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 activity and professional activities, physical and emotional discomfort, decreased quality of life - this is what people with diseases of the cervical spine have to face.Therefore, you need to be attentive 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 bone 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: 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 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 pathology of the shoulder, 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 features, 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, then first of all you need to 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, such a symptom is called cervicalgia.And the spread of pain to the shoulder receives a new name - cervicobrachialgia.This occurs 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 subjective sensations of the patient himself.As a rule, they are as follows:
- Sharp or dull.
- Shooting, stabbing, aching, pulling.
- Single or double sided.
- Weak, moderate or strong.
- Paroxysmal or constant.
- Appears when moving the head, arms or remains at rest.
Along with neck pain, there are other symptoms that make it possible to 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, pathology of the spinal column comes first.Many patients have osteochondrosis and disc hernias; they often have to deal with immune spondyloarthritis; infectious spondylitis is somewhat less common.Neck pain may develop from 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, shoulder, and arms.
- Revitalization or suppression of tendon reflexes.
- Muscle weakness.
- Pallor of the skin, its “marbling”.
The neck muscles are reflexively tense and can be felt in the form of dense ridges on the side of the spinal column.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, pathology of the spinal column can become a source of very serious problems, leading to loss of ability to work.
Myositis
When the neck muscles hurt, myositis is likely to develop.It occurs in response to prolonged stress, hypothermia, or appears due to infection.As a rule, the pain is aching in nature and does not spread to other areas.The range of movement 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.
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 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.
- Hiccups.
- Dyspnea.
Damage to the brachial plexus is accompanied by motor, sensory and autonomic disorders of the upper limb: weakness, decreased 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 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 occur:
- Shoulder swelling.
- Redness of the skin over it.
- Increase in local temperature.
- Limitation of movements in the joint.
Damage to the shoulder 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 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 primarily cartilage tissue.Characterized by slow but steady progression.As osteoarthritis develops, it is accompanied by the following symptoms:
- Crunching in the neck, friction, clicking in the joint.
- “Starting” 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 performing 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.
- Sharp 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 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
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 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 (computer) tomography.
- Neuromyography.
- Arthroscopy.
Pain that radiates to the left shoulder and arm must be differentiated from cardiac pathology, so electrocardiography should be added to the above studies.It is impossible to do without consulting specialized specialists: a neurologist, vertebrologist, traumatologist, rheumatologist.
The origin of pain is determined based on the results of a comprehensive examination.Once the diagnosis has been 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 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 in order to relieve the affected areas.It may be necessary to wear a Shantz collar.
Drug therapy
Treatment of neck pain necessarily includes drug correction.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 is poorly responsive to such treatment, paravertebral blockades 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 pathology of the skeletal system, which provokes pain in the neck and shoulder joint, without medications.
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
Physical therapy exercises are good for neck pain.An individual gymnastics complex is developed for each patient, which will help treat the pathology: form a strong muscle corset, give ligaments flexibility and strength, restore range of motion in 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 expand the motor mode gradually, avoid sharp turns and bends, and active rotation of the head.
Regular performance of 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 blocks 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 required 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.Prosthetics can be performed 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.