Neck pain, symptoms of pinched nerves in the neck, sciatica, cervical spine injuries, causes, treatment in Moscow
According to statistics, neck pain has become more common in people in recent years. This was facilitated by the advent of computers and new "sedentary" occupations. Many do not exercise today, are overweight and often have stress - these factors also play a role in the development of neck pain. What exactly causes neck pain and how to deal with it?
Cervical sciatica ("pinched nerve")
Radiculitis at the level of the cervical spine most commonly occurs when the roots of the spinal nerves are compressed.
This is usually caused by spondylosis of the cervical spine or a herniated disc when its outer part (annulus fibrosus) tears and the nucleus pulposus of the disc protrudes into the spinal canal. Sometimes cervical sciatica occurs due to infections (herpes virus infection, Lyme disease).
How is it expressed? Often there is pain in the neck that extends into the arm. In addition, the hand may become numb or weak. Usually, after a neurological examination, the diagnosis of "cervical sciatica" can be made. However, in some cases, it may be necessary to perform computed tomography or electromyography.
Diffuse skeletal hyperostosis (Forestier's disease)
This disease develops mainly in people over 50 years of age. It has been established that the most likely cause of the development of Forestier's disease is the accumulation of calcium salts in the ligaments of the spine.
Forestier's disease can not manifest itself in any way, but in some cases a person's neck mobility decreases, pain appears. To confirm the diagnosis, the doctor will prescribe an X-ray examination, in some cases computer or magnetic resonance imaging is also required. There is no specific treatment for this disease.
Discogenic pain syndrome is perhaps the most common cause of neck pain. The syndrome arises as a result of degenerative changes in the structure of the intervertebral discs. This distributes the load unevenly between the discs, facet joints, and endplates. With this disease, neck pain occurs when turning and tilting the head, the condition worsens if you keep your head in one position for a long time. This pain can radiate to the arm or shoulder.
Spondylosis of the cervical spine is caused by degenerative changes in the cervical spine. The gradual obliteration of the intervertebral discs leads to a decrease in the intervertebral space, deformation of the bones and their growth (the formation of osteophytes). In most cases, these age-related changes do not bring any inconvenience. However, sometimes they put pressure on the spinal nerve root, causing chronic neck pain and, in some cases, numbness or pain in the shoulder or arm.
Spondylogenic cervical myelopathy. Degenerative changes in the cervical spine can narrow the central canal of the spinal cord, damaging the spinal cord itself and making it inoperable. As a result, pain in the neck, its limited mobility, as well as general weakness, impaired coordination of movements, uncontrolled urination and defecation, problems in the genital area. The disease most often develops after the age of 55 and often requires surgical intervention.
Cervical spine injuries
People usually suffer neck injuries in car accidents. The sharp reciprocating movement of the head causes damage to soft tissues, nerve fibers, intervertebral discs, the posterior longitudinal ligament, the facet joint (facet syndrome), etc. After the injury, there is pain, muscle spasms appear, and it becomes difficult to move the neck. Over time, the symptoms will go away on their own, but sometimes the pain can develop into chronic pain.
Cramps in the neck and upper back muscles are caused by injuries, physical overstrain over the course of the day, particularly poor posture, and mental stress. Also, muscles can cramp due to an uncomfortable pillow. Usually, this condition manifests itself in pain and limited mobility of the neck. The pain subsides within 6 weeks. To speed up the process, it is recommended to perform special exercises and, if possible, eliminate the cause of muscle tension.
Myofascial Pain Syndrome
Hypersensitive points can be identified in myofascial pain syndrome. They can occur after injury, overexertion, or emotional stress. These points provoke tension and muscle pain that often becomes chronic.
Among the diseases that cause neck pain, we did not mention "cervical osteochondrosis". This diagnosis is usually made in the countries of the former Soviet Union. In fact, all the diseases listed above are attributed to osteochondrosis.
