Cervical spine pain is pain in the back of the neck that is exacerbated by movement of the head. The symptom may be accompanied by painful muscle spasms, headaches, dizziness. The main causes of pain in the cervical spine are inflammatory diseases of the vertebrae and soft tissues, osteochondrosis, and traumatic injuries. To detect the etiological factor, radiography, CT and MRI, electromyography, electroneurography, and laboratory tests are performed. To eliminate the pain syndrome, NSAIDs and physiotherapy methods are used.
The cervical spine periodically hurts in 3/4 of the adult population. Most often, discomfort is caused by a long stay in a forced position with the head tilted forward and a hunched back, which is typical for office workers, students, and seamstresses. Drawing pains in the back of the neck come on in the evening, aggravated by turning the head. Sometimes the patient feels a “crunch” in the cervical region during movements. If the pain intensifies over time or there is irradiation of the pain syndrome in the area of the shoulder girdle and shoulder blades, you need to visit a specialist to figure out why the disorder has arisen.
The most common causes of severe pain in the cervical spine are degenerative changes in the intervertebral discs and the vertebrae themselves. With a slight lesion of the discs and ligamentous apparatus, discomfort is felt in the neck, aggravated after active head movements, sleeping in an uncomfortable position, exposure to drafts, and physical exertion. In addition to the pain syndrome, paresthesias, a feeling of "crawling", numbness of the cervical region are possible. In order not to aggravate the pain, patients try to keep their neck and head motionless, turn their whole body.
As osteochondrosis progresses or with a sharp unsuccessful movement, patients complain of "lumbago" when the cervical spine hurts. The pains are very intense, sharp, throbbing or burning in nature, felt as if in the depths of the neck. When the fibrous ring ruptures, an intervertebral hernia is formed, in which constant severe pain is felt in the neck. Pain syndrome forces a person to take a supine position, turning the head is impossible due to sharp shooting pains. This condition requires qualified medical attention.
Pain syndrome arising from a traumatic cause is detected immediately after a mechanical effect on the cervical region or after some time. Soreness is often combined with changes in the skin in the area of injury - redness and swelling are observed, bruises, abrasions are detected. If the integrity of the bone structures is violated, the contours of the neck are deformed, the head can hang down on the chest. The most common mechanical causes of pain in the cervical spine:
Characterized by constant pain of the type of cervicalgia, which can have different intensity. The person describes the pains as drawing, shooting, burning. In addition to the pain syndrome, there are violations of sensitivity in the posterior cervical regions, limitation of the ability to make active and passive movements. When the spinal cord is compressed, the cervical spine hurts very much, to alleviate the condition, the patients take a forced immobile position on their back.
Sensory and motor disturbances testify to the involvement of the substance of the spinal cord (compression myelopathy) in the process. There is numbness of the skin of the cervical region, "crawling". Later, weakness appears in the muscles of the hands, their tone decreases, individual muscle fibers twitch, muscle atrophy is possible. When the vascular bundle is infringed, the syndrome of the vertebral artery occurs - there are complaints of periodic or constant ringing in the ears, dizziness and pre-syncope.
Inflammatory causes cause sharp throbbing pains in the cervical spine, which are constantly disturbing. The pain is very intense, painful, often patients do not sleep at night. The symptom is detected against the background of a deterioration in the general condition, an increase in body temperature, chills and cold sweat are possible. Soreness is more often caused by osteomyelitis of the vertebrae. Intense pain with signs of para- and quadriplegia is observed during the formation of an epidural abscess, which complicates the destruction of the cervical vertebrae.
Among all cancers, metastases to the spine are the most common causes of pain in the cervical region. A similar type of metastasis is characteristic of neoplasia of the lungs, uterus, and stomach. Symptoms increase gradually: at first, there is slight discomfort or moderate pulling pains in the back of the cervical region, then the pain syndrome intensifies. Vertebral fractures are possible even when exposed to minor traumatic factors. The primary tumor causes of cervicalgia are osteogenic sarcoma, multiple myeloma, and leukemia.
