Every tenth person on the planet complains of neck pain.After lower back problems, this is the second most common reason for patients to visit an orthopedist.Restriction of daily activities and professional activities, physical and emotional discomfort, reduced quality of life - this is what people with cervical spine diseases have to face.Therefore, you must be attentive to all signs of pathology, and in order to prevent its progression, consult a doctor in a timely manner.
Reasons
The origin of neck pain is quite varied.Bone structures (spine), soft tissues (muscles, tendons, ligaments), nerves and blood vessels are located in this area.They are subject to mechanical, inflammatory, metabolic and dystrophic changes.In this case, other nearby areas are often affected: the head, shoulder, and thoracic region.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 load on the spine.The neck is its most mobile part, exposed to external factors.Uncomfortable positions, sedentary work, constant muscle tension, hypothermia and stress are common factors of 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 suffer from injuries, which cannot be called a rare occurrence.Given these characteristics, in order to determine the cause of the pain syndrome, it is necessary to carry out a careful differential diagnosis.And that is possible only after a medical examination and additional research.
If you are concerned about neck and shoulder pain, the first thing you should do is consult a specialist.All therapeutic measures follow diagnostic ones.
Symptoms
Every disease has its own symptoms.Neck pain is the most striking sign of spine pathology, which is hard not to pay attention to.According to medical terminology, such a symptom is called cervicalgia.And the spread of pain to the shoulder gets a new name - cervicobrachialgia.This happens due to the common innervation and blood supply of these areas.
The characteristics of neck pain depend on the severity and scope of the process, as well as on the subjective sensations of the patient himself.As a rule, they are as follows:
- Sharp or blunt.
- Shooting, stabbing, pain, pulling.
- Single-sided or double-sided.
- Weak, moderate or strong.
- Paroxysmal or constant.
- Appears when moving the head, hands or remains at rest.
In addition to neck pain, there are other symptoms that make it possible to determine the source of pathological impulses.This requires their detailed analysis, which is carried out as part of a clinical examination.
Diseases of the spine
Of all the causes of pain in the cervical region, pathology of the spinal column ranks first.Many patients have osteochondrosis and disc herniations;they often face immune spondyloarthritis;infectious spondylitis is somewhat less common.Neck pain can develop 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.
- Reduced sensitivity in the neck, shoulders and arms.
- Revitalization or suppression of tendon reflexes.
- Muscle weakness.
- Paleness of the skin, its "marbling".
The neck muscles are reflexively tense and can be felt in the form of dense protrusions on the side of the spinal column.Head movements are very limited.Often accompanied by throbbing or pressing 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, spine pathology can become a source of very serious problems, which lead to loss of working ability.
Myositis
When the neck muscles hurt, myositis is likely to develop.It occurs in response to long-term stress, hypothermia or occurs due to infection.As a rule, the pain is of a painful 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 difficult, the disease is rarely accompanied by complications.
Plexit
Pain can occur due to inflammation of the nerve plexuses located in the neck and shoulder area.They arise from the anterior branches of the spinal roots and are responsible for the innervation of the skin and muscles in the corresponding areas, as well as the diaphragm.Cervical plexitis is accompanied by the following symptoms:
- Acute paroxysmal neck pain.
- Paraspinal muscle weakness.
- Hiccups.
- dyspnoea.
Damage to the brachial plexus is accompanied by motor, sensory and autonomic disorders of the upper limb: weakness, reduction of superficial and deep sensations, pallor.
Pain in the neck and shoulder can be a sign of inflammation of the nerve plexus - plexitis.It should be distinguished from vertebrogenic causes.
Arthritis
Arthritis of the shoulder joint is also accompanied by pain.Inflammation can be immunological, metabolic or post-traumatic in nature.The following symptoms occur:
- Shoulder swelling.
- Redness of the skin over it.
- Increase in local temperature.
- Limitation of movement in the joint.
Damage to the shoulder can be isolated or part of the structure of polyarthritis in connective tissue diseases, gout.If the treatment is not timely, prerequisites are created for the development of arthrotic changes in the joint.
