One in ten people on the planet complain of neck pain.After back problems, it is the second most common reason patients see an orthopedist.Restriction of daily activity and professional activities, physical and emotional discomfort, reduced quality of life - this is what people with cervical spine diseases have to face.Therefore, you should be attentive to any signs of pathology and, to prevent its progression, consult a doctor in a timely manner.
Reasons
The origin of neck pain is quite varied.In this area are the 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 nearby areas are often affected: the head, shoulders and thoracic region.Neck pain becomes a kind of marker of the following pathology:
- Osteochondrosis.
- Intervertebral hernia.
- Spondyloarthrosis.
- Spondyloarthritis.
- 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 postures, sedentary work, constant muscle tension, hypothermia and stress are becoming 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, all parts of the skeleton suffer from injuries, which cannot be called rare.Taking into account 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, you should first consult a specialist.All therapeutic measures follow those of diagnosis.
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, such a symptom is called neck pain.And the spread of shoulder pain receives a new name - cervicobrachialgia.This happens because of 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 subjective sensations of the patient himself.Typically, they are as follows:
- Sharp or dull.
- Shoot, stab, hurt, shoot.
- Single or double sided.
- Weak, moderate or strong.
- Paroxysmal or constant.
- Appears when moving the head, arms or remains at rest.
In addition to neck pain, there are other symptoms that help establish the source of pathological impulses.This requires their detailed analysis, carried out as part of a clinical examination.
Spinal diseases
Of all the causes of pain in the cervical region, spinal pathology comes first.Many patients suffer from osteochondrosis and herniated discs;they often have to deal with immune spondyloarthritis;infectious spondylitis is somewhat less common.Neck pain may result from muscle spasms 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.
- Paleness of the skin, its “marbling”.
The neck muscles are tense reflexively and can be felt as dense ridges on the side of the spine.Head movements are severely 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, spinal pathologies can become a source of very serious problems, leading to a loss of work capacity.
Myositis
When neck muscles hurt, myositis is likely to develop.It occurs in response to prolonged stress, hypothermia or appears due to infection.Typically, the pain is aching in nature and does not spread to other areas.The range of movements is limited, local signs of inflammation are present: swelling, redness, increase in local temperature.The course of myositis is not serious, the disease is rarely accompanied by complications.
Plexit
Pain may occur due to inflammation of the nerve plexuses located in the neck and shoulder area.They are formed by the anterior branches of the spinal roots and are responsible for the innervation of 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 paraspinal muscles.
- Hiccups.
- Dyspnea.
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.
Neck and shoulder pain may be a sign of inflammation of the nerve plexuses - plexitis.It should be distinguished from vertebrogenic causes.
Arthritis
Arthritis of the shoulder joint is also accompanied by pain.Inflammation can be immune, metabolic or post-traumatic in nature.The following symptoms appear:
- Swelling of the shoulders.
- Redness of the skin above.
- Increase in local temperature.
- Limitation of movements in the joint.
Shoulder damage can be isolated or part of the structure of polyarthritis in connective tissue diseases, gout.If treatment is not timely, prerequisites are created for the development of osteoarthritic changes in the joint.
Osteoarthritis
Shoulder pain often becomes a manifestation of osteoarthritis.This pathology is degenerative and dystrophic in nature, affecting all components of the joint and mainly the cartilaginous tissue.Characterized by slow but steady progression.As osteoarthritis develops, it is accompanied by the following symptoms:
- Cracking in the neck, rubbing, clicking in the joint.
- “Starting” and “mechanical” pain (appearing at the beginning of the load), which then becomes constant.
- Shoulder deformity.
- Limitation of movements.
The disease causes significant suffering in 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 shoulder pain, radiating to the neck and arm, worse at night.
- Severe limitation of mobility, particularly in abduction and elevation of the arm.
- Forced position of the limb: flexed at the elbow and pressed against the body.
- Swelling along the anterior surface of the joint and to the side.
Humeral periarthritis is often confused with arthritis or osteoarthritis, but it differs from these diseases in the absence of pathological changes in the joint itself.
Diagnosis
To identify the causes of neck and shoulder pain, 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 necessary:
- General blood and urine analysis.
- Blood biochemistry (inflammation indicators, rheumatic tests, uric acid, calcium).
- X-ray of the spine and shoulder joint.
- Magnetic resonance tomography (computer).
- Neuromyography.
- Arthroscopy.
Pain that radiates to the left shoulder and arm must be differentiated from cardiac pathology, therefore electrocardiography must be added to the above studies.Impossible to do without consulting specialized specialists: a neurologist, a vertebrologist, a traumatologist, a rheumatologist.
The origin of the pain is determined based on the results of a thorough examination.Once the diagnosis has been established, therapeutic measures can begin.
Treatment
To treat neck pain, you need to know the mechanisms of their development and their causes.When they are clearly defined, a therapeutic program is put together 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 of all, you need to minimize the load on the neck and shoulder girdle in order to relieve the affected areas.It may be necessary to wear a Shantz collar.
Drug therapy
Treatment of neck pain necessarily includes medication correction.Modern medicine has a huge arsenal of drugs that help patients suffering from problems with the musculoskeletal system.The most commonly prescribed medications are:
- Non-steroidal anti-inflammatory drugs.
- Muscle relaxers.
- Chondroprotectors.
- B vitamins.
- Vascular.
For neck pain that responds poorly to such 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 area, 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.
The 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 movements of the spine and joints.
Post-isometric relaxation exercises, 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, as well as active rotation of the head.
Regular performance of therapeutic exercises not only restores the movement of 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 very pleasant.At the same time, blood supply to soft tissues improves, muscles relax, which helps activate tissue restoration processes.During manual therapy, functional blockages and subluxations in the cervical region are eliminated, 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, the operation is performed for severe hernias and osteochondrosis.Pathological disc protrusions, osteophytes, vertebral displacements are removed endoscopically and signs of instability are eliminated.Prostheses can be made in 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 unpleasant sensations and possible consequences, it is necessary to promptly diagnose and treat skeletal pathology.