Neck Pain In Front : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 12/07/2022

Neck pain in the front is pain of varying intensity felt along the front of the neck. Local or diffuse pain occurs with injuries and inflammatory processes in the organs of the neck, pathologies of the thyroid gland, lymphadenitis and sialadenitis. To determine the cause of discomfort, ultrasound imaging, X-ray examination, radioscintigraphy, electrophysiological methods, laboratory tests, and invasive research approaches are used. To relieve acute pain syndrome, analgesics, anti-inflammatory drugs, physiotherapeutic methods are used.

Causes of neck pain in the front

Thyroid diseases

Organ damage can occur in people of all ages, including children. Soreness in the neck in front can be the result of both inflammatory processes and endocrine pathology. Pain is aggravated by movements of the head, especially when the head is tilted forward. The symptom is accompanied by fever, increased sweating, constant feeling of heat, palpitations. Often, pain is caused by the following reasons:

  • Acute thyroiditis . Soreness develops suddenly, more often after an acute respiratory viral infection or other infections. Complaints of severe acute pains in the anterolateral part of the neck, which radiate to the mastoid process, the collarbone, are characteristic.
  • Toxic goiter . Pain sensations of a pressing or arching nature are localized along the cervical midline, in the case of a single thyroid nodule, pain is more pronounced on one side. Patients themselves notice an increase in the neck.
  • Hashimoto's thyroiditis . In the phase of thyrotoxicosis, patients note pronounced discomfort in the neck in front, which is not associated with changes in the position of the head. Pain in the neck is accompanied by irritability, tremor (trembling) of the limbs, sleep disturbances.

Sialadenitis

When the submandibular salivary glands are affected, complaints are usually made of a sharp soreness in the anterior part of the neck, radiating to the ear, lower jaw. Unpleasant sensations tend to increase with head turning, chewing and swallowing movements. Swelling and compaction up to several centimeters in size are formed very quickly. Due to the decrease in the amount of saliva, it becomes difficult to eat, there is a constant dry mouth. Often, sialadenitis occurs with violations of the general condition - subfebrile fever, chills, weakness.

Purulent inflammation

Frequent causes of sharp pains are purulent processes in the pharynx, which pass to the adjacent fiber with the development of a pharyngeal abscess. Patients complain that the neck begins to hurt in front, the skin in this part is hot to the touch and bright pink. Pain is strong, throbbing. Due to severe discomfort, a person refuses food and water. The symptom occurs against the background of febrile fever. Similar manifestations can be detected with extensive paratonsillar abscesses complicating bacterial tonsillitis.

 

Myositis

Inflammation of the muscles of the neck causes sharp shooting or dull pain in the neck, disturbing for several days or even weeks. Pain in myositis often occurs after hypothermia, exposure to drafts. As a rule, pain sensations are noted in front of the neck, go to the chin, collarbone and shoulders. The intensity increases with a long stay in one forced position, heavy physical exertion. If the symptoms worsen over time, interfere with daily work, you should contact a specialist to determine the cause of the neck pain.

cervical plexitis

The severity of symptoms depends on the number of damaged nerves. Most often, they are concerned about sharp pains along the anterolateral surface, difficulty when trying to speak loudly, cough. Painful sensations can radiate to the ear, occipital region, chest. Characterized by paresthesia, a feeling of "crawling". Patients associate the appearance of unpleasant symptoms with hypothermia, complications after vaccination, and injuries. Damage to the cervical plexus - plexitis - is also provoked by other causes: diabetes mellitus, infectious diseases.

Rheumatic diseases

Pain in the front of the neck is observed with systemic pathologies of the connective tissue (collagenosis) with a predominant lesion of muscle tissue and skin - scleroderma, dermatomyositis. Typical are constant painful sensations of a pulling or aching nature, which are accompanied by thickening and swelling of the skin. Shooting pains radiating to the anterior surface of the neck are possible with the involvement of the spinal column against the background of rheumatoid arthritis. With collagenosis, along with local symptoms, signs of damage to other systems develop.

