Neck pain (or cervicalgia) is a real widespread disease, because it affects a large part of the population: around two thirds of them suffer from neck pain once in their life.
In most cases there is no serious illness behind it.
It is often not clear at all what causes the pain in the cervical spine, in this case one speaks of “unspecific neck complaints”.
In the course of time, the pain usually subsides on its own without leaving any side effects.
The neck muscles can shorten and harden over time due to poor posture, especially if you work a lot on your PC or desk.
Many people keep their shoulders pulled up because there is strong muscle tension between the trapezius muscle and shoulder blade lifter.
Osteoarthritis is one of the most common causes of neck pain, which affects people from the age of 50 in particular.
The treatment includes posture correction and a program of postural exercises.
Most neck pain gets better over time and does not require surgery.
What are the causes of neck pain?
Muscle tension and weakness
Muscle-related neck pain is the most common.
The exact cause of the pain is usually not known at all, it can result from muscle contractures, tension or signs of fatigue in the muscles.
Symptoms include pain in the neck and back of the shoulder, restricted movement, and in some cases headache and dizziness.
Poor posture is certainly a factor that affects the muscles and can cause pain and stiffness in the neck, even in children.
Indeed, neck pain is more common in people who spend most of the working day leaning forward at the desk.
Pillows and mattresses can also be the cause of neck pain caused by malposition. They should be selected carefully.
The muscle pain in the neck can also be caused by fibromyalgia (literally fiber-muscle pain), this unpleasant disease affects the muscles of the human body, causes pain and diffuse muscle weakness, also in the neck and shoulder area.
Poor sitting posture with head extended.
Stress and neck pain
The main cause of neck pain is muscle tension.
When there is great stress, the muscles contract.
Mental muscle tension can cause shoulder, back and neck pain.
Worry, fear and stress are not rare triggers for neck pain.
Many people experience muscle tension in the neck when under great stress.
Anxious and anxious people immediately feel the contracture and focus on the symptoms, they have a very low pain threshold.
Stressed people tend to fixate on negative sensations, so their neck pain seems to be worse than those who are emotionally balanced, although objectively it’s the same pain intensity.
Stress does not necessarily lead to neck pain, but it is often the case.
There may be mild or severe symptoms and there may also be restricted movement.
Bruxism and jaw pain
The neck is connected to the muscles of the tongue and jaw.
The people who grind their teeth at night (bruxism) may feel tension in the neck muscles.
An incorrect jaw position is another cause of neck pain.
In these cases, a dentist or orthodontist and possibly an osteopath should be consulted to relieve muscle tension and correct the chewing movements.
Cervical distortion for neck pain
Whiplash usually results from a car accident, which can result in muscle tears or lesions, strain on the spinal joints and overstretching of the ligaments.
The possible symptoms are: pain in the cervical spine, dizziness, confusion, restricted movement and tingling in the arms.
In the event of a rear-end collision, the spine is first thrown backwards by the driver and passengers against the seat and then immediately thrown forward, causing the neck muscles to be overstretched.
In more severe cases, the cervical vertebrae can break come.
Torticollis for neck pain
The acute torticollis usually affects children and has a sudden onset.
The head is turned to the side and remains in this position, it is practically impossible to turn it in the painful direction.
The muscles are clearly hardened and make the rotation and inclination of the head on one side impossible, while the movements on the other side can be free and painless.
The pain occurs on the right or left side, but not on both sides.
With a torticollis, the stretching of the cervical spine (head back) is painful, but bending (chin to chest) is not difficult.
The cause of a torticollis is usually the sleeping position, in some cases it can also be a longer stay in a cold environment, for example at night, or a bad posture for a longer period.
People are usually fine when they go to sleep, but have an acute torticollis when getting up in the morning.
The pain usually resolves on its own in a few days without treatment.
Osteoarthritis for neck pain
Cervical arthrosis or spondylosis is the wear-related degeneration of the vertebral joints and intervertebral discs; it is a common cause of sustained pain in the neck region.
