Всеки десети човек на планетата се оплаква от болки във врата.After lower back problems, this is the second most common reason for patients to visit an orthopedist.Limitation of daily activity and professional activity, physical and emotional discomfort, reduced quality of life - this is what people with diseases of the cervical spine face.That is why you should watch out for any signs of pathology and to prevent its progression, consult a doctor in a timely manner.
Reasons
The origin of neck pain is quite diverse.In this area there are 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 areas located nearby are often affected: the head, shoulder and chest area.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.Awkward postures, sedentary work, constant muscle tension, hypothermia and stress are 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, all parts of the skeleton suffer from injuries, which cannot be called a rare phenomenon.Given these characteristics, in order to identify the cause of the pain syndrome, it is necessary to carefully carry out a differential diagnosis.And this is possible only after a medical examination and additional tests.
If you are worried about neck and shoulder pain, then you should first consult a specialist.All therapeutic measures follow the diagnostic ones.
Symptoms
Each disease has its own symptoms.Neck pain is the most striking sign of spine 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 gets a new name - cervicobrachialgia.This is due to the general innervation and blood supply of these areas.
The characteristics of neck pain depend on the severity and degree of the process, as well as on the subjective sensations of the patient himself.As a rule, they are as follows:
- Sharp or blunt.
- Shooting, stabbing, pain, pulling.
- One-sided or two-sided.
- Weak, moderate or strong.
- Paroxysmal or constant.
- Occurs when moving the head, arms or remaining at rest.
Along with pain in the neck, there are other symptoms that make it possible to determine the source of pathological impulses.This necessitates their detailed analysis carried out within the framework of a clinical examination.
Diseases of the spine
Of all the causes of pain in the cervical region, in the first place is the pathology of the spine.Many patients have osteochondrosis and disc herniation;often have to deal with immune spondyloarthrosis;infectious spondylitis is slightly less common.Neck pain can 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:
- Tingling, 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 are felt in the form of dense ridges on the sides of the spine.Head movements are severely limited.Often accompanied by a throbbing or throbbing headache.If the spinal cord is involved in the pathological process, conduction disorders develop in the form of paresis of the upper and lower limbs.
In addition to neck pain, spine pathology can be the source of many serious problems leading to loss of work ability.
myositis
When the muscles of the neck hurt, myositis is likely to develop.Appears in response to prolonged stress, hypothermia or occurs due to infection.As a rule, the pain is painful 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, 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 respective areas, as well as the diaphragm.Cervical plexitis is accompanied by the following symptoms:
- Acute paroxysmal pain in the neck.
- Paraspinal muscle weakness.
- hiccups
- dyspnea.
Damage to the brachial plexus is accompanied by motor, sensory and vegetative disorders of the upper limb: weakness, reduced superficial and deep sensations, pallor.
Pain in the neck and shoulder may 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 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.In case of untimely treatment, prerequisites are created for the development of arthritic changes in the joint.
Osteoarthritis
Pain in the shoulder often becomes a manifestation of arthrosis.This pathology has a degenerative and dystrophic nature, affects all components of the joint and primarily the cartilage tissue.It is characterized by a slow but steady progression.When osteoarthritis develops, it is accompanied by the following symptoms:
- Creaking in the neck, rubbing, clicking in the joint.
- "Starting" and "mechanical" pain (appears at the beginning of the load), which then becomes constant.
- Deformity of the shoulder.
- Restriction of movements.
The disease brings 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 the shoulder, radiating to the neck and arm, worse 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 on the front surface of the joint and on the side.
Shoulder periarthritis is often confused with arthritis or arthrosis, but it differs from these diseases in the absence of pathological changes in the joint itself.
Diagnosis
In order to identify the causes of pain in the neck and shoulders, it is necessary to conduct a comprehensive examination of the patient, including additional methods.With the help of laboratory and instrumental tests, it is possible to establish metabolic and structural disorders in the body.Depending on the clinical situation, the following procedures may be necessary:
- General analysis of blood and urine.
- Blood biochemistry (indicators of inflammation, rheumatic tests, uric acid, calcium).
- X-ray of spine and shoulder joint.
- Magnetic resonance (computed) tomography.
- Neuromyography.
- Arthroscopy.
Pain radiating to the left shoulder and arm should be differentiated from cardiac pathology, so electrocardiography should be added to the above investigations.It is impossible to do without consultation with 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, you can begin the treatment.
Treatment
To treat neck pain, you need to know the mechanisms of its development and causes.When these are clearly defined, a therapeutic program is formed for the patient.Treatment includes methods of multidirectional impact on the musculoskeletal system, which allows to eliminate inflammatory changes, stop dystrophic processes, relieve pain and muscle spasms.First, you need to minimize the load on the neck and shoulder girdle to relieve the affected areas.You may need to wear a Shantz collar.
Drug therapy
The treatment of neck pain necessarily includes drug correction.Modern medicine has a wide arsenal of drugs that help patients with musculoskeletal problems.The most commonly prescribed drugs are:
- Nonsteroidal anti-inflammatory drugs.
- Muscle relaxants.
- Chondroprotectors.
- B vitamins.
- Vascular.
For neck pain that does not respond to such treatment, paravertebral blocks with novocaine or intra-articular administration of hormonal agents are used.After removing the acute symptoms, you can use local forms - ointment, gel, patch.
Effective treatment of the pathology of the bone system, which provokes pain in the neck and shoulder joint, without drugs is almost impossible.
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 the tissues.The following procedures can be used for pathologies of the neck and shoulder joints:
- Physiotherapy.
- Laser treatment.
- Wave therapy.
- Magnetotherapy.
- Paraffin and mud treatment.
- 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.
Physical therapy
Physiotherapy exercises are good for neck pain.An individual gymnastic complex is developed for each patient, which will help to treat the pathology: it forms a strong muscle corset, gives flexibility and strength to the ligaments, restores the 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 gradually expand the motor mode, avoid sharp turns and turns, active rotation of the head.
Regular performance of therapeutic gymnastics 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, the blood supply to the soft tissues improves, the muscles relax, which helps to activate the recovery processes in the 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 necessary when conservative measures are ineffective.Most often, the operation is performed for severe hernias and osteochondrosis.Pathological disc protrusions, osteophytes, displacements of the vertebrae are removed endoscopically and signs of instability are eliminated.A shoulder replacement can be performed due to severe osteoarthritis and contractures can be corrected.After the operation, rehabilitation is required, which depends on the volume of the operation.
Neck and shoulder pains bother many patients.In order to get rid of the unpleasant sensations and possible consequences, it is necessary to promptly diagnose and treat the skeletal pathology.