One in ten people 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 activity and professional activities, physical and emotional complaints, reduced quality of life - this is what people with diseases of the cervical spine have to deal with.Therefore, you need to pay attention to signs of pathology and consult a doctor in a timely manner to prevent progression.
Reasons
The development of neck pain varies greatly.This area contains bone structures (spine), soft tissues (muscles, tendons, ligaments), nerves and blood vessels.They undergo mechanical, inflammatory, metabolic and dystrophic changes.In this case, other nearby areas are often affected: the head, shoulder and chest areas.Neck pain becomes a kind of marker for the following pathology:
- Osteochondrosis.
- Intervertebral hernia.
- Spondyloarthrosis.
- Spondylitis.
- Myositis.
Most of these diseases arise under conditions of constant stress on the spine.The neck is its most mobile part, which is exposed to external influences.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 radiating.They often spread to this area due to pathology of the shoulder, which includes:
- Arthritis.
- Osteoarthritis.
- Humeroscapular periarthritis.
- Brachial plexitis.
In addition, injuries to parts of the skeleton occur, which is not uncommon.Given these features, careful differential diagnosis is required to identify the cause of the pain syndrome.And this is possible only after a medical examination and additional examinations.
If you are concerned about neck and shoulder pain, you must first consult a specialist.All therapeutic measures follow the diagnostic ones.
Symptoms
Each disease has its own symptoms.Neck pain is the most noticeable sign of spinal pathology, which is difficult 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 occurs due to the common innervation and blood supply to these areas.
The severity of neck pain depends on the severity and extent of the process as well as the subjective feeling of the patient himself.They are usually as follows:
- Sharp or blunt.
- Shooting, stabbing, pain, pulling.
- Single or double sided.
- Weak, moderate or strong.
- Paroxysmal or constant.
- Appears when moving the head, arms or while 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 as part of a clinical examination.
Spinal diseases
Of all the causes of pain in the neck area, spinal pathology ranks first.Many patients suffer from osteochondrosis and herniated discs;they often struggle with immune spondyloarthritis;Infectious spondylitis occurs somewhat less frequently.Neck pain can result from muscle spasms or compression of nerve roots (radiculopathy).In the latter case, innervation disorders are associated, 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 reflexively tense and can be felt in the form of dense ridges on the sides of the spine.Head movements are severely restricted.Often accompanied by a throbbing or pressing headache.If the spinal cord is involved in the pathological process, conduction disorders occur in the form of paresis of the upper and lower extremities.
In addition to neck pain, spinal pathology can also lead to very serious problems that can lead to loss of ability to work.
Myositis
If the neck muscles hurt, myositis may occur.It occurs in response to prolonged stress, hypothermia or as a result of infection.As a rule, the pain is painful 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 serious, the disease is rarely accompanied by complications.
Plexit
Pain can occur due to inflammation of the nerve plexuses 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 in 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.
- Hiccup.
- Dyspnea.
Damage to the brachial plexus is accompanied by motor, sensory and autonomic disorders of the upper extremity: weakness, reduced superficial and deep sensations, pallor.
Pain in the neck and shoulder can be a sign of inflammation of the nerve plexuses - plexitis.It should be differentiated 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 above.
- Increase in local temperature.
- Restriction of movement in the joint.
Damage to the shoulder can be isolated or be part of the structure of polyarthritis in connective tissue diseases, gout.If treatment is not carried out in a timely manner, conditions are created for the development of arthritic changes in the joint.
Osteoarthritis
Shoulder pain is often a sign of osteoarthritis.This pathology is degenerative and dystrophic in nature and affects all components of the joint and primarily the cartilage tissue.Characterized by slow but steady progress.When osteoarthritis develops, it is accompanied by the following symptoms:
- Crunching in the neck, friction, clicking in the joint.
- “Incipient” and “mechanical” pain (occurs at the beginning of exercise), which then becomes constant.
- Shoulder deformity.
- Restriction of movement.
