Symptom of pain in the neck, back of the head and arm, cervical osteochondrosis
Most people in their life are faced with the problem of neck pain. Most often, these pains occur in the muscles of the neck. The neck muscles (trapezius, scapula levator, scalene muscle), in addition to moving the neck and holding the head, also participate in the work when the arms are moved.
A widespread situation is when acute pains in the neck appear more often in the morning (after sleeping in an uncomfortable position) or with a sudden movement of the head. These pains are exclusively muscular and can radiate to the back of the head, forehead, eye, ear, or shoulder with a pulling sensation or burning sensation in the area of the scapula (or under it). In the event of pain in the muscles of the neck, errors are often made by both the patients themselves and their attending physicians during the diagnosis process.
A patient with acute muscle pain in the neck begins, either alone or with the help of a doctor, to undergo hardware diagnostics: X-ray of the cervical spine, computed tomography (CT), or magnetic resonance imaging (MRI). As a result, in addition to financial costs, the patient also receives unreasonably radiation exposure to his body.
When natural age-related changes or peculiarities in the structures of the spine (osteochondrosis of the cervical spine, straightening of cervical lordosis, spondylosis, uncovertebral arthrosis, protrusion, or herniation of the intervertebral disc) are found on the images and tomograms of such a patient, there is a deviation from understanding the essence of what is happening process. Unfortunately, after that, in the overwhelming majority of cases, doctors skip and do not carry out further elementary diagnostics of the biomechanics of the cervical spine. The changes in the spine detected by the apparatus become more significant in clinical diagnosis than clinical data (tone and strength of the neck muscles, range of motion of the cervical spine).
With muscle pain in the neck (acute, burning, or pulling), the patient just needs to undergo a clinical examination by a specialist, after which adequate medical assistance will be provided to relieve the pain symptom. After examination by a neuropathologist or neurosurgeon in the clinic, the patient:
- receives an accurate clinical diagnosis
- avoids unreasonable diagnostic methods and the accompanying financial and time costs
- avoids unnecessary radiation exposure
- receives adequate pain management
- receives further treatment recommendations for rehabilitation after pain relief
Pain in the neck, in the back of the head, and in the hand can provoke an injured or inflamed intervertebral (facet) joint (with its arthrosis). The neck can also hurt after a long stay in one position (sedentary work, watching TV while lying down, etc.), or after a whiplash mechanism of a neck injury. The appearance of a symptom of pain in the neck is facilitated by age-related osteochondrosis or spondylosis of the cervical spine, tense and overloaded neck muscles, etc.
With radicular pain in the neck (cervical radiculopathy), the nerve may experience compression from the shells of the facet joint, hypertrophied ligaments of the spinal canal, displaced vertebrae, protrusion, or disc herniation. Cervical radiculopathy will manifest itself as a sensation of pain of the type of electric shock in the arm, scapula, in the occipital region, in the temple, etc.
The symptom of neck pain with a sprain of the ligaments of the cervical spine is comparable to a boring toothache. When the neck hurts due to injury to the ligaments and muscles, the patient cannot find a comfortable sleeping position, it is difficult to turn his head. Without specialized help, pain in the neck, back of the head, or head can last for several weeks unabated.
Muscle and radicular types of neck pain are usually well eliminated by physiotherapy, cervical spine traction (Glisson loop, hand traction during manual therapy sessions), drug therapy (anti-inflammatory drugs, muscle relaxants, etc.).
Neck and occiput pain can also be caused by spinal epiduritis, which rapidly develops in the patient's spinal cord being compressed by infected epidural fat.
Дегенерация дисков и позвонков
Daily stress can cause neck pain. With age, our vertebrae and intervertebral discs wear out and degenerate. As a result, some experience chronic or persistent neck pain. This is part of the natural aging process.
Some of us degenerate discs and vertebrae faster than others. This could be due to the kind of work we do, our lifestyle, posture, and genetic factors. As we get older, the height of the intervertebral discs decreases, which increases the stress and wear on the intervertebral joints. The result of this process can be narrowing of the spinal canal or nerve damage. In most cases, pain resulting from degeneration can be relieved without surgery with physical therapy.
Неправильное положение во время сна
Your sleeping position, the number of pillows you use, and the firmness of your mattress can all affect how you feel when you wake up in the morning. A wrong sleeping position is the main cause of neck pain. Sleep is something that many people do not pay much attention to, but it has a huge impact on the occurrence of neck pain. It is very important to have a good sleeping position as well as a good bed and pillows. For example, a worn pillow will keep your neck tilted, which can cause muscle tension. In many cases, patients with neck pain are advised to sleep on their side so that their neck is in a neutral position. This usually helps.
Плохая осанка и сутулость
In many cases, neck pain is the result of poor posture while sitting or walking. It can also be the result of constant use of a smartphone, tablet, and prolonged sitting in front of a low computer screen. This is what we all face daily. And this also applies to doctors. Poor posture significantly affects the occurrence of spinal diseases and can aggravate any pre-existing complaints and symptoms. Patients with poor posture experience pulling pain in the muscles of the neck and between the shoulder blades. Most often it will be a burning sensation at the base of the neck. The best way to deal with this type of pain is to work on improving your posture. Poor posture can be more serious when the patient begins to experience weakness in the arms and legs or numbness and tingling in the hands. Another symptom that indicates a more serious impairment is decreased manual dexterity.
