Every tenth person on the planet complains of neck pain.After back problems, this is the second most common reason for patients to visit an orthopedist.Limitation of daily activity and professional activities, physical and emotional discomfort, reduced quality of life - this is what people with cervical spine disease have to deal with.Therefore, you should be attentive to any signs of pathology and to prevent its progression, consult a doctor at the right time.
reason
The origin of neck pain is quite different.In this area there are bony structures (back), 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 chest 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 the most mobile part of it, 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, which includes:
- Arthritis.
- Osteoarthritis.
- Humeroscapular periarthritis.
- Brachial plexitis.
In addition, every part of the skeleton suffers from injuries, which cannot be called a rare occurrence.Given these characteristics, in order to identify the cause of the pain syndrome, it is necessary to carry out differential diagnosis carefully.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 should consult a specialist.Every therapeutic measure follows the diagnostic ones.
Symptoms
Every 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 in the shoulder gets a new name - cervicobrachialgia.This happens because of the common innervation and blood supply in these areas.
The characteristics of neck pain depend on the severity and extent of the process, as well as on the patient's own subjective sensations.As a rule, they are as follows:
- Sharp or dull.
- Shooting, stabbing, pain, withdrawal.
- Single or double.
- Weak, moderate or strong.
- Paroxysmal or constant.
- Appears when moving the head, arms, or standing 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, performed as part of a clinical examination.
Diseases of the spine
Of all the causes of pain in the cervical region, pathology of the spine comes first.Many patients have osteochondrosis and disc herniation;they often have to deal with immune spondyloarthritis;Infectious spondylitis is somewhat less common.Neck pain can develop from muscle spasm or nerve root compression (radiculopathy).In the latter case, it is associated with innervation disorders, which are manifested by the following symptoms:
- Numbness, creeping, burning, tingling.
- Decreased sensitivity in the neck, shoulder 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 a throbbing or pressing headache.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, leading to the loss of the ability to work.
myositis
When the neck muscles are injured, myositis is likely to develop.It occurs in response to prolonged stress, hypothermia or occurs 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, 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 can 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 neck pain.
- Paraspinal muscle weakness.
- hiccup.
- Dyspnea.
Damage to the brachial plexus is associated with motor, sensory and autonomic disorders of the upper limbs: weakness, decreased surface and deep sensations, pallor.
Pain in the neck and shoulder can be a sign of inflammation of the nerve plexus - plexitis.It must be distinguished from vertebrogenic causes.
Arthritis
Arthritis of the shoulder joint is also associated with pain.Inflammation can be immune, metabolic or post-traumatic in nature.The following symptoms appear:
- Shoulder swelling.
- Redness of the skin on it.
- Increase in local temperature.
- Limitation of joint movements.
Damage to the shoulder can be isolated or part of the structure of polyarthritis in connective tissue diseases, gout.If the treatment is not on time, preconditions are created for the development of arthrosis changes in the joints.
Osteoarthritis
Shoulder pain often becomes a manifestation of arthrosis.This pathology is degenerative and dystrophic in nature, affecting all joint components and mainly cartilage tissue.It is characterized by slow but steady progression.As osteoarthritis develops, it is accompanied by the following symptoms:
- Neck snapping, rubbing, clicking in joints.
- "Initial" and "mechanical" pain (appears at the beginning of the load), which then becomes constant.
- Deformation of the shoulders.
- Restriction of movements.
The disease causes considerable 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 synovium of the shoulder.Periarthritis is often the result of injury or overuse.It is accompanied by the following symptoms:
- Sudden pain in shoulder, radiating to neck and arm, worse at night.
- Sharp limitation of mobility, especially abduction and raising of the arm.
- Forced position of the limbs: 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.
Diagnosing
To identify the causes of neck and shoulder pain, it is necessary to carry out a comprehensive examination of the patient, including additional methods.With the help of laboratory and instrumental studies, it is possible to create 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 (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 pathology, electrocardiography must be added to the above studies.It is impossible to do without consulting specialized specialists: a 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, you need to know the mechanisms of development and its 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 the elimination of inflammatory changes, stopping dystrophic processes, relieving pain and muscle spasms.First, 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 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 responds poorly to such treatment, paravertebral blocks with novocaine or intra-articular administration of hormonal agents are used.After elimination of acute symptoms, you can use local forms - oil, gel, patch.
It is almost impossible to effectively treat the pathology of the skeletal system, which provokes pain in the neck and shoulder joint, 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 cervical and shoulder joint pathologies, the following procedures can be used:
- 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 exercises
Physical therapy exercises are good for neck pain.An individual gymnastic complex is developed for each patient, which will help in the treatment of the pathology: forming a strong muscular corset, giving the ligaments flexibility and strength, restoring the range of motion in the back 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 and active rotation of the head.
Regular performance of therapeutic exercises not only restores movements 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, the blood supply to the soft tissues improves, the muscles relax, which helps to activate the restoration processes in the tissues.During manual therapy, functional blocks and subluxations in the cervical region are eliminated, the spine is pushed, 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.Prosthesis can be performed 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 bothers many patients.To get rid of unpleasant sensations and possible consequences, it is necessary to immediately diagnose and treat the pathology of the skeleton.