The disease causes significant suffering for patients as it reduces their physical activity and prevents them from carrying out 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 that radiates to the neck and arm and worsens at night.
- Severe limitation of mobility, especially abduction and elevation of the arm.
- Forced position of the extremity: bent at the elbow and pressed against the body.
- Swelling along the front of the joint and on the side.
Humeral periarthritis is often confused with arthritis or arthrosis, but differs from these diseases in the absence of pathological changes in the joint itself.
diagnosis
To determine the causes of neck and shoulder pain, a comprehensive examination of the patient is required, including other methods.With the help of laboratory and instrumental studies, it is possible to identify metabolic and structural disorders in the body.Depending on the clinical situation, the following procedures may be required:
- General blood and urine analysis.
- Blood biochemistry (indicators of inflammation, rheumatic tests, uric acid, calcium).
- X-ray of the spine and shoulder joint.
- Magnetic resonance imaging (computed tomography).
- Neuromyography.
- Arthroscopy.
Pain radiating to the left shoulder and arm must be differentiated from cardiac pathologies, therefore electrocardiography should be added to the above studies.It is impossible to do without consulting specialized specialists: a neurologist, vertebrologist, traumatologist, rheumatologist.
The cause of the pain is determined based on the results of a comprehensive examination.Once the diagnosis is established, treatment measures can begin.
Treatment
To treat neck pain, you need to know the mechanisms of its development and causes.When they are clearly defined, a therapy program is created for the patient.Treatment includes methods with a multidirectional effect on the musculoskeletal system, allowing to eliminate inflammatory changes, stop dystrophic processes, relieve pain and muscle spasms.First, you should minimize the strain on the neck and shoulder girdle to relieve pressure on the affected areas.It may be necessary to wear a Shantz collar.
Drug therapy
Treatment of neck pain inevitably includes medication correction.Modern medicine has a wide arsenal of drugs that help patients with problems with the musculoskeletal system.The most commonly prescribed medications are:
- Nonsteroidal anti-inflammatory drugs.
- Muscle relaxants.
- Chondroprotectors.
- B vitamins.
- Vessel.
For neck pain that responds poorly to such treatment, paravertebral blocks with novocaine or intra-articular administration of hormones are used.After eliminating acute symptoms, you can use local forms – ointment, gel, plaster.
Without medication, it is almost impossible to effectively treat pathologies of the skeletal system that cause pain in the neck and shoulder joints.
Physiotherapy
Comprehensive treatment of neck pain includes physical methods.With their help, you can eliminate inflammatory phenomena and improve biochemical processes in tissues.The following procedures can be used for diseases of the neck and shoulder joints:
- Physiotherapy.
- Laser treatment.
- Wave therapy.
- Magnetic field therapy.
- Paraffin and mud therapy.
- Reflexology.
- Balneotherapy.
The optimal procedures are 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 helps to treat the pathology: form a strong muscular corset, give flexibility and strength to the ligaments, restore mobility of the spine and joints.
Exercises with post-isometric relaxation are suitable for the neck, in which static tension is replaced by relaxation.It is necessary to gradually expand the motor mode, avoid sharp turns and bends, active rotation of the head.
Regular performance of therapeutic exercises not only restores movement of the affected skeletal parts, 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 circulation in the soft tissue improves, the muscles relax, which helps to activate restorative processes in the tissue.Manual therapy eliminates functional blocks and subluxations in the neck area, stretches the spine, which leads to decompression of the nerve roots.
Operation
If conservative measures remain ineffective, radical treatment of neck pain is required.Most often, the operation is performed for severe hernias and osteochondrosis.Pathological disc bulges, osteophytes and vertebral displacements are removed endoscopically and signs of instability are eliminated.In cases of severe osteoarthritis, prostheses can be used in the shoulder joint and contractures can be corrected.Rehabilitation is required after surgery, depending on the extent of the operation.
Neck and shoulder pain bother many patients.To get rid of unpleasant sensations and possible consequences, it is necessary to promptly diagnose and treat skeletal pathologies.