Degenerative changes in the spine are observed in almost everyone over the age of 40, and this is absolutely no reason to call a person sick and start active treatment. Neck pain and other symptoms should indicate a real diagnosis, after which therapy will be prescribed.
When should you see a doctor for neck pain?
The main reasons why you need to consult a neurologist:
- Strong headache;
- neck injury;
- loss of control over urination or bowel movements;
- numbness, tingling, weakness in your arms or legs;
- the pain does not go away for a week and there is no improvement;
- when conventional painkillers don't help.
See a doctor right away if:
- You have a fever, a headache, and your neck is so stiff that you can't bring your chin to your chest. It could be meningitis;
- There are signs of a heart attack: chest pain, rapid breathing, sweating, nausea, vomiting, and pain in the arm or jaw.
Treatment of neck pain
Medicines that relieve pain or tension. There is usually no specific treatment for conditions that cause neck pain. In simple situations, a doctor may recommend nonsteroidal anti-inflammatory drugs (diclofenac) for pain relief. If the cramps are severe, the doctor may prescribe a muscle relaxant (a drug that relaxes muscles) to take at night. For chronic neck pain, your doctor may prescribe tricyclic antidepressants. Botulinum injections have proven ineffective. Most muscle sprains resolve within 2-3 weeks with conservative treatment.
ice and heat. Ice is also recommended to relieve neck pain after an injury, especially in the first 48 to 72 hours. If the problem is in the muscles, heat can be used (e. g. shower, bath, use a damp towel).
Stretching. Stretching exercises, including qigong, have been shown to be effective. However, they should be carried out carefully, preferably only after consulting a specialist. Exercise is especially helpful for chronic pain. It is better to do it in the morning and before bed, after warming up the throat. If you engage in habitual physical activity (jogging, football, yoga, etc. ), you should definitely consult a doctor.
relaxation techniques. Emotional stress can increase neck pain and delay healing. Relaxation techniques (breathing exercises, self-hypnosis, prayer, meditation) and psychotherapy help relieve muscle tension.
change habits. In order not to repeatedly provoke neck pain, it is important to correct the positions in which a person spends a lot of time. To do this, you need to monitor your posture, minimize stress (change position, stretch your neck once an hour, put the computer at eye level). You need to sit up straight, shoulders should be relaxed. During sleep, the neck needs support and the head should be level with the whole body. The ideal sleeping position is on your back, lying on your stomach is the worst for your neck.
Massage relieves muscle spasms, and it is useful to use a vibrating massager. However, it should be borne in mind that massage is most likely ineffective in chronic pain.
Manual therapy. Manipulations do not have proven effectiveness and in some cases can be accompanied by a worsening of the condition. Therefore, it is recommended to resort to "gentle" manual therapy and only in combination with physical exercises. It is better not to contact chiropractors if there is cervical spondylotic myelopathy (narrowing of the central canal of the spinal cord).
Biofeedback (BFB). Using a method called "biofeedback", a person is given a task (to release tension in the neck muscles) and, with the help of sensors, controls its implementation. The patient himself sees an image on the screen, which, for example, can be cloudy, and if itselfthe muscles relax, it becomes clear. This is how a person learns to control the tension of the neck muscles.
Although the cervical spine restraint brace relieves pain, it is not recommended to wear it for long periods of time (1-3 hours a day, no more than 1-2 weeks) as it can weaken the muscles.
There are a number of methods whose effectiveness and safety are quite difficult to prove because too few studies with reliable results have been carried out. For example, according to some reports, acupuncture helps with chronic neck pain, while traction has no effect. Electromagnetic therapy, low-frequency laser therapy, and electromyostimulation seem to work. However, it is not recommended to use all these methods and ignore physical exercises.
operate on neck painIn most cases, neck pain does not require surgery: it is initially treated conservatively, and only if it does not help and the cause of the pain is pressure on the spinal nerve root ("nerve compression") or a narrowing of the central canal of the spinal cord is surgical treatmentrecommended.