patient.
- It is emphasized that after an injury, mood changes may be observed for several (usually two) weeks - irritability, depression.
- It is recommended to rest and wear a collar splint for 2 days.
- Analgesics such as paracetamol are prescribed. Narcotic analgesics are not used.
- NSAIDs and small doses of tranquilizers are prescribed for up to 2 weeks.
- The patient is consulted by a physiotherapist (heat treatments and massage are effective for whiplash injuries).
- As soon as possible, begin therapeutic exercises (a special set of exercises for the neck muscles).
- The patient is consulted by a specialist in manual therapy - mobilization is performed, manipulations are not used.
Content
Neck pain or cervicalgia affects neither young nor older people. Malaise can occur due to completely different reasons: excessive mobility or limited movement during sedentary work. Sometimes this symptom is a consequence of serious illness and requires seeing a doctor.
Why does my neck hurt?
The neck, as one of the vertebral sections, is the shortest and therefore more susceptible to damage. You should not immediately consult a doctor if you have cervicalgia. First you need to determine the nature of the pain and its frequency. If pain symptoms in the cervical region both at rest and during exercise make themselves felt, then it is better to be examined for possible neck diseases in a medical institution.
There is a classification depending on the location:
- Somatic superficial indicates damage to the muscular and skeletal systems.
- Somatic deep - that important internal organs are injured.
Depending on the location of the deterioration of the nervous system:
- Nerve cells in the periphery are affected - neuropathic.
- If the pain is associated with the central nervous system, it is central.
The reason often lies in childhood diseases that were asymptomatic, without medical supervision. It is especially important to pay attention to this sign in a child to avoid problems in the future. The causes of neck disease in children can be:
- Development of incorrect posture. When sitting at a table or on a sofa with a sedentary lifestyle, the spine curves. It is easy to identify the defect; to do this, you need to stand the child near the wall and evaluate whether the spinal column has sufficient deflection or not.
- Minor injuries sustained during games, running, or falling from a height require examination by a doctor.
- Muscle spasm when trying to turn your head results in severe pain. Such a minor nuisance, which occurs after a long uncomfortable position of sitting or lying, leads to complications and inflammation.
- Lifting weights. A satchel, bag or briefcase that has a lot of weight strains the child’s neck muscles. Afterwards, a nagging pain is observed in this area.
- Inflammation of the lymph nodes. Sudden sharp pain, radiating into the ear, characterizes the disease. In severe cases, an increase in temperature is added.
- Meningitis. Particularly dangerous for children. Symptoms: temperature above 38 degrees, vomiting, loss of consciousness, convulsions.
- Torticollis. A pathological condition in which the cervical vertebrae cannot take the correct position. The defect needs to be treated before the age of 9-10, otherwise the face will be asymmetrical.
Behind
To answer the question: why does the back of your neck hurt, you need to observe the sensations. Periodic pain in the back of the head, at the base of the skull, numbness when turning sharply indicates the likelihood of spondylosis. With this disease, osteophytes (growths) form in the bone tissue. The nerve roots are compressed and pain occurs. The same symptoms are observed with spondylolisthesis.
Front
The front part hurts in cases where there is local inflammation of the lymph nodes under the jaw. This occurs with tonsillitis and otitis media. Often the pain in the front is continuous, nagging and intense. In addition, inflammatory diseases of the thyroid gland also manifest themselves - acute thyroiditis. Pain in the front that does not go away after taking painkillers is evidence of heart problems, which is how angina pectoris manifests itself.
Muscles from the side
Soreness in the lateral muscles of the neck occurs if hypothermia or inflammation of the lymph nodes on the side occurs. When the side of the neck hurts, there is often added discomfort that radiates to the arm or chest. Such pain can lead to dizziness, increased blood pressure, and fainting. The symptom is characteristic of displacement of the vertebral discs.
It hurts to turn your head to the left
Turning the head can cause pain in the cervical region. This indicates muscle strain. The use of warming ointments with an anesthetic component or a pepper patch blocks severe pain, but if it hurts to turn your head to the left side for more than two days, this should be a reason to contact a specialist for further consultation.
When tilting your head back
The consequences of malaise when throwing the head back are whiplash injuries of the cervical spine with cracks and fractures. In addition, pain is evidence of pathological changes in the structure of the spine that appear in overweight patients. If it constantly hurts to tilt your head back, doctors cite the following diseases as possible causes:
- hypertensive crisis;
- brain tumors;
- strokes (brain circulatory disorders);
- subarachnoid hemorrhage.