Lymphadenitis

Common causes of pain in the upper neck are inflammatory processes in the lymphoid tissue. Patients note severe local pain in the submandibular region on one side. Discomfort is aggravated by talking, tilting the head in the direction of the lesion. The symptom is combined with a swelling ranging in size from a pea to a walnut. The skin over the formation is edematous and hyperemic. With inflammation of the lymph nodes, there is a high body temperature, general weakness, myalgia is possible. A similar clinical picture is also characteristic of lymphangitis.

Damage to the cartilage of the larynx

Severe dull pain in the midline of the neck may be a manifestation of the tuberculous process of the cartilaginous tissue of the larynx. Men note local discomfort in the region of the Adam's apple. In addition to pain, prolonged subfebrile body temperature and increased night sweats are found. With chondroperichondritis of the larynx, there are sharp pains in the upper and middle third of the neck. Also in this area, a round, painful formation is palpated, the skin over which acquires a bright red color. Other causes also cause symptoms: recurrent perichondritis, developmental anomalies.

angina pectoris

With atypical variants of angina attacks, patients instead of compressive pains in the heart feel that the neck hurts in front. The pain is very strong, combined with a feeling of lack of air, it becomes difficult to talk and swallow. In addition to soreness, other symptoms are noted: severe weakness, cold sweat and blanching of the extremities, shortness of breath. Intense pain in the cervical region, which occurs against the background of uncomfortable sensations in the heart, accompanied by fainting, pallor and fear of death, may indicate the development of myocardial infarction.

Injuries

Severe pain can occur after blows to the neck from the front, sports injuries, car accidents. With minor injuries, bruises, the pain syndrome persists for several days, and breathing and swallowing disorders are usually absent. With damage to internal organs, primarily injuries of the larynx, patients complain of unbearable pain, which is combined with shortness of breath, hemoptysis. In any case, after injuries of the cervical region, it is necessary to consult a doctor as soon as possible to determine the extent of damage and provide medical assistance.

Diseases of the internal organs

In inflammatory diseases of the mucous membrane of the trachea or esophagus, pain can be localized in front of the surface of the neck. In this case, they are called referred pains. With esophagitis, in addition to pain, swallowing is disturbed, there is constant heartburn and retrosternal discomfort. In the case of tracheitis, pain in the front of the neck occurs against the background of a painful dry cough, an increase in body temperature to subfebrile numbers, and sometimes shortness of breath develops. Pain syndrome can serve as a sign of widespread mediastinitis involving the cervical tissue.

Rare Causes

  • Spinal lesions: osteochondrosis of the SHOP, ankylosing spondylitis, stenosis of the spinal canal and intervertebral hernia.
  • Tumor metastases.
  • Prolonged stay in an uncomfortable position .
  • Congenital pathologies : short neck syndrome (Klippel-Feil), axis tooth hypoplasia, syndrome of additional cervical ribs.
  • Neck compression syndrome .

Diagnostics

If the patient's neck hurts in front, he needs to consult a general practitioner, who either prescribes an examination on his own, or directs the patient to a specialist. Diagnostic search includes instrumental imaging methods to identify pathological changes, due to which the neck hurts in front. To clarify the diagnosis, laboratory methods are carried out. The most informative for identifying the cause of the disorder are:

  • Ultrasonic method . Ultrasound of the neck allows you to study in detail the condition of soft tissues and organs in order to detect signs of the inflammatory process, neoplasms and structural anomalies. Be sure to perform a targeted scan of the thyroid gland to exclude the endocrine cause of pain in the neck in front.
  • X-ray examination . X-ray of the neck is performed to detect damage to the cartilage of the larynx and vertebrae. For more detailed visualization, methods of computed and magnetic resonance imaging are used. During the study, attention is paid to the presence of volumetric formations, abscesses and median cysts of the neck.
  • Radioisotope scintigraphy . A highly informative research method using a contrast agent is prescribed to assess the functional ability of the thyroid gland and the degree of degenerative changes. With a defect in the accumulation of contrast, nodular formations are visualized, diffuse changes are characteristic of thyroiditis.
  • Electromyography . To study the functional state of the neck muscles, the bioelectrical activity of individual muscle fibers is recorded. Depending on the method of performing the study, superficial, stimulation and needle electromyography are distinguished. The technique allows to identify the level of damage to the neuromuscular apparatus.
  • Electroneurography . A special study is recommended for plexitis and injuries of the cervical region to assess the speed of impulse conduction along the peripheral nerves. This painless and non-invasive diagnostic method is necessary to accurately determine the location of nerve fiber damage and clarify the condition of the myelin sheath.
  • Laboratory Research . To confirm the cause of pain in the front of the neck, a general and biochemical blood test, a coagulogram is done. Be sure to examine the level of thyroid hormones, insulin. If an infectious process is suspected, bacteriological culture of blood, swabs from the throat, and serological reactions are indicated.
  • EKG . To exclude myocardial ischemia, with a sharp onset of pain in the neck, which is accompanied by blanching of the skin, dizziness, cold sweat, an electrocardiogram is required. If pathological signs are detected on the ECG, ultrasound of the heart, dopplerography of blood vessels are additionally prescribed.

