In medicine, neck pain is called cervicalgia. According to the results of numerous screening studies, during the year they occur in 12-72% of people of working age. This means that the sensationsfamiliar to almost everyone. . . In 1. 7-11. 5% of people, cervicalgia ultimately leads to disability. Let's find out their most common causes and methods of treatment.
Classification of cervicalgias
All painful sensations in the neck are divided into acute and chronic. The first ones appear suddenly and have a pronounced character. They usually appear after hypothermia, strenuous exercise, or heavy lifting. Chronic pain sensations bother a person constantly, over a long period of time. They are mild, have an aching character and worsen after prolonged sitting or sleeping in an uncomfortable position.
Depending on localizationpain is visceral, somatic superficial and deep. . . The first occurs due to damage to internal organs. Visceral (reflected) pain may indicate angina, diseases of the esophagus or pharynx, acute thyroiditis, dissection of the vertebral or carotid arteries.
Superficial somatic pain occurs in the skin due to trauma or small scratches, deep localized in the tissues. The reason for the appearance of the latter is usually muscle overstrain or pathology of the spinal column.
How to distinguish visceral pain from somatic pain? The former are diffuse, that is, a person cannot determine their exact localization: they radiate to other parts of the body, are accompanied by nausea, vomiting, dizziness, fever, etc.
In 2008, the Neck Pain Task Forse proposed the following:tadia cervicalgia:
- The patient has no symptoms suggesting structural abnormalities. The daily activity of a person is not limited, he does not need additional examination and treatment. Such cervicalgias disappear after minimal lifestyle correction.
- The person has no signs of serious structural damage to the spine or cervical organs, but their daily activities are slightly impaired. The patient sometimes needs pain relievers. To prevent disability, he needs a change in lifestyle, special exercises.
- The person has no signs of serious organic damage, but there are neurological symptoms. The patient needs additional examination, complex treatment of the revealed pathology.
- The patient notes the appearance of signs of organic changes. He is worried about severe soreness in the neck, which most often indicates trauma, tumors, myelopathy, systemic diseases, etc. The patient needs a serious examination and specialized treatment.
Neck pain can be central and neuropathic. Cervicalgia of central genesis occurs with meningitis, acute disorders of cerebral circulation, TBI, increased intracranial pressure, intracerebral tumors.Neuropathic pain occurs due to pinching of the spinal roots, tunnel neuropathies, traumatic nerve damage, polyneuropathies, multiple sclerosis, etc. . . .
The main causes of neck pain
Neck pain may occur occasionally or bother a person on a daily basis. Periodic cervicalgias that occur every few months are most often harmless and do not indicate any pathology. They go away quickly after a good rest or the application of an anesthetic ointment.
But constant aching or sudden severe pain in the neck should cause serious concern in a person.
Table 1. Main reasons
| Cause | The mechanism of development of pain syndrome | Characteristic signs of pathology |
|---|---|---|
| Hard work or gym workout | The formation of large amounts of lactic acid in the muscles. It is this substance that causes painful sensations. | Pain occurs the next morning after intense physical activity. Unpleasant sensations intensify with hand movements, head turns. It passes in a few days |
| Hypothermia | Development of neuralgia - pain in the area of innervation of the occipital nerves | Usually, a person has a pain under the ear on the neck and in the back of the head. In most cases, neuralgia of the occipital nerve has one-sided localization: painful sensations appear only on one side |
| Psychosomatics | Formation of muscle blocks - spastic contractions of the muscles of the neck and shoulder girdle | A person's neck hurts for no apparent reason. With a full examination, doctors fail to detect signs of spinal lesions or diseases of internal organs |
| Pathological biomechanics of the shoulder girdle | Disruption of the normal functioning of the muscles of the upper limb girdle. Overstrain and spasm of the trapezius muscle | Slight impairment of mobility in the shoulders and cervical spine. Aching pain that worsens after prolonged sitting in the same position or doing physical work |
| Cervical osteochondrosis | The appearance of pathological changes in one or more spinal motion segments. Impaired mobility of the spine, the development of myofascial pain syndromes and pinching of the spinal roots | Pain, paresthesias and movement disorders in the cervical region that extend to the back of the head and upper limbs. Detection of characteristic changes in the spine on MRI and radiographs (osteophytes, a decrease in the distance between the vertebrae, signs of damage to the intervertebral joints) |