Osteoarthritis
Pain in the shoulder often becomes a manifestation of arthrosis.This pathology is of a degenerative and dystrophic nature, affecting all components of joint and primarily cartilage tissue.It is characterized by a slow but steady progression.As osteoarthritis develops, the following symptoms accompany it:
- Cracking in the neck, friction, clicking in the wrist.
- "Initial" and "mechanical" pain (appears at the beginning of the load), which then becomes constant.
- Shoulder deformity.
- Restriction of movement.
The disease brings significant suffering to patients, reducing their physical activity and preventing them from performing their usual activities.
Humeroscapular periarthritis
This disease occurs as a result of inflammation of the periarticular tissue 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, spreading to the neck and arm, worse at night.
- Severe limitation of mobility, especially abduction and elevation of the arm.
- Forced position of the limb: bent at the elbow and pressed against the body.
- Swelling along the front surface of the joint and on the side.
Humeral periarthritis is often confused with arthritis or arthrosis, but it differs from these diseases in the absence of pathological changes in the joint itself.
Diagnostics
In order to identify the causes of pain in the neck and shoulder, it is necessary to conduct 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 required:
- 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 (computed) tomography.
- Neuromyography.
- Arthroscopy.
Pain radiating to the left shoulder and arm must be differentiated from cardiac pathology, so electrocardiography should be added to the above studies.It is impossible without consultation with specialized specialists: neurologist, vertebrologist, traumatologist, rheumatologist.
The origin of the pain is determined based on the results of a comprehensive examination.Once the diagnosis is made, treatment measures can be started.
Treatment
To treat neck pain, you need to know the mechanisms of its development and causes.When they are clearly defined, a therapeutic program is formed for the patient.Treatment includes methods of multidirectional action on the musculoskeletal system, enabling the removal of inflammatory changes, stopping dystrophic processes, alleviating pain and muscle spasms.First, you need to reduce the load on the neck and shoulder girdle to relieve the affected areas.It may be necessary to wear a Shantz collar.
Drug therapy
Treatment of neck pain necessarily includes medication adjustments.Modern medicine has a wide arsenal of drugs that help patients with problems of the musculoskeletal system.The most commonly prescribed drugs are:
- Nonsteroidal anti-inflammatory drugs.
- Muscle relaxants.
- Chondroprotectors.
- B vitamins.
- Vascular.
For neck pain that responds poorly to such treatment, paravertebral blockades with novocaine or intra-articular administration of hormonal agents are used.After removing acute symptoms, you can use local forms - ointment, gel, patch.
It is almost impossible to effectively treat pathology of the bone system, which causes pain in the neck and shoulder joint, without drugs.
Physiotherapy
Comprehensive treatment of pain in the cervical region includes physical methods.With their help, you can remove inflammatory phenomena and improve biochemical processes in tissues.The following procedures can be used for pathologies of the cervical and shoulder joints:
- 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
Physical therapy exercises are good for neck pain.An individual gymnastic complex is developed for each patient, which will help in the treatment of pathology: form a strong muscle corset, give ligaments flexibility and strength, restore the range of motion in the spine and joints.
Exercises with postisometric relaxation, in which static tension is replaced by relaxation, are suitable for the neck.It is necessary to gradually expand the motor mode of operation, avoid sharp bends and turns and active rotation of the head.
Regular performance of therapeutic exercises not only restores mobility 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 in the treatment of pain in the neck muscles.Massage is not only a useful procedure, but also quite pleasant.At the same time, the blood supply to the soft tissues improves, the muscles relax, which helps to activate the regeneration process in the tissues.During manual therapy, functional blocks and subluxations in the cervical region are removed, the spine is stretched, which leads to decompression of the nerve roots.
Operation
Radical treatment of neck pain is necessary when conservative measures are ineffective.Most often, surgery is performed in severe hernias and osteochondrosis.Pathological disc protrusions, osteophytes, vertebral displacements are removed endoscopically and signs of instability are eliminated.Prosthetics can be done in the shoulder joint due to severe osteoarthritis and contractures can be corrected.After the operation, rehabilitation is required, which depends on the extent of the operation.
Neck and shoulder pain plagues many patients.In order to get rid of unpleasant sensations and possible consequences, it is necessary to timely diagnose and treat skeletal pathology.