In medicine, neck pain is commonly called cervicalgia.According to the results of numerous screening studies, between 12% and 72% of people of working age occur throughout the year.This means that the sensationsfamiliar to almost everyone.In 1.7-11.5% of people, neck pain ultimately leads to disability.Let's find out its most common causes and treatment methods.
Classification of neck pain.
All neck pain is divided into acute and chronic.The first arise suddenly and have a pronounced character.They usually appear after hypothermia, intense physical activity, or lifting heavy objects.Chronic pain bothers a person constantly, over a long period of time.They are mild, painful, and worse after sitting or sleeping for a long time in an uncomfortable position.
Depending on locationPain can be visceral, superficial somatic and deep..The first occurs due to damage to internal organs.Visceral (referred) pain may indicate sore throat, diseases of the esophagus or pharynx, acute thyroiditis, dissection of the vertebral or carotid arteries.
Superficial somatic pain occurs in the skin due to minor injuries or scratches, while deep pain is located in the tissues.The cause of the latter is usually a muscle strain or a pathology of the spine.
How to distinguish visceral pain from somatic pain?The first are diffuse in nature, that is, a person cannot determine their exact location: they radiate to other parts of the body, accompanied by nausea, vomiting, dizziness, fever, etc.
In 2008, the Neck Pain Task Forse proposed the following:stages of neck pain:
- The patient has no symptoms that indicate structural abnormalities.A person's daily activity is not limited and does not require additional examinations or treatments.This neck pain disappears after a minimal lifestyle correction.
- The person has no signs of serious structural damage to the spine or cervical organs, but their daily activities are slightly affected.Sometimes the patient needs pain relievers.To avoid losing your ability to work, you need lifestyle changes and special exercises.
- The person does not present signs of serious organic damage, but does present neurological symptoms.The patient needs additional examination and comprehensive treatment of the identified pathology.
- The patient notices the appearance of signs of organic changes.You are concerned about severe pain in the neck, which usually indicates injuries, tumors, myelopathies, systemic diseases, etc.The patient requires a thorough examination and specialized treatment.
In the neck, pain can be central and neuropathic.Cervicalgia of central origin occurs with meningitis, acute strokes, head trauma, increased intracranial pressure, and intracerebral tumors.Neuropathic pain appears due to impingement of spinal roots, tunnel neuropathies, traumatic nerve injuries, polyneuropathy, multiple sclerosis, etc..
Main causes of neck pain.
Pain in the neck area can appear occasionally or bother a person every day.Periodic neck pain, which occurs every few months, is usually harmless and does not indicate any pathology.They pass quickly after adequate rest or the use of anesthetic ointment.
But constant or sudden and severe pain in the neck should cause serious concern in a person.
Table 1. Main reasons
| Cause | Mechanism of development of pain syndrome. | Characteristic signs of pathology. |
|---|---|---|
| Hard work or training in the gym. | The formation of large amounts of lactic acid in the muscles.It is this substance that causes pain. | The pain appears the next morning after intense physical activity.The unpleasant sensations intensify when you move your arms or turn your head.It leaves in a few days |
| Hypothermia | Development of neuralgia - pain in the zone of innervation of the occipital nerves. | Usually a person feels pain under the ear, in the neck and at the back of the head.In most cases, occipital neuralgia is unilateral: the pain appears on only one side. |
| Psychosomatics | Formation of muscle blocks - spastic contractions of the muscles of the neck and shoulder girdle. | A person has neck pain for no apparent reason.With a complete examination, doctors cannot detect signs of damage to the spine or diseases of internal organs. |
| Pathological biomechanics of the shoulder girdle. | Alteration of the normal functioning of the muscles of the girdle of the upper limb.Strain and spasm of the trapezius muscle. | Mild impairment of mobility in the shoulders and cervical spine.Aching pain that intensifies after sitting for a long time in the same position or doing physical work. |