If suspicious masses of the thyroid gland are detected on radiographs, it is necessary to biopsy the node to exclude malignant degeneration of cells. A diagnostic puncture of the lymph node can also be performed. To verify the rheumatic cause of pain in the neck, blood is examined for rheumatoid factor, specific antibodies. The patient may need to consult an osteopath, an endocrinologist.

Thyroid ultrasound

 

Treatment

Help before diagnosis

The appearance of pain in the anterolateral cervical region is a sign of various diseases, therefore, to identify the immediate cause, a specialist consultation is required. Before verifying the diagnosis, with severe pain in the neck in the front, analgesics from the NSAID group are allowed to eliminate discomfort. It is undesirable to use warm compresses or other local effects on the cervical region without a doctor's prescription, as this can aggravate the symptoms. It is important to limit movements in the cervical spine as much as possible.

Conservative therapy

Drug treatment is primarily aimed at eliminating the underlying disease as the cause of pain, and symptomatic therapy is also required to relieve pain. For chronic pain, physiotherapy methods are indicated - electrophoresis with anti-inflammatory drugs and local anesthetics, laser therapy and UHF. In the acute period, physiotherapy is undesirable. It is necessary to provide maximum functional rest for the neck and head. Of the pharmaceutical preparations, the following groups are most often prescribed:

  • Analgesics . Widely used anti-inflammatory drugs (NSAIDs), which have a pronounced analgesic effect. They reduce the amount of pathological cytokines that irritate nerve endings and eliminate local signs of inflammation.
  • Antibiotics . With purulent lesions, massive etiotropic therapy is needed to eradicate the pathogen. With common processes in the cervical tissue, a combination of their two drugs is indicated. With tuberculosis, specific treatment regimens are selected.
  • Corticosteroids . If the causes of pain in the neck are rheumatic diseases, long-term use of hormones is necessary. For rapid relief of exacerbations, pulse therapy with prednisolone is recommended. If ineffective, cytostatics may be added.
  • Antithyroid drugs . With thyrotoxicosis of various etiologies, medications are indicated that selectively inhibit the function of the thyroid gland. If a decrease in the endocrine function of the organ is determined, thyroid hormone replacement therapy is used.
  • Antianginal agents . For the prevention of angina attacks, drugs that improve myocardial blood supply, antiplatelet agents are effective. The best therapeutic effect is provided by beta-adrenergic blockers, calcium antagonists, myotropic antispasmodics.
  • Restorative therapy . With lesions of peripheral nerves, B vitamins (especially thiamine) are prescribed, which improve the nutrition of nerve fibers and the speed of impulse conduction. Additionally, anabolic agents are recommended.

Surgery

With unbearable pain in the neck, local anesthesia is performed in the form of novocaine blockades. When an abscess is formed in the pharyngeal space or in case of suppuration of the median cyst of the neck, it is necessary to promptly open the abscess and set up adequate drainage. After dissection of the abscess capsule, the cavity must be washed with solutions of antibiotics and antiseptics. When sialadenitis is complicated by strictures of the excretory duct, its bougienage is required, followed by the introduction of proteolytic enzymes.

In the case of proliferation of nodular goiter of the thyroid gland, which is accompanied by pain and compression syndrome, surgical interventions of various volumes are indicated. With the preserved function of the rest of the organ, the node is enucleated, with diffuse pathology - hemithyroidectomy or subtotal resection of the thyroid gland. In severe neck injuries with damage to internal organs, revision, removal of bone fragments and elimination of defects in hollow organs are performed.

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