In medicine, neck pain is commonly called cervicalgia.According to the results of numerous screening studies, throughout the year they occur in 12-72% of people of working age.This means sensationsfamiliar to almost every person.In 1.7-11.5% of people, neck pain ultimately leads to disability.Let's find out their most common causes and treatment methods.
Classification of cervical pain
All neck pain is divided into acute and chronic.The former arise suddenly and have a pronounced character.They usually appear after hypothermia, strenuous physical activity, or heavy lifting.Chronic pain bothers a person constantly, for a long period of time.They are mild, painful, and worsen after prolonged sitting or sleeping in an uncomfortable position.
Depending on the locationthe pain can be visceral, superficial somatic and deep.The first occurs due to damage to internal organs.Visceral pain (referred) may indicate sore throat, disease of the esophagus or pharynx, acute thyroiditis, dissection of the vertebral or carotid arteries.
Superficial somatic pain occurs on the skin due to injuries or small scratches, while deep pain is localized 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 former are of a diffuse nature, that is, a person cannot determine their exact localization: they radiate to other parts of the body, accompanied by nausea, vomiting, dizziness, fever, etc.
In 2008, the Neck Pain Task Maybe proposed the following:stages of cervicalgia:
- The patient has no symptoms indicating structural abnormalities.A person's daily activity is not limited and does not require further testing or treatment.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 his daily activities are slightly impaired.The patient sometimes needs painkillers.To prevent loss of working capacity, he needs lifestyle changes and special exercises.
- The person shows no signs of serious organic damage, but neurological symptoms are present.The patient requires additional examination and comprehensive treatment of the identified pathology.
- The patient notes the appearance of signs of organic changes.He is concerned about severe pain in the neck, which most often indicates injuries, tumors, myelopathies, systemic diseases, etc.The patient requires serious examination and specialized treatment.
In the neck, pain can be central and neuropathic.Neck pain of central origin manifests itself with meningitis, acute cerebrovascular accidents, head trauma, increased intracranial pressure and intracerebral tumors.Neuropathic pain appears due to crushed 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 often harmless and does not indicate any pathology.They pass quickly after adequate rest or the use of an anesthetic ointment.
But constant pain or sudden 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 occurs the next morning after intense physical activity.The unpleasant sensations intensify when you move your arms or turn your head.He's leaving in a few days |
| Hypothermia | Development of neuralgia – pain in the area 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 only on one side |
| Psychosomatics | Formation of muscle blocks - spastic contractions of the muscles of the neck and shoulder girdle | A person has a sore neck for no apparent reason.With a comprehensive examination, doctors are unable to detect signs of damage to the spine or diseases of internal organs |
| Pathological biomechanics of the shoulder girdle | Disruption of the normal functioning of the girdle muscles of the upper extremities.Stretching and spasm of the trapezius muscle | Mild impairment of shoulder and cervical spine mobility.Aching pain that intensifies after sitting in the same position for a long time or doing physical work |
| Cervical osteochondrosis | The appearance of pathological changes in one or more spinal motion segments.Impaired spinal mobility, development of myofascial pain syndromes and pinching of spinal roots | Pain, paresthesia and motor disturbances in the cervical region, extending to the back of the head and upper limbs.Detection of characteristic changes in the spine on MRI and x-rays (osteophytes, decrease in the distance between the vertebrae, signs of damage to the intervertebral joints) |
| Cervicobrachial radiculitis | Development of an inflammatory process in the nerves that form the brachial plexus | Sharp unilateral pain radiating to the upper limb.The patient complains of a burning sensation and numbness in the hands and back of the head.Unpleasant symptoms occur after hypothermia or heavy physical work |
| Acute thyroiditis | Formation of inflammatory or purulent foci in the thyroid gland with subsequent development of pain syndrome | Sharp pain and swelling in the thyroid area.An enlarged, painful, nodular thyroid gland may be felt on palpation |
| 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, reduced working capacity |
| Burns of the pharynx or esophagus | Exposure to the mucosa of chemicals, high or low temperatures with further development of the inflammatory process | Severe pain along the esophagus, which intensifies when swallowing |
| Tension headache | Constant overstrain of the shoulder girdle muscles, frequent stress, depression | Diffuse, aching pain in the head, radiating to the cervical region |
| Subarachnoid hemorrhage | Irritation of the membranes of the brain caused by blood spilling into the subarachnoid space | Sharp pain in the back of the neck, reminiscent of a blow to the head |
| Multiple sclerosis | Damage to the myelinated fibers of the brain and spinal cord with further development of neurological symptoms | Sudden pain in the neck, radiating to the spine.The patient himself describes his sensations as “electric shock” |
| Tumors of the spine, lungs, neck organs | Compression of tissues, nerves or organs by a malignant neoplasm | Aching pain that persists for a long time.If you have tumors in 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 swollen 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 can occur after hypothermia.Due to the effect of low temperature, neuralgia of the occipital nerve develops.The pathology is characterized by paroxysmal, stabbing and 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 to do is change your pillow.If the pain does not go away, you need to go to a traumatologist or vertebrologist.