Due to their age, older people are particularly affected.
This is called a cervical spondylosis.
Most people over 50 have some degree of degenerative vertebral changes (spondylosis), but are not affected by neck pain.
The symptoms of cervical arthrosis are: pain and stiffness that increases in the morning, after exertion, and when the weather changes, as well as restricted movement and an audible crunch when the head is turned.
In rare cases, patients experience nausea, vomiting, and dizziness.
Spondylosis can cause stenosis, i.e. narrowing of the vertebral canal, which causes pressure on the spinal nerves. In this case, the symptoms radiate from the neck to the arm, sometimes even to the hand.
The patient with cervical stenosis complains of pain, tingling, loss of strength and sensitivity.
Inflammation of the cervical nerves
Inflammation of the cervical nerves is usually a symptom of the nerve becoming trapped at the root or later.
- Disc herniation or protrusion of the intervertebral disc in the area of the cervical spine, which due to its displacement jams the root of a nerve or damages the nerve.
- Contracture and shortening of some muscles (e.g. the scalene muscles), which put pressure on the nerves.
- Canal stenosis of the cervical spine: narrowing of the space in which the nerve roots and spinal cord run.
- Spinal tumor or infection (e.g. meningitis).
In addition to pulsating neck pain, cervicobrachialgia can develop with the following symptoms: loss of sensitivity (numbness) of the upper limbs, tingling in the hand and muscle weakness in the arm.
The pain increases during and after running, but walks are possible.
In this case, a neurosurgeon who specializes in nervous disorders must be consulted.
Some symptoms may indicate a serious illness, and patients should see a doctor immediately.
Progressive, neurological deficiency symptoms with muscle weakness in the arms, feeling disorders, coordination problems of the upper or lower limbs can indicate nerve damage.
Neck pain in pregnancy
Pregnancy itself does not cause neck pain, but changing posture can negatively affect the muscles in this region.
The only diagnostic method that can be used in this case is magnetic resonance because it does not emit radiation, but an attempt is made to do this before birth to avoid.
Medication is generally not advisable during pregnancy, apart from a few exceptional cases that are decided together with the doctor.
cervical lymph nodes
The cervical lymph nodes can swell and hurt.
The reason for this is probably a virus (e.g. flu virus).
Lymph nodes that are enlarged due to a tumor – such as Hodgkin’s lymphoma – do not cause pain, not even when palpated, but they feel hard.
Serious and rare causes include: rheumatoid arthritis, broken bones, infections, meningitis, tumors, and serious injuries that damage the vertebrae, spinal cord, or nerves in the neck region.
Most of the acute pain in the neck region is caused by tired and tense muscles.
Acute neck pain can be localized as follows:
- Back of the neck: often paired with stiffness and muscle pain.
- Neck and head: in the upper cervical vertebrae, can radiate all over the neck and be accompanied by dizziness, headache and mental confusion.
The pain in the upper region of the cervical vertebrae can radiate to the back of the neck and forehead as far as behind the eyes.
Contractures of the upper cervical spine or a blockage of the first two cervical vertebrae (C1 and C2) can cause dizziness, difficulty swallowing and headache.
The pain increases when the head is turned or stretched upwards.
The cervical treatment primarily provides massages and exercises according to McKenzie.
- Neck and arm: in the lower neck area due to pinched nerves; from here the pain can radiate down the shoulder and arm to the fingers.
In the case of neck pain that radiates up to the upper limb, loss of strength and sensitivity in the arm, tingling in the hand and restriction of head movements can also be noticed.
It can feel like your hand is being hit by pinpricks.
A cervical disc herniation mainly occurs between the cervical vertebrae C5 and C6 or between C6 and C7.
The pain can be intense and may be accompanied by numbness or tingling in the arms and / or hands. The symptoms can appear suddenly or develop slowly.
Pain that radiates to the upper limb is not always caused by a herniated disc, it can also be caused by hardened and shortened muscles (contracture) or adhesions (adhesions) of the connective tissue, such as the bottleneck syndrome of the upper thoracic aperture.