Стресс и тревожность
Daily stress can lead to muscle contraction in the shoulders and neck, and pain can result from over-straining them. Psychological factors have a big impact on how we perceive pain. Stressful situations also force us to focus more on pain, which intensifies it. While this is easier said than done, stress management is extremely important in relieving neck pain. Therefore, try to overcome stress by increasing your physical activity. We are all different, but finding some strategy for coping with stress is really important.
Острая кривошея или тортиколлис
Torticollis is a condition in which the head becomes tilted to one side. The attempt to straighten the head from this position is accompanied by pain. Although the cause of torticollis is not always known, doctors suspect that in most cases it is caused by minor sprains of the ligaments or muscles in the neck. Exposure of the neck to cold temperatures for an extended period can also be the cause. This muscle tension causes pain and also puts the head in a position where the nerve roots are taut and potentially damaged. Acute torticollis occurs in a large part of the population.
Травма плечевого сплетения
The brachial plexus is a collection of nerves at the cervical level that connects the spinal cord to the arms. If these nerves are damaged, it can cause neck pain. Conversely, if a neck injury affects the brachial plexus, pain may also occur in the arm. Brachial plexus injury manifests itself in a variety of motor and sensory disorders. Light injuries to the brachial plexus resulting from traffic accidents and falls can heal quickly. In most cases, the plexus injury is stretching and heals on its own. However, in more severe cases of injury (complete separation of the roots), reconstructive surgery of the brachial plexus should be performed.
Хлыстовая травма шеи
With a whiplash injury of the neck, the head shifts sharply relative to the body in the anteroposterior direction, and then very quickly returns. In many cases, recovery from a whiplash injury occurs on its own. A sharp jolt can lead to deformity, which damages the muscles and ligaments in the neck. With the help of manipulations on the neck, damaged tissue can be restored. Severe whiplash injury can result in a fracture of the cervical spine or damage to the spinal cord and nerves. If your neck pain continues to worsen following an accident or sports injury, it is recommended that you seek the advice of a spine specialist.
Cervical radiculopathy ("pinched nerve"), when the nerves in the cervical level of the spinal cord are damaged, causes pain that radiates down the arm. Cervical radiculopathy is a lesion of the nerve roots of the cervical spinal cord. Nerve roots can be pinched as they travel down or out of the spinal canal. This can manifest as a lumbago pain with numbness or weakness in the arm. The location of this numbness on the arm helps the doctor determine which nerve is affected.
Диагностика симптома боли в шее, затылке и руке (остеохондроза шейного отдела позвоночника)
What to do when the neck hurts (behind or from the side) and self-treatment of this neck pain in the form of rubbing with ointments, warming it up, and taking painkillers does not help? You should consult a doctor as soon as possible for a neurological and orthopedic examination at the clinic. This is the only way to make the correct diagnosis and reveal the true cause of the neck pain.
Magnetic resonance imaging of the suboccipital (suboccipital) muscles. Muscles at the level of the anterior arch of the C1 vertebra (A): 1 - the small posterior rectus muscle of the head, 2 - the large posterior rectus muscle of the head. Muscles at the level of the middle of the odontoid process of the C2 vertebra (B): 3 - longus muscle of the neck/head, 4 - lower oblique muscle of the head, 5 - semispinal muscle of the neck, 6 - semispinal muscle of the head, 7 - belt muscle of the head.
Based on the results of a doctor's consultation, if necessary, a patient with a symptom of neck pain with cervical osteochondrosis may be prescribed the following additional diagnostic procedures:
- REG, USDG of the vessels of the neck and brain (in the presence of dizziness, tinnitus, unsteadiness when walking)
- X-ray of the cervical spine with functional tests
- computed tomography (CT) of the cervical spine
- magnetic resonance imaging (MRI) of the cervical spine
Osteochondrosis of the cervical spine can lead to reflex spasm of the vessels of the cervical spine - these are the vertebral arteries (runs in the transverse processes of the cervical vertebrae). As a result of this spasm of the vertebral arteries, persistent blood supply disturbances (ischemia) of the posterior parts of the brain occur with attacks of dizziness, noise or ringing in the ears and head, unsteadiness when walking, numbness of the face and tongue, etc.
In patients with osteochondrosis of the cervical spine, the back neck often hurts, as well as headaches in the occiput at the same time. Sometimes these pains in the neck can simultaneously radiate (radiate) to the arm and reach from the shoulder to the hand with numbness of the fingers.
In a patient with cervical osteochondrosis with a symptom of neck pain (lying down in sleep or sitting), the little finger and ring fingers on the hand usually go numb. This numbness in the hand and fingers (ring and little fingers) is associated with chronic overstrain of the scalene muscles. a similar state of hypertonicity of the anterior group of neck muscles leads to partial compression of the nerve plexus of the neck and is manifested by paresthesias in the hand and fingers.