| Cervicobrachial sciatica | Development of the inflammatory process in the nerves that form the brachial plexus | One-sided sharp pain that radiates 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 hard physical work |
| Acute thyroiditis | Formation of inflammatory or purulent foci in the thyroid gland with the subsequent development of pain syndrome | Sharp pain and swelling in the thyroid gland. On palpation, you can feel an enlarged, painful, nodular thyroid gland |
| Colds and infectious diseases | Inflammation of the mucous membrane 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, fever. General weakness, apathy, decreased ability to work |
| Burns to the throat or esophagus | Exposure to the mucous membrane of chemicals, high or low temperatures with the further development of the inflammatory process | Severe pain along the esophagus, which is worse when swallowing |
| Tension headaches | Constant overstrain of the muscles of the shoulder girdle, frequent stress, depression | Aching diffuse pain in the head, radiating to the cervical region |
| Subarachnoid hemorrhage | Irritation of the meninges of the brain with blood poured into the subarachnoid space | Sharp pain in the back of the head, reminiscent of a blow to the head |
| Multiple sclerosis | Damage to the myelin fibers of the brain and spinal cord with further development of neurological symptoms | Sudden neck pain radiating to the spine. The patient himself describes his feelings as "electric shock" |
| Tumors of the spine, lungs, neck organs | Compression of tissues, nerves, or organs by a malignant neoplasm | Aching pains that persist for a long time. With tumors of the pharynx or esophagus, a person has difficulty swallowing food |
| Inflammation of the lymph nodes | The development of an inflammatory process in the lymph nodes in response to the penetration of infection, hypothermia, etc. | Painful sensations on the sides of the neck. On palpation along the sternocleidomastoid muscle, enlarged painful lymph nodes can be felt |
Overwork or hypothermia
If your neck hurts after exercise, exercise, or prolonged monotonous work, muscle strain is to blame. Intense physical activity leads to the formation of lactic acid, which causes severe pain. The unpleasant sensations completely disappear after 3-4 days.
Neck pain that radiates to the ear may appear after hypothermia. . . Due to the action of low temperature, neuralgia of the occipital nerve develops. The pathology is characterized by paroxysmal, shooting, burning pains in the back of the head. Pathology can be unilateral or bilateral.
Some people often have neck pain after sleeping. This may be due to the wrong choice of pillow. However, painful sensations may also indicate cervical osteochondrosis. Therefore, if your neck hurts after sleeping, the first thing to do is change your pillow. If the pain syndrome does not disappear, you need to go to a traumatologist or a vertebrologist.
Psychosomatic pain
If your neck hurts constantly, for no apparent reason, it may be a matter of psychosomatics. Muscle blocks can occur due to repressed emotions, stubbornness, and one-sided thinking. In people with psychosomatic cervicalgias, the muscles of the cervical spine regularly hurt and stretch, but doctors cannot find the cause of this phenomenon even after a thorough examination.
Recent scientific research has established a relationship between personality traits and the appearance of vertebral cervicalgias. 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 that your neck and shoulders hurt may be due to improper functioning of the muscles of the shoulder girdle. Functional weakness of the deltoid and overloading of the trapezius muscles leads to the appearance of myofascial trigger points, which cause the development of pain syndrome. At first, the muscles of the neck are sore, but over time, organic changes in the spine develop.
Incorrect distribution of the load on the muscles of the shoulder girdle is a common cause of cervicalgia. It is necessary to eliminate the cause of the pathologies, that is, to restore normal biomechanics in the upper limb girdle. To achieve this, you need to carefully monitor your posture and perform special exercises.
Spinal osteochondrosis and its complications
Does the neck and spine between the shoulder blades constantly hurt? This may be a signal of the development of osteochondrosis of the cervical spine. 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.
Typical signs of osteochondrosis:
- pain in the muscles of the neck, collar area;
- feeling of numbness in the back of the head;
- limitation of mobility in the cervical spine;
- violation of the sensitivity of the upper limbs;
- slight weakness in the arms;
- tinnitus, frequent dizziness, headaches.
A person with osteochondrosis not only hurts the spine in the neck. Due to reflex muscle tension, he develops myofascial pain syndromes. They are characterized by the appearance of pain, paresthesias and feelings of numbness in the muscles of the back, shoulder girdle, and upper limb.