Left or right rear
Doctors call fibromyalgia the cause of neck pain on the back left side. With this disease, tendons, muscles, and tissues become more sensitive and respond with unpleasant sensations when bending and turning the head. The disease can be caused by colds, injuries and incorrect position during sleep, sudden physical activity during sports. Spinal stenosis and arthritis present themselves with the same symptoms.
In cases where the cervical spine hurts in the back right, you need to pay attention to the type of activity performed the day before. Sometimes this sign indicates a simple muscle strain caused by uncomfortable sleep or sitting for a long time with your head tilted to the right. Even this reason can lead to pathological conditions. However, constant severe pain on the right side for no reason is a symptom of intervertebral hernia or osteochondrosis.
Front left
Any pain in the anterior part of the cervical spine is associated with inflammation of the organs located in this area. These are the thyroid gland, larynx, trachea. The neck hurts on the front left side in cases where there are diseases with left-sided localization:
- angina;
- pharyngitis;
- tonsillitis;
- myositis;
- lymphadenitis;
- lymphangitis;
- cervical cyst.
In the neck and shoulders
The occurrence of simultaneous unpleasant sensations in the lower cervical and shoulder regions not only limits activity, but also serves as a reason for urgent medical attention. In addition to the obvious causes of pain in the neck and shoulders, such as excessive physical exertion, doctors name dangerous ailments. These include: arthritis, arthrosis of the shoulder joint, myalgia, plexitis, glenohumeral periarthritis.
Symptoms - causes
Sometimes the patient cannot determine where exactly the pain is most disturbing, but it is concentrated in or near the cervical region. Such pain in the neck area is even more dangerous; immediate examination is required using modern devices: MRI, radiography, ultrasound. In most cases, the diseases are not confirmed, but sometimes serious diseases are detected: osteoarthritis, radiculopathy, osteochondrosis.
Pulls
The department is responsible for part of the spine, muscles, lymph nodes and nerve endings. Often muscles hurt and pull due to damage to one or more organs. The pulling sensation is caused by:
- Stretched or cold muscles, physical strain, minor injuries.
- Cervical osteochondrosis. It is diagnosed with pain radiating to the back of the head and spine.
- Thyroiditis. In addition to all the listed symptoms, high fever, lethargy, and swelling of the neck in the thyroid area are added. Often the pain still extends to the ear.
Heaviness
Hypertension, neurosis, angina pectoris, and other ailments associated with the vegetative-vascular and cardiac systems lead to heaviness in the neck. The ubiquitous osteochondrosis, which affects most of the population, is often to blame here. If this symptom is combined with nausea, dizziness, lightheadedness, high/low blood pressure, it is better to get tested and make an appointment with a therapist or osteopath.
Burns from behind
Pain that causes a burning sensation in the back is very dangerous. If the back of the neck burns, radiating to the head, this is a complication of spinal stenosis. It leads to compression of the spinal cord and the occurrence of cervical myelopathy. This is caused by thickening of the spinal ligaments, bulging discs, and bone spines. In some cases, pain is completely absent, leaving only an unpleasant burning sensation.
Acute pain
This type of cervicalgia indicates that the disease has not yet become chronic. It may appear for a short time and go away, but even this should alert a person. Causes: injuries, pinched nerves, spondylosis, ankylosing spondylitis, herniated discs, meningitis. If acute pain in the neck recurs every day after work, it is worth thinking about how to organize work so that the cervical spine does not experience tension.
It hurts constantly
Constant pain for 3 months or more is classified as an independent disease. They can continue for a long period, and if the patient is not examined and continues to suppress attacks with antispasmodic tablets and creams, then sooner or later they will become chronic. Any disease goes into this form and cannot be treated, but there are drugs that alleviate the condition for a long period.
Sharp pain
A sharp or shooting pain occurs suddenly, it is short-lived, it is quickly forgotten, but it is a harbinger of many diseases. Here you need to pay attention to where the return occurs. Unpleasant sensations radiating into the arm indicate that you need to be examined for cervical radiculitis and osteochondrosis. The diseases are similar in symptoms because the second often follows the first. When irradiation occurs in the arm or chest, we are talking about an acute muscle spasm or cervicago (lumbago).
Lomit
Aches and numbness in the cervical region are characteristic of all forms of osteochondrosis. If symptoms occur, you can try self-massage, it helps a lot. However, in case of recurrence, the appearance of headaches, or a return to the heart area when the neck hurts, you need to urgently call a doctor. This is one of the signs of a heart attack, and this disease is not to be joked about.