| Cervical osteochondrosis | The appearance of pathological changes in one or more spinal motion segments.Impairment of spinal mobility, development of myofascial pain syndromes and pinching of the spinal roots. | Pain, paresthesia and motor alterations in the cervical region, which extend to the neck and upper extremities.Detection of characteristic changes in the spine using MRI and X-rays (osteophytes, decreased distance between vertebrae, signs of damage to the intervertebral joints) |
| Cervicobrachial radiculitis | Development of an inflammatory process in the nerves that form the brachial plexus. | Acute unilateral pain that radiates to the upper limb.The patient complains of burning sensation and numbness in the hands and neck.Unpleasant symptoms occur after hypothermia or intense physical work. |
| acute thyroiditis | Formation of inflammatory or purulent foci in the thyroid gland with subsequent development of pain syndrome. | Acute pain and swelling in the thyroid area.On palpation, a nodular, painful, enlarged thyroid gland may be felt. |
| Colds and infectious diseases. | Inflammation of the mucosa of the pharynx, larynx, trachea due to inhalation of cold air or under the influence of infectious factors. | The appearance of pain and sore throat, headache, runny nose, increased body temperature.General weakness, apathy, decreased ability to work. |
| Burns of the pharynx or esophagus. | Exposure to the mucous membrane of chemicals, high or low temperatures with further development of the inflammatory process. | Intense pain along the esophagus, which intensifies when swallowing. |
| Tension headaches | Constant overstrain of the muscles of the shoulder girdle, frequent stress, depression. | Diffuse painful pain in the head, radiating to the cervical region. |
| subarachnoid hemorrhage | Irritation of the brain membranes from blood spilling into the subarachnoid space. | Sharp pain in the back of the head, reminiscent of a blow to the head. |
| multiple sclerosis | Damage to myelin fibers of the brain and spinal cord with further development of neurological symptoms. | Sudden pain in the neck, which radiates to the spine.The patient himself describes his sensations as “electric shock.” |
| Tumors of the spine, lungs and neck organs. | Compression of tissue, nerves or organs by a malignant neoplasm. | Aching pain that persists for a long time.If you have tumors of the pharynx or esophagus, a person has difficulty swallowing food. |
| Inflammation of the lymph nodes. | Development of the inflammatory process in the lymph nodes in response to infection, hypothermia, etc. | Painful sensations on the sides of the neck.When palpating along the sternocleidomastoid muscle, you may feel enlarged and painful lymph nodes. |
Overwork or hypothermia
If your neck hurts after training, physical activity, or prolonged monotonous work, muscle strain is to blame.Intense physical activity leads to the formation of lactic acid, which causes severe pain.The discomfort disappears completely after 3-4 days.
Neck pain radiating to the ear may occur after hypothermia..Due to the effect of low temperature, neuralgia of the occipital nerve develops.The pathology is characterized by paroxysmal, stabbing, burning pain in the back of the head.The pathology can be unilateral or bilateral.
Some people often have neck pain after sleeping.The reason for this may be the wrong choice of pillow.However, painful sensations can also indicate cervical osteochondrosis.Therefore, if your neck hurts after sleeping, the first thing you should do is change your pillow.If the pain does not disappear, it is necessary to go to a traumatologist or vertebrologist.
psychosomatic pain
If you constantly have neck pain for no apparent reason, it may be due to psychosomatic problems.Muscle blocks can occur due to repressed emotions, stubbornness, and one-sided thinking.People with psychosomatic cervicalgia regularly experience pain and tension in the muscles of the cervical spine, but doctors cannot find out the cause of this phenomenon even after a thorough examination.
Recent scientific research has established a relationship between personality characteristics and the appearance of vertebrogenic neck pain.As it turned out, increased anxiety and aggressiveness contribute to the development of cervical osteochondrosis.The discovered relationship can be used for more effective treatment of vertebrogenic pain in the shoulders and neck in people with neuroses or neurosis-like diseases.
Violation of the biomechanics of the shoulder girdle.