Psychosomatic pain
If you constantly suffer from neck pain for no apparent reason, it may be due to psychosomatic factors.Muscle blocks can occur due to repressed emotions, stubbornness, and one-sided thinking.People suffering from psychosomatic neck pain regularly feel pain and tension in the muscles of the cervical spine, but doctors are unable to discover the cause of this phenomenon even after a thorough examination.
Recent scientific research has established a relationship between personality characteristics and the onset of vertebrogenic neck pain.As it turned out, increased anxiety and aggression contribute to the development of cervical osteochondrosis.The discovered relationship can be used for more effective treatment of vertebrogenic shoulder and neck pain in people with neurosis 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 shoulder girdle muscles.Functional weakness of the deltoid and overload of the trapezius muscles lead to the appearance of myofascial trigger points, which cause the development of pain.Initially, pain is felt in the neck muscles, but over time, organic changes develop in the spine.
A common cause of neck pain is improper distribution of the load on the muscles of the shoulder girdle.It is necessary to eliminate the cause of the pathologies, that is, to restore the normal biomechanics of the upper limb girdle.To achieve this, you need to 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, collar area;
- numbness in the back of the head;
- limited mobility in the cervical spine;
- sensory disorders in the upper limbs;
- slight weakness in the arms;
- tinnitus, frequent dizziness, headache.
A person with osteochondrosis not only has spinal pain in the neck area.Due to reflex muscle tension, myofascial pain syndromes develop.They are characterized by the appearance of pain, paresthesia and sensation of numbness in the muscles of the back, shoulder girdle and upper limbs.
In the early stages, osteochondrosis is detected by MRI.Subsequently, the pathology can be diagnosed by x-ray.On radiographs of the cervical spine, a decrease in the distance between the vertebrae, pathological changes in the facet joints and osteophytosis become evident.
Many people complain of not being able to turn their neck due to the severe pain that appears 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 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 can 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, back of the head, shoulder, and even upper limb.Painful sensations occur sharply and have a burning character.Many people complain of a feeling of numbness in the back of the head, crawling on the arm, sensory and motor disturbances in the upper limb.
What to do if your neck hurts, it hurts to turn your head, it's difficult to move your arm?Contact your doctor immediately.Cervicobrachial radiculitis requires serious treatment, which you cannot provide on your own.
Thyroid diseases
Most thyroid conditions are not accompanied by pain.And only people with acute thyroiditis (inflammation of the thyroid gland) experience pain in the front of the neck.Patients also experience increased body temperature, chills, general weakness, muscle pain and other signs of intoxication.With closer examination, you may feel an enlarged and painful thyroid gland.In some cases numerous dense infiltrates are found.
Many people experience neck pain after a diagnostic puncture of the thyroid gland.The unpleasant sensations persist for several days.The cause of the pain is soft tissue trauma during the procedure.
Inflammatory diseases of the cervical organs
With inflammatory diseases of the pharynx and larynx, a person often has a sore throat, and the lymph nodes in the neck become inflamed.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;
- diphtheria;
- infectious mononucleosis;
- scarlet fever;
- epiglottitis;
- pharyngeal abscess;
- chemical burn of the esophagus.
The sides of your throat and neck hurt more 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.Good rest, hot tea and some analgesic tablets help to cope with the disease.
If you have a sore throat in the lower 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 polluted air.If the throat and back of the neck hurt, a retropharyngeal abscess is possible.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 “thrust in the head” and a throbbing sensation in the back of the head.The patient develops nausea, vomiting, confusion, and meningeal signs.Neck stiffness develops about 6 hours after the first pain appears.
Meningitis has a similar clinical picture..A person with inflammation of the meninges experiences very intense pain in the neck and head.Painful sensations intensify with movement.During the examination, tension in the occipital muscles is detected in the patient.For this reason, a person cannot bring his chin to his chest even with outside 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, central nervous system tumors, demyelinating diseases, etc.All these diseases have a polymorphic clinical picture and pain is one of the symptoms of the pathology.
Back and spinal pain may be one of the first signs of multiple sclerosis, a demyelinating disease of the central nervous system.People with this condition develop the so-called Lhermitte symptom.It is characterized by an electric shock sensation in the back of the neck that occurs when the head is tilted forward.
Malignant or benign tumors
Various tumors of the cervical spine, pharynx, esophagus, thyroid, or other organs can also cause pain.Pain can also occur in people with Pancoast cancer, a malignant neoplasm located subpleurally in 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 at any location.If a person notices tenderness in the neck muscles on one side for no apparent reason, he or she may have one of these diseases.