Systemic inflammatory diseases (rheumatic pathology) always occur with the involvement of bone and cartilage structures in the process. Usually pain is caused by the progression of rheumatoid arthritis. At the same time, the cervical spine periodically hurts, the greatest intensity of pain is observed in the morning after waking up. Morning stiffness in the neck lasting more than 1 hour is also characteristic. Cervicalgia is often a sign of other collagenoses: scleroderma, dermatomyositis, periarteritis nodosa.
The cervical spine can be very painful in the initial period of meningitis or encephalitis. The pain is dull or aching and persists for one to two days. Over time, the pain syndrome passes to the head area: unbearable pains in the occipital and frontal regions are disturbing, and repeated vomiting is also noted. With the spread of the inflammatory process to the spinal canal, in addition to intense pain, paresis and paralysis, sensitivity disorders develop. Inflammation of the brain is caused by infectious causes such as:
The cervical spine can hurt with pathologies of nearby internal organs (esophagus, trachea), which is explained by the presence of viscero-somatic reflexes. Pain impulses from the affected organ are transmitted to soft tissues, which leads to pain in the neck. The rest of the symptoms depend on the cause of cervicalgia. With tracheitis, a barking dry cough and subfebrile body temperature are observed. For esophagitis, excruciating heartburn and belching of sour, retrosternal discomfort are typical.
Patients with pain in the cervical spine go to an orthopedist or traumatologist. A comprehensive examination of the spinal column and adjacent anatomical structures is carried out using modern instrumental methods. Laboratory tests are needed to clarify the cause of cervicalgia. The most diagnostic value are:
Laboratory methods of examination are of auxiliary importance. To confirm the infectious cause of pain, a general and biochemical blood test is done, and a blood culture is examined. Additionally, serological tests are recommended to identify the most typical pathogens of neuroinfections. To exclude the rheumatic etiology of pain in the cervical spine, the level of rheumatoid factor and antinuclear antibodies in the blood is determined.
Patients who have severe cervical spine pain should be given functional rest for the neck, avoiding head movements, especially turning from side to side. To reduce the tension of the neck muscles, it is necessary to regularly take breaks from working at a computer or machine. To find out the cause of cervicalgia and the selection of treatment, you should consult a doctor as soon as possible. Before verifying the diagnosis, it is permissible to take analgesics from the NSAID group to relieve excruciating pain. Independent use of warming compresses is prohibited.
Massage of the cervical spine
Medical tactics depend on the cause of the disease and the clinical stage. In the absence of pronounced destructive changes in the spinal column, a combination of drug treatment and physiotherapy is sufficient. Physiotherapeutic procedures are prescribed after the subsidence of acute pain in the cervical spine, the most effective are acupuncture, transcutaneous electrical stimulation, ultrasonic and electromagnetic methods. In chronic pain syndrome resort to manual therapy. Of the drugs usually used:
In case of unstable fractures of the vertebral bodies and arches, surgical reposition of the fragments is indicated, followed by their subsequent stabilization by the methods of bone osteosynthesis - metal plates with transpedicular fixation are usually installed. In benign spinal tumors, they are removed after preliminary decompression of the brain structures. In the case of osteomyelitis of the spine, sequestrectomy is necessary with further restoration of the anatomical integrity of the spinal column.
Surgical methods of treatment used for osteochondrosis can be divided into two groups: decompression and stabilizing. Decompression operations are designed to reduce pressure on the spinal canal and relieve radicular syndrome. For this purpose, laminectomy, endoscopic discectomy, facetectomy are performed. Stabilizing operations are required when the cervical vertebrae are displaced in the frontal plane and there is a risk of spinal cord injury. Anterior or posterior spinal fusion is performed (fixation of bone structures to ensure their complete immobility).