The reason why your neck and shoulders hurt may be due to improper functioning of the muscles of the shoulder girdle.Functional weakness of the deltoid and overload of the trapezius muscles cause the appearance of myofascial trigger points, which cause the development of pain.At first, there is pain in the neck muscles, but over time organic changes develop in the spine.
Inadequate load distribution on the muscles of the shoulder girdle is a common cause of neck pain.It is necessary to eliminate the cause of the pathologies, that is, restore normal biomechanics in the waist of the upper limb.To achieve this, you must carefully monitor your posture and perform special exercises.
Osteochondrosis of the spine and its complications.
Does your neck and spine between your shoulder blades constantly hurt?This may be a sign of the development of osteochondrosis of the cervical spine.The pathology is characterized by the gradual destruction of the nuclei of the intervertebral discs with the subsequent development of protrusions, hernias, spondyloarthrosis and cervical spondylosis.
Characteristic signs of osteochondrosis:
- pain in the neck muscles, neck area;
- numbness in the back of the head;
- limited mobility in the cervical spine;
- sensory alterations in the upper extremities;
- slight weakness in the arms;
- tinnitus, frequent dizziness, headaches.
A person with osteochondrosis not only has pain in the spine, in the neck area.Due to reflex muscle tension, myofascial pain syndromes develop.They are characterized by the appearance of pain, paresthesia and a sensation of numbness in the muscles of the back, shoulder girdle and upper limb.
In the initial stages, osteochondrosis is detected using MRI..Subsequently, the pathology can be diagnosed by x-ray.On x-rays of the cervical spine, a decrease in the distance between the vertebrae, pathological changes in the facet joints and osteophytosis are noted.
Many people complain that they cannot turn their neck due to severe pain that occurs after suddenly lifting something heavy.This phenomenon indicates the formation of a herniated disc.The cause of pain in the back, neck and upper extremities is the pinching of one of the nerve roots emerging from the spinal cord.
Cervicobrachial radiculitis
The disease is characterized by inflammation of the spinal nerves involved in the formation of the brachial plexus.The cause of the inflammatory process may be acute intoxication, hypothermia, pinching of a nerve root by spasmodic muscles,intervertebral hernias or osteophytes.
People with sciatica experience severe pain in the neck, neck, shoulders, and even upper extremities..Painful sensations occur acutely and have a burning character.Many people complain of a feeling of numbness in the back of the head, tingling in the arm, sensory and motor disturbances in the upper extremities.
What to do if your neck hurts, it hurts to turn your head, it's hard to move your arm?Seek medical attention immediately.Cervicobrachial radiculitis requires serious treatment that you cannot provide yourself.
Thyroid diseases
Most thyroid pathologies are not accompanied by pain.And only people with acute thyroiditis (inflammation of the thyroid gland) feel pain in the front of the neck.Patients also experience increased body temperature, chills, general weakness, body aches and other signs of poisoning.With a more thorough examination, you may feel an enlarged and painful thyroid gland.In some cases, several dense infiltrates are found.
Many people have neck pain after a diagnostic puncture of the thyroid gland.The unpleasant sensations persist for several days.The cause of the pain is trauma to the soft tissues during the procedure.
Inflammatory diseases of the cervical organs.
In inflammatory diseases of the pharynx and larynx, a person usually has a sore throat, and the lymph nodes in the neck become swollen.The cause of the pathology can be hypothermia, infections, consumption of low-quality alcohol or accidental contact with the mucous membranes of chemicals.Damage to the pharynx, larynx, or esophagus is indicated by neck pain that worsens when swallowing..
Diseases that cause neck and throat pain:
- pharyngitis;
- laryngitis;
- angina pectoris;
- diphtheria;
- infectious mononucleosis;
- scarlet fever;
- epiglottitis;
- pharyngeal abscess;
- Chemical burn of the esophagus.