There are other reasons for the onset of a symptom of neck pain:
- injuries to the ligaments and muscles of the neck - cervico-cranial syndrome
- fracture of the bodies and arches of the vertebrae of the cervical spine
- degenerative diseases of the cervical spine - osteochondrosis of the cervical spine, osteoporosis of the vertebral bodies, spondyloarthrosis of the intervertebral joints, spondylosis
- tumors of the cervical vertebrae, spinal cord, and its membranes
- infections at the level of the neck - myelitis, epiduritis, inflammation, and enlargement of the cervical group of lymph nodes
- damage to the intervertebral disc of the cervical spine - disc herniation, disc protrusion, discitis
Дегенеративные болезни позвоночника (остеохондроз шейного отдела позвоночника, остеопороз шейных позвонков и остеоартроз межпозвонковых суставов) на уровне шеи происходят обычно из-за естественного старения позвоночника. Повторная травма шеи может ускорить эти процессы дегенерации при имеющемся остеохондрозе, спондилоартрозе и спондилёзе шейного отдела позвоночника.
Пациенты часто жалуются на боль в шее, онемение и покалывания вниз в руках до пальцев кистей (иногда усиливающихся лёжа на спине во время сна), треск, хруст или щелчки в шейном отделе при осуществлении движения (повороты, наклоны головы) в нём.
Symptoms of an exacerbation of osteochondrosis of the cervical spine:
- symptom of muscle pain in the neck, back of the head, shoulder, or arm
- a crunch in the neck when turning or tilting the head to the sides
- burning or pain between the shoulder blades
- limitation of neck mobility with exacerbation of muscle pain symptom
- dizziness, nausea, double vision, numbness of the face, tongue, weakness
- numbness in the hand, in the fingers
- lumbago in the neck, back of the head, temple, frontal part of the head, shoulder, arm, fingers
Лечение симптома боли в шее, затылке и руке (остеохондроза шейного отдела позвоночника)
At the initial stage of treatment of neck pain, pain relievers, muscle relaxants, heat or cold applications can be used. A neck brace helps heal the injury and relieve neck pain. It is very important to wear it correctly to get the most out of it. Steroid injections can relieve neck pain in some cases. Cervical manipulation by a chiropractor or osteopath can also relieve pain and speed recovery. Acupuncture uses thin needles placed in the area of pain. Massage therapy relieves pain by improving blood circulation, relaxing muscles, and releasing the body's natural pain relievers, endorphins. More serious cases may require surgery. Cervical spine surgery is constantly progressing and gives good results.
Depending on the severity of the manifestations and causes of pain (osteochondrosis of the cervical spine, trauma, and sprain of the ligaments and muscles of the neck during a fall, etc.) in the patient's neck, the following therapeutic actions are possible:
- drug therapy (NSAIDs, analgesics, hormones)
- blockages - injections of drugs into painful muscles
- manual therapy (non-surgical "reduction" of the vertebral disc herniation using muscle, articular and radicular techniques)
- physiotherapy (UHF, TENS, etc.)
- surgical treatment
Intervertebral joints (facets) can also be treated by an experienced neuropathologist or neurosurgeon. Therapeutic injections are used when the usual treatment of acute or chronic neck pain with osteochondrosis of the cervical spine does not give a lasting positive effect.
To carry out a therapeutic injections for acute or chronic pain in the neck, sufficiently low doses of an anesthetic (novocaine, lidocaine) and cortisone, diprospan, or kenalog, injected into the lumen or soft tissues near the affected joint.
When combined with a properly selected physiotherapy regimen, these injections can have a good and long-term effect on headaches and neck pain.
Wearing a cervical brace (Shants' splint) for neck pain and osteochondrosis of the cervical spine limits the range of motion. At the same time, it creates additional unloading of tense and defensively spasmodic muscles as a result of neck pain.
Against the background of wearing a cervical collar (bandage, corset, Shants' splint), the patient's pain symptom in the neck area is eliminated much faster. The onset of the weakening of pain in the neck leads to a rapid restoration of the previous volume of movements of the head and neck in osteochondrosis of the cervical spine.
The duration of wearing a cervical brace (cervical collar, Shants splint) depends only on the presence of a pain symptom in a patient with neck pain and osteochondrosis of the cervical spine. In a cervical brace, the patient can also sleep.
There are several types of a neck brace. All cervical collars and bandages are selected in size and can be used repeatedly in case of recurrence of neck pain and osteochondrosis of the cervical spine. In the cervical collar, the patient can sleep and go about his normal daily activities.
The timing of wearing a cervical brace (cervical collar, Shants splint) in case of neck pain against the background of cervical osteochondrosis is established by the attending physician based on the clinical manifestations of a patient with neck pain. The duration of wearing a cervical brace (cervical collar, Shants splint) for neck pain against the background of cervical osteochondrosis can be from several days to several weeks, depending on the severity of the patient's condition with neck pain.