In the initial stages, osteochondrosis is detected using MRI. . . Later, the pathology can be diagnosed thanks to radiography. On radiographs of the cervical spine, a decrease in the distance between the vertebrae, pathological changes in the facet joints, and osteophytosis become noticeable.
Many people complain that they cannot turn their neck due to severe pain that appeared after a sharp increase in weight. A similar phenomenon indicates the formation of a herniated disc. The cause of pain in the back, neck and upper limb is a pinching of one of the nerve roots that emerge from the spinal cord.
Cervicobrachial sciatica
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 the nerve root by spasmodic muscles,intervertebral hernias or osteophytes. . .
People with sciatica have severe pain in the neck, back of the head, shoulder and even the upper limb.. . . Painful sensations arise acutely, have a burning character. Many people complain of a feeling of numbness in the back of the head, crawling on the arm, sensory and movement disorders in the upper limb.
What to do if your neck hurts, it hurts to turn your head, and it is difficult to move your arm? Seek medical attention immediately. Cervicobrachial sciatica requires serious treatment that you cannot provide for yourself.
Diseases of the thyroid gland
Most thyroid pathologies are not accompanied by painful sensations. And only in people with acute thyroiditis (inflammation of the thyroid gland), the front neck hurts. Also, patients have a rise in body temperature, chills, general weakness, body aches and other signs of intoxication. On closer examination, an enlarged and painful thyroid gland can be felt. In some cases, several dense infiltrates are found in it.
For many people, the neck hurts after a diagnostic puncture of the thyroid gland. The unpleasant sensations persist for several days. The cause of pain is trauma to soft tissues 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 lymph nodes in the neck become inflamed. The cause of the pathology can be hypothermia, infections, the use of low-quality alcohol or accidental contact with the mucous membranes of chemicals. Neck pain, worse when swallowing, indicates involvement of the pharynx, larynx, or esophagus. . .
Diseases in which the neck and throat hurt:
- pharyngitis;
- laryngitis;
- angina;
- diphtheria;
- Infectious mononucleosis;
- scarlet fever;
- epiglottitis;
- pharyngeal abscess;
- chemical burn of the esophagus.
The throat and neck on the sides are most often sore with a cold. The causes of the disease are hypothermia, sudden inhalation of cold air or a long walk in the cold. A good rest, warm tea and a few analgesic tablets help to cope with the disease.
If you have a sore throat at the bottom 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 polluted air. If the throat and neck hurts from behind, a pharyngeal abscess is possible. The pathology is characterized by an increase in temperature, 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 feeling of throbbing in the back of the head. The patient develops nausea, vomiting, confusion, meningeal signs. A stiff neck develops about 6 hours after the first pain occurs.
Meningitis has a similar clinical picture.. . . A person with inflammation of the meninges has a very bad neck and head. Painful sensations increase with movement. During the examination, the patient reveals the tension of the occipital muscles. Because of this, a person cannot bring his chin to his chest, even with outside help. Along with this, 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 painful sensations are one of the symptoms of pathology.
Back and spine pain can be one of the early signs of multiple sclerosis, a demyelinating disease of the central nervous system. In people with this pathology, the so-called Lermitte symptom appears. It is characterized by the feeling of an electric shock to the back of the head, which 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. Also, pain can occur in people with Pancost's cancer, a malignant neoplasm located subpleurally in the apex of the lung.
Muscle damage
In some cases, the lateral muscles of the neck hurt in people with myositis, polymyalgia, fibromyalgia. These diseases are characterized by damage to skeletal muscles of any localization. If a person notes soreness in the muscles of the neck from the side for no apparent reason, he may have one of these diseases.
If you have painful neck muscles in the front of your larynx, remember if you recently had to scream loudly, sing or talk for a long time. Then the cause of the discomfort is overstrain of the vocal cords.
Other possible causes of cervicalgias
Left pain in the chest and collarbone extending into the neck usually indicates heart disease. In persons with a similar pain syndrome, angina pectoris, arrhythmias, heart failure or heart attack are detected.