The sides of your throat and neck hurt most often when you have a cold.The causes of the disease are hypothermia, sudden inhalation of cold air or a long walk in the cold.A good rest, hot tea and some analgesic pills help to cope with the disease.
If you have a sore throat in the lower part of your neck, you should suspect pharyngitis or tracheitis (inflammation of the larynx or trachea).The development of diseases is provoked by a viral infection, inhalation of hot, cold or contaminated air.If your throat and neck hurt, it may be a retropharyngeal abscess.The pathology is characterized by fever, difficulty swallowing, loss of appetite, general weakness and apathy.
Damage to the central or peripheral nervous system.
Severe pain occurs with subarachnoid hemorrhages.The person himself describes them as a “blow to the head” and a throbbing sensation in the back of the neck.The patient develops nausea, vomiting, confusion, and meningeal signs.Neck stiffness appears about 6 hours after the first pain appears.
Meningitis has a similar clinical picture..A person with inflammation of the meninges has very severe head and neck pain.Painful sensations intensify with movement.During the examination, tension is detected in the patient's occipital muscles.Because of this, a person cannot bring his chin to his chest even with external help.At the same time, a characteristic rash appears on the patient's body.
Neck pain can be caused by damage to the spinal cord or peripheral nerves, tumors of the central nervous system, demyelinating diseases, etc.All these diseases have a polymorphic clinical picture and pain is one of the symptoms of the pathology.
Pain in the back and spine may be one of the first signs of multiple sclerosis, a demyelinating disease of the central nervous system.People with this pathology develop the so-called Lhermitte symptom.It is characterized by a sensation of electric shock in the back of the head that occurs when the head is tilted forward.
Malignant or benign neoplasms
Various tumors of the cervical spine, pharynx, esophagus, thyroid gland, or other organs can also cause pain.Pain can also occur in people with Pancoast cancer, a malignancy located subpleurally at the apex of the lung.
muscle damage
In some cases, the lateral neck muscles hurt in people with myositis, polymyalgia, and fibromyalgia.These diseases are characterized by damage to skeletal muscles of any location.If a person notices tenderness in the lateral neck muscles for no apparent reason, they may have one of these diseases.
If the muscles in the front of your neck near the voice box hurt, think about whether you recently had to shout loudly, sing loudly, or talk for a long time.Then the cause of the discomfort is the overstrain of the vocal cords.
Other possible causes of neck pain
Pain in the left side of the chest and collarbone, extending to the neck, usually indicates heart disease.In people with a similar pain syndrome, angina, arrhythmias, heart failure or heart attack are detected.
The sides of the neck may hurt in people with cavities, diseases of the oropharynx or nasopharynx.Unpleasant sensations may occur with tonsillitis, inflammation of the tonsils.If pain is noted in the shoulders near the neck, this may be a result of scoliosis of the cervical and/or thoracic spine.
Why do the lymph nodes in the neck hurt?
Cervical lymph nodes are located on the sides of the neck, along the sternocleidomastoid muscle.They are usually small in size and can be difficult to feel.However, in some cases, the lymph nodes in the neck may become enlarged and cause pain.This phenomenon should be alarming, as it can indicate serious diseases and even malignant tumors.
Most often, pain in the lymph nodes of the neck is due to their inflammation (lymphadenitis).Pathology develops against the background of tonsillitis, rhinitis or acute respiratory viral infection..The reason may be its damage from metastasis of tumors of the pharynx, esophagus, lungs or other organs.
Signs of cervical lymphadenitis:
- enlarged lymph nodes.In some cases, its size can increase to 2-3 centimeters or more;
- the appearance of hyperemia and edema.Lymphadenitis is usually accompanied by redness of the skin and swelling in the area of swollen lymph nodes;
- painful sensations.A person has pain behind the ear and neck on one or both sides.It may be difficult for the patient to turn his head and make active shoulder movements;
- poisoning symptoms.The body temperature rises, chills, general weakness, apathy and headaches appear.Intoxication phenomena appear in the acute form of lymphadenitis.