There are numerous diseases that can cause chronic neck problems.
Neck pain that intensifies in the morning and evening
Anyone suffering from osteoarthritis has greater complaints in the morning when getting up and at the end of the day.
An improvement occurs when the neck is moved; the pain often subsides on warm, sunny days and intensifies in cold, rainy weather.
Cartilage degeneration of the facet joints can lead to neck pain, especially older people over 60 are affected.
The facet joints actually have a smooth joint surface, but the cartilage breakdown creates increased friction and the movement is restricted.
Pain and stiffness are particularly intense in the morning when you get up and are sensitive to damp weather.
Head rotation due to neck pain.
The best treatments to maintain range of motion and keep discomfort within limits are exercise to restore mobility, physical therapies, traction, and manipulation.
In addition to the diseases listed above, there are other complaints of the cervical spine, but these are less common.
Depending on where they occur tumors (Neoplasia) pain on the spine or bones, loss of sensitivity and strength, sexual and sphincter dysfunction, as well as tingling and limping.
Tumors can be divided as follows:
- malignant (neoplasms) that can form dangerous metastases (glioblastomas, osteosarcomas, etc.);
- Benign neoplasms are masses of tissue that can grow and cause symptoms but do not represent a risk to life (lipomas, meningiomas, neurinomas, etc.).
Neck and arm pain
Neck pain that develops slowly (sometimes over years) and tends to occur during or after performing certain activities or neck positions can be caused by spinal stenosis of the cervical spine.
As a rule, the symptoms are caused by a pinched nerve root.
This type of spinal stenosis arises due to a change in the vertebral joints (facet joints) or intervertebral discs, which show signs of wear due to age.
These structural changes can be diagnosed with an MRI or CT with a myelogram.
How a herniated disc becomes also the Medically treated spinal stenosis (medication, therapy, exercise therapy, injections, etc.). In the event of severe or prolonged pain or important functional restrictions, the neurosurgeon can recommend surgery to enlarge the vertebral hole and make room for the nerve root.
Arm pain with coordination disorder
Neck pain radiating into the arm, combined with symptoms such as coordination and functional disorders in the arms and legs, as well as irregular, stabbing pain, are probably caused by cervical spinal stenosis with myelopathy.
The symptoms can also be caused by a herniated disc in the cervical spine or degenerative changes in the joints that press on the spinal cord. The development is usually slow.
Diagnostics and imaging procedures
During the physical exam, the doctor will check for stiffness, numbness, and muscle weakness.
Neck movement test, sideways tilt.
The patient is asked to turn his head, lean to the side, bend and stick to evaluate the ability to move.
In some cases, the doctor may prescribe diagnostic imaging tests to find out what is causing the symptoms in the throat.
An X-ray image can show the area in which spinal nerves or spinal cord are pressed by protrusions and where there is a flattening of the articular cartilage and intervertebral discs.
Computed Tomography (CT)
Using numerous transverse sections (as if the neck was cut into many horizontal slices), a CT provides detailed images of the internal neck structures.
magnetic resonance imaging (MRT)
With the help of radio waves and a strong magnetic field, magnetic resonance imaging creates particularly detailed images of bones and soft tissue, including the spinal cord and the nerves arising from it.
Nevertheless, x-rays or magnetic resonance show structural problems of the neck region in many people without feeling these symptoms.
It is therefore difficult to determine whether the symptoms are really caused by the problems that the images display.
If it is suspected that the neck pain is caused by a pinched nerve, the doctor can do an electromyography (EMG).
In this test, fine needles are inserted through the skin into a muscle and electrical impulses are sent to check whether the nerves are functioning correctly.
Blood test. The blood values can provide information about whether there is an inflammation or infection that could cause the neck pain.
Lumbar puncture. In spinal puncture, a needle is inserted into the spine to take a sample of the fluid that surrounds the brain and spinal cord.
This test can be used to diagnose meningitis.
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