If you have pain in the muscles at the front of your neck, near the larynx, think about whether you have recently had to shout loudly, sing loudly, or talk for a long time.So the cause of the discomfort is the overload of the vocal cords.
Other possible causes of neck pain
Pain on the left side of the chest and collarbone, extending to the neck, usually indicates heart disease.In people with a similar pain syndrome, angina pectoris, arrhythmias, heart failure or heart attack are detected.
The sides of the neck can hurt in people with tooth decay, diseases of the oropharynx or nasopharynx.Unpleasant sensations can occur with tonsillitis - inflammation of the tonsils.If you notice shoulder pain near the neck, this may be a consequence of scoliosis of the cervical and/or thoracic spine.
Why do the lymph nodes in the neck hurt?
The cervical lymph nodes are located on the sides of the neck, along the sternocleidomastoid muscle.They are normally small in size and can be difficult to feel.However, in some cases, the lymph nodes in the neck can become enlarged and painful.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 occurs due to their inflammation (lymphadenitis).Pathology develops against the background of tonsillitis, rhinitis or acute respiratory viral infection.The reason may be their damage from metastasis of tumors of the pharynx, esophagus, lungs or other organs.
Signs of cervical lymphadenitis:
- swollen lymph nodes.In some cases their size can reach 2-3 or more centimeters;
- the appearance of hyperemia and edema.Lymphadenitis is usually accompanied by redness of the skin and swelling in the area of the inflamed 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 the head and perform active shoulder movements;
- symptoms of intoxication.Increased body temperature, chills, general weakness, apathy and headache appear.Intoxication phenomena appear in the acute form of lymphadenitis.
Cervical lymph nodes can become inflamed after a long stay in a draft.Most often, pain is felt in the ear and under the ear on the neck.Slightly swollen and painful lymph nodes can be felt under the patient's skin.
Are your 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 further tests.After passing the necessary tests, you can find out the cause of the pathology.
Reasons why your head and neck hurt more often
According to statistics, 70% of people with frequent headaches (cephalgia) experience pain not only in the head, but also in the cervical region.Neck pain can be caused by the irradiation of painful sensations or have a vertebrogenic nature.Many men and women with osteochondrosis suffer from 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;
- overload of the shoulder girdle muscles.
The most common type of headache is tension-type headache (TTH).It occurs due to mental stress, heavy mental activity or prolonged spasm of the muscles of the neck, back and girdle of the upper extremities.For tension headaches, neck massage, foot reflexology, and short-term use of pain relievers may be helpful.
If you often suffer from neck pain and dizziness, don't hesitate to seek treatment.Massage of the cervical neck area and acupuncture can help cope with tension-type headaches.If after a course of massage you continue to feel pain, you need a complete examination.Perhaps behind a trivial headache lies a serious problem.
What are the reasons for neck pain in a child?
A child's sore throat is manifested by 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, we should mention stiff neck.The pathology is characterized by a congenital shortening of the sternocleidomastoid muscle.Due to the defect, the baby's head assumes a forced position.It is constantly pointing up and away from the defective muscle.A child with stiff neck also feels pain on the side of the neck.The main reason for this is constant muscular effort.
What to do?Take your baby immediately and go to the hospital.Timely seeking medical help will help identify the problem in time and begin treatment.
Which doctor should I contact?It is better to go to the pediatrician first.After the examination, the pediatrician will make a diagnosis and prescribe treatment or send you for a consultation with a specialist.
How to relieve acute neck pain
Some people, after hypothermia or after 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, you should always consult a doctor.
To relieve pain, you can use compresses, gel or a patch.In this case it is better to use non-steroidal anti-inflammatory drugs, corticosteroids or warming ointments.Dry heat (a heating pad, sandbag or heated cereal) also has a good effect.
Not sure which doctor to turn to if you feel unbearable neck pain?Since such neck pain usually indicates inflammation or compression of the nerves, it is best to immediately consult a neurologist.He will prescribe appropriate treatment and, if necessary, carry out a drug block.Injectable corticosteroids can relieve pain quickly and effectively.
How to treat vertebrogenic neck pain
Neck pain is treated by an orthopedic traumatologist or vertebrologist.After injuries and operations in the cervical region, doctors prescribe the patient to wear a Shants collar.Painkillers and muscle relaxants are used to relieve pain.To relieve muscle spasms and restore normal biomechanics of the shoulder girdle, experts recommend a set of exercises.Therapeutic gymnastics allows you to develop muscles and restore normal mobility of the spine.
Which doctor should you contact if your neck hurts during pregnancy?First of all you should visit your attending gynecologist.He will examine you and send you for a consultation with a specialist who will prescribe appropriate treatment.