Every tenth person on the planet complains of neck pain.After lower back problems, this is the second most common reason for patients to see an orthopedist.Restriction of daily and professional activities, physical and emotional discomfort, decreased quality of life - this is what people with diseases of the cervical spine face.Therefore, you need to pay attention to any signs of pathology and, to prevent it from progressing, consult a doctor in a timely manner.
Reasons
The origin of neck pain is quite varied.In this area there are bony structures (spine), soft tissues (muscles, tendons, ligaments), nerves and blood vessels.They are subject to mechanical, inflammatory, metabolic and dystrophic changes.In this case, other areas located nearby are often affected: head, shoulders and chest area.Neck pain becomes a kind of marker of the following pathology:
- Osteochondrosis.
- Intervertebral hernia.
- Spondyloarthrosis.
- Spondylitis.
- Myositis.
Most of these conditions develop under conditions of constant loading on the spine.The neck is the most mobile part, exposed to external factors.Uncomfortable postures, sedentary work, constant muscle tension, hypothermia and stress are becoming common factors in modern life that contribute to the development of diseases.
Neck pain is not only local, but also referred.They often spread to this area due to shoulder pathology, which includes:
- Arthritis.
- Osteoarthritis.
- Humeroscapular periarthritis.
- Brachial plexitis.
In addition, any parts of the skeleton are injured, which cannot be considered a rare occurrence.Given these characteristics, to identify the cause of the pain syndrome, it is necessary to carefully carry out differential diagnosis.And this is possible only after a medical examination and additional research.
If you are concerned about neck and shoulder pain, first consult a specialist.Any therapeutic measures follow diagnostic ones.
Symptoms
Each disease has its own symptoms.Neck pain is the most striking sign of spinal pathology, which is difficult not to pay attention to.According to medical terminology, this symptom is called neck pain.And the spread of pain to the shoulder gets a new name - cervicobrachialgia.This is due to the common innervation and blood supply to these areas.
The characteristics of neck pain depend on the severity and extent of the process, as well as the patient's own subjective sensations.As a rule, they are the following:
- Sharp or dull.
- Shoot, stab, hurt, pull.
- Single or double sided.
- Weak, moderate or strong.
- Paroxysmal or constant.
- It appears when moving the head, arms or remaining at rest.
Along with pain in the neck, there are other symptoms that make it possible to establish the origin of pathological impulses.This requires its detailed analysis, carried out as part of a clinical examination.
Spine diseases
Of all the causes of pain in the cervical region, spinal pathology comes first.Many patients have osteochondrosis and herniated discs;they often have to deal with immunological spondyloarthritis;infectious spondylitis is somewhat less common.Neck pain may occur due to muscle spasm or compression of nerve roots (radiculopathy).In the latter case, it is accompanied by innervation disorders, which are manifested by the following symptoms:
- Numbness, crawling, burning, tingling.
- Decreased sensitivity in the neck, shoulders and arms.
- Revitalization or suppression of tendon reflexes.
- Muscle weakness.
- Pallor of the skin, its “marbling”.
The neck muscles become reflexively tense and can be felt in the form of dense ridges on the side of the spine.Head movements are severely limited.Often accompanied by throbbing or severe headaches.If the spinal cord is involved in the pathological process, conduction disorders develop in the form of paresis of the upper and lower extremities.
In addition to neck pain, spinal pathology can become a source of very serious problems, leading to loss of working capacity.
Myositis
When your neck muscles hurt, myositis is likely to develop.It occurs in response to prolonged stress, hypothermia or appears due to an infection.As a rule, the pain is aching in nature and does not spread to other areas.The range of motion is limited, local signs of inflammation are present: swelling, redness, increased local temperature.The course of myositis is not severe, the disease is rarely accompanied by complications.
Plexito
Pain may occur due to inflammation of the nerve plexuses located in the neck and shoulder region.They are formed by the anterior branches of the spinal roots and are responsible for innervating the skin and muscles of the corresponding areas, as well as the diaphragm.Cervical plexitis is accompanied by the following symptoms:
- Acute paroxysmal pain in the neck.
- Weakness of the paravertebral muscles.
- Hiccups.
- Dyspnea.
Brachial plexus injury is accompanied by motor, sensory and autonomic disorders of the upper limb: weakness, decreased superficial and deep sensations, pallor.
Pain in the neck and shoulders can be a sign of inflammation of the nerve plexuses - plexitis.It must be differentiated from vertebrogenic causes.
Arthritis
Shoulder joint arthritis is also accompanied by pain.Inflammation can be immunological, metabolic or post-traumatic in nature.The following symptoms occur:
- Swelling in the shoulders.
- Redness of the skin above.
- Increase in local temperature.
- Limitation of movements in the joint.
Shoulder damage can be isolated or be part of the structure of polyarthritis in connective tissue diseases, gout.If treatment is not timely, prerequisites are created for the development of arthrosis changes in the joint.