Severe pain
The degree of pain is determined by each patient individually; in any case, severe pain in the neck cannot be tolerated. These symptoms indicate the likelihood of diseases: ankylosing spondylitis, rheumatoid arthritis, rheumatoid polymyalgia (focuses in the shoulders). If the neck is still swollen, then you need to conduct an examination to determine if there are any tumors in the cervical spine. They are confirmed extremely rarely, but you need to know about them. The easiest way is to take a blood test in expanded form.
Whining from behind
Aching sensations, which you often don’t want to pay attention to, are not so safe. They are cause for concern. The cause may be the onset of exacerbation of a chronic disease, or nervous strain. The second factor begins after any experience. When the back of your neck hurts, in most cases it is better to relax, give a light massage, and take a sedative.
How to get rid of the problem
A large number of ailments that cause such sensations have given rise to many ways to combat it. To understand how to relieve neck pain, you first need to undergo an examination or at least go to see a doctor. Specialists dealing with cervical diseases:
- therapist;
- neurologist;
- rheumatologist;
- traumatologist;
- orthopedist;
- osteopath.
It is not necessary to go through all the doctors at once; it is much more important to correctly describe the sensations that are bothering you. It is often possible to relieve pain after following some medical recommendations at home:
- Do gymnastics with an instructor or according to a specially designed program, without overloading your neck.
- In cold weather, wear a scarf and avoid drafts to avoid catching a cold or getting sick.
- Stop smoking, it harms blood vessels and blood supply.
- Choose a comfortable pillow and a firm mattress for sleeping.
- Do not make sudden movements.
- Do not be nervous.
- Take antispasmodics during an attack.
- Explore folk remedies such as compresses and decoctions, but use only after consulting a doctor.
In some cases, surgery is required, although neck pain is more often treated with physical therapy, acupuncture and massage. For each type, there are different diagnostics with or without equipment. Thus, CT, MRI, digital X-ray of the cervical spine determine complex inflammatory diseases and their concentration. Thanks to this, treatment begins at an early stage.
When stress first manifests itself through neck pain one day, a clear physical consequence can quickly be felt. The muscles are tense, and as a result, pain in the back of the head or headache appears. Stress and neck tension are often related. We will explain to you the reason and show you exercises that really help.
A typical accompanying phenomenon of long-term stress is muscle tension. This is especially true for the shoulder and neck area. If you add to this a draft or poor posture, the experience of pain in the shoulders and back of the head will come even faster.
Strained neck due to stress: find out the reasons
If you often suffer from neck muscle tension, you urgently need to be examined by a doctor. In addition to stress, the cause of your pain can be a herniated disc.
If such physiological causes are excluded and it is determined that the neck pain is a consequence of your experiences, the doctor will prescribe you medications against these acute pains. As a rule, this drug is Diclofenac. Psychotherapy, such as massage or therapeutic exercises, is then usually prescribed.
In addition to professional treatment prescribed by a specialist, there are many things you can do yourself to relieve neck tension.
Tight neck muscles due to stress: long-term relief with PMR
The most effective is the continuous elimination of the triggering stimulus of tension. If stress is the cause of your neck pain, you should especially pay attention to progressive muscle relaxation. This technique actively relaxes your muscles and reduces your overall stress levels.
Tight neck muscles due to stress: current help
If your muscles are tense, the first step is to warm them up. Try this with
- hot bath
- warm water bottles
- grain pillow, which should be heated in the microwave or oven
- a wet scarf, which should also be heated in the microwave and placed on top of a dry scarf on the back of the head
- warming ointment (please talk to your pharmacist). Heat promotes blood flow to the muscles. This increases energy supply and regeneration capacity.
Please note that in addition to stress, you do not aggravate the situation with your neck by poor posture.
- If your job involves a sedentary lifestyle, you should get up and take a few steps more often. When you hold your body position correctly, the neck muscles also straighten.
- Always watch your back when you are sitting. Loads on the spine also lead to tension in the neck muscles.
- Sit back when you have the opportunity. This not only stretches the muscles, but also prevents stress.
- Work on relaxing your muscles by doing stretching exercises.
- Sit up straight, stretch your neck and in this position lower your chin to your chest.
- Drop your shoulders down and tilt your head (do not twist it) towards one or the other shoulder so that you feel your neck stretching.
You will find more exercises against tension in the back of the head and neck in the second part of the series “
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