The neck on the sides can hurt in people with caries, diseases of the oropharynx or nasopharynx. Unpleasant sensations can occur with tonsillitis - inflammation of the tonsils. If pain is noted in the shoulders near the neck, it may be due to 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. Normally, they are small in size, but you can hardly find them. However, in some cases, the lymph nodes in the neck can grow in size and hurt. This phenomenon should be alarming, as it can indicate serious diseases and even malignant tumors.
Most often, the soreness of the lymph nodes in 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 defeat by metastases of tumors of the pharynx, esophagus, lungs or other organs.
Signs of cervical lymphadenitis:
- swollen lymph nodes. In some cases, their size can increase up to 2-3 centimeters or more;
- the appearance of hyperemia and edema. Lymphadenitis is usually accompanied by reddening of the skin and the appearance of swelling in the area of inflamed lymph nodes;
- painful sensations. A person has a pain behind the ear and neck from one or both sides at once. It is difficult for the patient to turn his head and perform active movements with his shoulders;
- symptoms of intoxication. The body temperature rises, chills, general weakness, apathy, headaches appear. Intoxication phenomena appear in the acute form of lymphadenitis.
Cervical lymph nodes can become inflamed after prolonged exposure to a draft. Most often, there is soreness in the ear and under the ear on the neck. Slightly enlarged and painful lymph nodes can be felt under the patient's skin.
Your lymph nodes in your neck have enlarged and hurt, but you don't know what to do? It is best to go to your doctor right away. The specialist will carefully examine you and prescribe an additional examination. Having passed the necessary tests, you can find out the cause of the pathology.
The reasons why the head and neck hurt most often
According to statistics, 70% of people with frequent headaches (cephalgias) have not only headaches, but also the cervical spine.Cervicalgias can be caused by irradiation of painful sensations or have a vertebrogenic nature. Many men and women with osteochondrosis have a sore neck and headache. Among all headaches, 15-20% have a cervicogenic nature.
The reasons why a person has a neck, head and temple pain:
- overwork;
- violation of blood circulation in the tissues of the brain;
- diseases of the cervical spine;
- inflammation of the paranasal sinuses;
- high blood pressure;
- heart disease;
- menopause period;
- migraine;
- overstrain of the muscles of the shoulder girdle.
The most common type of cephalalgia is tension headache (HDN). It occurs due to mental strain, severe mental activity or prolonged spasm of the muscles of the neck, back and upper limb girdle. For tension headaches, neck massage, reflexology, and a short intake of painkillers help a lot.
If you have frequent neck pain and dizziness, do not hesitate with treatment. Massage of the cervical-collar zone and acupuncture helps to cope with HDN. If, after a course of massage, you continue to feel soreness, you need a full examination. Perhaps there is a serious problem behind the banal headache.
For what reasons does the child have a neck pain?
A sore throat in a baby appears with angina, acute respiratory viral infections, rubella, mumps, meningitis and some other infectious diseases. If a child has a neck pain on only one side, the cause may be otitis media, retropharyngeal abscess, lymphadenitis, or trauma.
Speaking of childhood diseases, we should mention torticollis. The pathology is characterized by congenital shortening of the sternocleidomastoid muscle. Due to the defect, the baby's head takes a forced position. It is constantly turned up and in the opposite direction to the defective muscle. A child with torticollis also has a side pain in the neck. The main reason for this is constant muscle strain.
What to do?Grab your baby immediately and go to the hospital. . . Timely seeking medical help will help to identify the problem in time and begin treatment.
Which doctor should I go to? It's best to see your pediatrician first. After the examination, the pediatrician will diagnose and prescribe treatment or send you for a consultation with a narrow specialist.
How to relieve acute neck pain
Some people, after hypothermia or lifting weights, 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 you experience such pains, you should always see a doctor.
To relieve pain, you can use tablets, gels, or a patch. In this case, it is best to use non-steroidal anti-inflammatory drugs, corticosteroid or warming ointments. Dry heat also has a good effect (heating pad, bag of heated sand or cereal).
Not sure which doctor to see if you experience unbearable neck pain? Since these cervicalgias usually indicate inflammation or pinched nerves, it is best for you to go to a neurologist right away. He will prescribe adequate treatment, and, if necessary, perform a drug blockade. Injection of corticosteroids can quickly and effectively relieve pain.
How to treat vertebral 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. Pain relievers and muscle relaxants are used to relieve pain. In order 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, return normal mobility to the spine.
Which doctor should you go to 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 adequate treatment.