Osteoarthritis
Shoulder pain often becomes a manifestation of arthrosis.This pathology is degenerative and dystrophic in nature, affecting all components of the joint and especially the cartilaginous tissue.Characterized by slow but steady progression.As osteoarthritis develops, it is accompanied by the following symptoms:
- Crushing in the neck, friction, clicking in the joint.
- “Initial” and “mechanical” pain (appears at the beginning of the load), which then becomes constant.
- Shoulder deformity.
- Limitation of movements.
The disease brings significant suffering to patients, reducing their physical activity and preventing them from carrying out their usual activities.
Humeroscapular periarthritis
This disease develops as a result of inflammation of the periarticular tissues and synovium of the shoulder.Periarthritis is often the result of injury or overuse.It is accompanied by the following symptoms:
- Sudden pain in the shoulder, radiating to the neck and arm, worsening at night.
- Marked limitation of mobility, especially abduction and elevation of the arm.
- Forced position of the limb: bent at the elbow and pressed to the body.
- Swelling along the front surface of the joint and on the sides.
Periarthritis of the humerus is often confused with arthritis or arthrosis, but it differs from these diseases in the absence of pathological changes in the joint itself.
Diagnosis
To identify the causes of pain in the neck and shoulders, it is necessary to carry out a comprehensive examination of the patient, including additional methods.With the help of laboratory and instrumental studies, it is possible to establish metabolic and structural disorders in the body.Depending on the clinical situation, the following procedures may be necessary:
- General analysis of blood and urine.
- Blood biochemistry (inflammation indicators, rheumatic tests, uric acid, calcium).
- X-ray of the spine and shoulder joint.
- Magnetic resonance tomography (computed).
- Neuromyography.
- Arthroscopy.
Pain radiating to the shoulder and left arm must be differentiated from cardiac pathology, therefore electrocardiography must be added to the above studies.It is impossible to do without consulting specialized specialists: neurologist, vertebrologist, traumatologist, rheumatologist.
The source of pain is determined based on the results of a comprehensive examination.Once the diagnosis has been established, treatment measures can be initiated.
Treatment
To treat neck pain, it is necessary to know the mechanisms of its development and its causes.When they are clearly defined, a therapeutic program is formed for the patient.Treatment includes methods of multidirectional effects on the musculoskeletal system, allowing to eliminate inflammatory changes, stop dystrophic processes, relieve pain and muscle spasms.First, you should minimize the load on the neck and shoulder girdle to relieve the affected areas.You may need to use a Shantz collar.
Drug therapy
Treatment of neck pain necessarily includes drug correction.Modern medicine has a wide arsenal of medicines that help patients with problems of the musculoskeletal system.The most commonly prescribed medications are:
- Nonsteroidal anti-inflammatory drugs.
- Muscle relaxants.
- Chondroprotectors.
- B vitamins.
- Vascular.
For neck pain that is unresponsive to this treatment, paravertebral blocks with novocaine or intra-articular administration of hormonal agents are used.After eliminating acute symptoms, you can use local forms - ointment, gel, patch.
It is almost impossible to effectively treat the pathology of the skeletal system, which causes pain in the neck and shoulder joints, without medication.
Physiotherapy
Comprehensive treatment of pain in the cervical region includes physical methods.With their help, you can eliminate inflammatory phenomena and improve biochemical processes in tissues.For pathologies of the cervical and shoulder joints, the following procedures can be used:
- Physiotherapy.
- Laser treatment.
- Wave therapy.
- Magnetotherapy.
- Paraffin and mud therapy.
- Reflexology.
- Balneotherapy.
Optimal procedures will be prescribed by a physiotherapist, taking into account the specifics of the disease and the characteristics of the patient's body.
Therapeutic exercise
Physiotherapy exercises are good for neck pain.An individual gymnastics complex is developed for each patient, which will help treat the pathology: form a strong muscular corset, give flexibility and strength to the ligaments, restore the range of motion of the spine and joints.
Exercises with post-isometric relaxation, in which static tension is replaced by relaxation, are suitable for the neck.It is necessary to gradually expand the motor mode, avoid sharp turns and turns and active rotation of the head.
Regularly performing therapeutic exercises not only restores movement in the affected parts of the skeleton, but also improves the general condition of patients.
Massage and manual therapy
Methods of manual stimulation of the musculoskeletal system help treat pain in the neck muscles.Massage is not only a useful procedure, but also quite pleasant.At the same time, blood supply to soft tissues improves, muscles relax, which helps to activate restoration processes in tissues.During manual therapy, functional blockages and subluxations in the cervical region are eliminated, the spine is lengthened, which leads to decompression of the nerve roots.
Operation
Radical treatment of neck pain is necessary when conservative measures are ineffective.Most often, the operation is performed for severe hernias and osteochondrosis.Pathological disc protrusions, osteophytes, vertebral dislocations are removed endoscopically and signs of instability are eliminated.Prosthetics can be performed on the shoulder joint due to severe osteoarthritis and contractures can be corrected.After surgery, rehabilitation is required, which depends on the extent of the operation.
Neck and shoulder pain bothers many patients.To get rid of discomfort and possible consequences, it is necessary to promptly diagnose and treat skeletal pathology.