One in ten people on the planet complains of neck pain.After lower back problems, this is the second most common reason patients visit an orthopedist.Restriction of daily and professional activity, physical and emotional discomfort, decreased quality of life - this is what people with cervical spine diseases face.Therefore, it is necessary to 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 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 nearby areas are usually affected: the head, shoulders and thoracic region.Neck pain becomes a kind of marker for the following pathology:
- Osteochondrosis.
- Intervertebral hernia.
- Spondylarthrosis.
- Spondylitis.
- Myositis.
Most of these conditions develop under conditions of constant loading 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 shoulder pathology, including:
- Arthritis.
- Osteoarthritis.
- Humeroscapular periarthritis.
- Brachial plexitis.
In addition, any part of the skeleton suffers injuries, which cannot be considered a rare phenomenon.Taking these features into account, to identify the cause of the pain syndrome, it is necessary to carry out a careful differential diagnosis.And this is only possible after a medical examination and further investigation.
If you are worried about neck and shoulder pain, you should first consult a specialist.Any 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, this symptom is called cervicalgia.And the extension 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 patient's own subjective sensations.As a general rule, they are the following:
- Sharp or dull.
- Shoot, stab, hurt, throw.
- One or two-sided.
- Weak, moderate or strong.
- Paroxysmal or constant.
- It appears when you move your head, arms or remain at rest.
Along with neck pain, there are other symptoms that allow us to establish the origin of the pathological impulses.This requires detailed analysis, carried out as part of a clinical examination.
Spinal diseases
Of all the causes of pain in the cervical region, spinal pathology is the first.Many patients have osteochondrosis and herniated discs;they often have to deal with 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 alterations in innervation, which are manifested by the following symptoms:
- Numbness, tingling, 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 side of the spine.Head movements are very limited.It is often accompanied by throbbing or crushing 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 that lead to loss of the ability to work.
myositis
When the muscles in the neck 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 painful in nature and does not spread to other areas.The range of motion is limited, there are local signs of inflammation: swelling, redness, increased local temperature.The course of myositis is not severe, and 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.
- Hiccup.
- Dyspnoea.
Damage to the brachial plexus is accompanied by motor, sensory and autonomic disorders of the upper limb: weakness, decreased superficial and deep sensations, paleness.
Pain in the neck and shoulder can be a sign of inflammation of the nerve plexuses - plexitis.It must 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 that covers 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 carried out in a timely manner, preconditions are created for the development of arthritic 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.It is characterized by a slow but constant progression.As osteoarthritis develops, it is accompanied by the following symptoms:
- Cracking in the neck, rubbing, 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 the synovial membrane of the shoulder.Periarthritis is usually the result of injury or overuse.It is accompanied by the following symptoms:
- Sudden pain in the shoulder, radiating to the neck and arm, and worsening at night.
- Acute 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 osteoarthritis, but it is differentiated from these diseases by 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 complete examination of the patient, including additional methods.With the help of instrumental and laboratory 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 tests.
- 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, so electrocardiography must be added to the previous studies.It is impossible to do without consulting 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 established, treatment measures can begin.
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 action on the musculoskeletal system, which allow eliminating inflammatory changes, stopping dystrophic processes and relieving pain and muscle spasms.First of all, the load on the neck and shoulder girdle should be minimized to relieve the affected areas.It may be necessary to use a Shantz collar.
Drug therapy
Treatment of neck pain necessarily includes pharmacological correction.Modern medicine has a wide arsenal of drugs that help patients with problems of the musculoskeletal system.The most commonly prescribed medications are:
- Non-steroidal anti-inflammatory drugs.
- Muscle relaxants.
- Chondroprotectors.
- B vitamins.
- Vascular.
For neck pain that does not respond well 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 pathology of the skeletal system, which causes pain in the neck and shoulder joint, without medications.
Physiotherapy
Comprehensive treatment of pain in the cervical region includes physical methods.With its help, it is possible to 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.For each patient, an individual gymnastics complex is developed that will help treat the pathology: form a strong muscle corset, give flexibility and strength to the ligaments, restore the range of motion in 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 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 to 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 removed, the spine is stretched, which leads to decompression of the nerve roots.
Operation
Radical treatment of neck pain is required when conservative measures are not effective.Most often, the operation is performed for severe hernias and osteochondrosis.Pathological disc protrusions, osteophytes, vertebral displacements are removed by endoscopy and signs of instability are eliminated.Prostheses 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 unpleasant sensations and possible consequences, it is necessary to quickly diagnose and treat skeletal pathology.