Cervical lymph nodes can become swollen after a long stay in a draft.Most often, pain is felt in the ear and under the ear in the neck.Slightly enlarged and painful lymph nodes can be felt under the patient's skin.
Are the lymph nodes in your neck swollen and painful, but you don't know what to do?It is best to go to the doctor immediately.The specialist will carefully examine you and prescribe additional tests.After passing the necessary tests, you can find out the cause of the pathology.
Reasons why the head and neck hurt more often
According to statistics, 70% of people with frequent headaches (cephalgia) feel pain not only in the head, but also in the cervical region.Cervicalgia can be caused by the irradiation of painful sensations or have a vertebrogenic nature.Many men and women with osteochondrosis have neck pain that radiates to the head.Among all headaches, 15-20% are cervicogenic in nature.
Reasons why a person has pain in the neck, head and temples:
- overwork;
- impaired blood circulation in the brain tissue;
- diseases of the cervical spine;
- inflammation of the paranasal sinuses;
- hypertension;
- heart disease;
- menopause period;
- migraine;
- overstrain of the muscles of the shoulder girdle.
The most common type of headache is tension-type headache (TTH).It occurs due to mental stress, intense mental activity or prolonged spasms of the muscles of the neck, back and waist of the upper extremities.For tension headaches, neck massage, reflexology, and brief use of pain relievers may be helpful.
If you frequently experience neck pain and dizziness, don't hesitate to get treatment.Massage of the cervical collar area and acupuncture can help deal with tension headaches.If you continue to feel pain after a massage, you need a complete examination.Perhaps behind a banal headache lies a serious problem.
What are the reasons for a child's neck pain?
A baby's sore throat occurs with sore throat, acute respiratory viral infections, rubella, mumps, meningitis and some other infectious diseases.If a child has neck pain on only one side, the cause may be otitis media, retropharyngeal abscess, lymphadenitis, or trauma.
Speaking of childhood diseases, it is worth mentioning torticollis.The pathology is characterized by a congenital shortening of the sternocleidomastoid muscle.Due to the defect, the baby's head adopts a forced position.It is constantly rotated upward and in the opposite direction to the defective muscle.A child with torticollis also has pain on one side of the neck.The main reason for this is constant muscle tension.
To do?Immediately take your baby and go to the hospital..Timely seeking medical help will help to identify the problem in time and start treatment.
Which doctor should I contact?It is best to go to the pediatrician first.After the examination, the pediatrician will make a diagnosis and prescribe treatment or refer you for consultation with a specialist.
How to relieve acute neck pain
Some people, after hypothermia or lifting heavy objects, complain: “My neck hurts, I can't turn my head…”.This symptom indicates acute inflammation of the spinal roots or neuralgia of the occipital nerve.If such pain occurs, a doctor should always be consulted.
To relieve pain, you can use pills, gels, or a patch.In this case, it is best to use non-steroidal anti-inflammatories, corticosteroids or warm ointments.Dry heat (a heating pad, a bag of sand, or hot cereal) also has a good effect.
Don't know which doctor to go to if you experience unbearable neck pain?Since this neck pain usually indicates inflammation or pinched nerves, it is best to see a neurologist immediately.He will prescribe appropriate treatment and, if necessary, perform a pharmacological blockade.Injectable corticosteroids can relieve pain quickly and effectively.
How to treat vertebrogenic neck pain
Neck pain is treated by an orthopedic traumatologist or a vertebrologist.After injuries and operations in the cervical region, doctors prescribe the patient to wear a Shants collar.Pain relievers and muscle relaxants are used to relieve pain.To relieve muscle spasms and restore normal biomechanics of the shoulder girdle, experts recommend a series of exercises.Therapeutic gymnastics allows you to develop muscles and restore normal mobility of the spine.
Which doctor should you go to if your neck hurts during pregnancy?First of all, you should visit your treating gynecologist.He will examine you and send you for consultation with a specialist who will prescribe the appropriate treatment.