18.09.2021

My neck hurts, what to do

Numerous muscles of the neck (primarily the trapezius muscle) surround the spine, ensuring the preservation of the position of the head and its movement relative to the human body. When pain occurs, the muscles reflexively increase tone, which, in turn, can contribute to the development of myofascial pain syndrome.

It is believed that the most common causes of neck pain are changes in the musculoskeletal system, namely neck muscle tension, cervical spondylosis and discogenic neck pain. Despite the abundance of lesion options, such conditions respond well to therapy and do not require additional diagnosis.

Neck pain (cervicalgia) is a very common disease that occurs in 10-20% of the adult population. The most common causes are degenerative changes in the spine. Anatomically, the cervical spine is represented by seven alternating vertebrae connected by intervertebral discs, uncovertral and facet joints. Movement in the cervical region is unevenly distributed, as it is mainly due to the joints of the base of the skull and the first two vertebrae – atlas and epistrophy. Their anatomy is atypical for the rest of the spine, in particular, the epistrophy has a process (tooth) that extends upward to the atlas and forms a vertical axis around which half the volume of rotation of the head occurs.

However, most often degenerative changes affect the lower parts of the neck, where they can cause narrowing of the intervertebral foramina and impair the spinal nerves, causing pain, weakness, or numbness in the hands.

Sometimes the cause of pain is a previous neck injury. For example, a whiplash injury, as a result of which the neck bends sharply or straightens (this happens with a head-on collision). Less commonly, infectious, rheumatic, oncological and cardiovascular diseases become the causes. The need to exclude them is the main reason for going to the doctor.

Ways to treat pain

In the vast majority of cases, neck pain is treated conservatively – with painkillers and exercises. However, if the pain syndrome does not decrease or is accompanied by a neurological deficit (weakness or numbness in the body and limbs), the need for surgical treatment increases.

Conditions such as neck muscle tension, degenerative lesions of the intervertebral disc, facet joints, have a favorable prognosis. Their treatment involves reducing pain and learning methods of physiotherapy.

Postural correction is an important part of the treatment regimen; it consists in the correct direct landing at the working table, in a comfortable sleeping position using a pillow under the head and neck, avoiding prolonged stay in a forced position and the need to take breaks to warm up.

Gymnastics for the neck is a set of exercises, the simplest of which are moving your head back and forth, tilting and turning left and right. Exercises are performed slowly – you need to help yourself with your hands and strive to achieve the desired amplitude. Often a warm-up for the shoulders is added to the exercises.

Drug therapy comes down to taking painkillers, often these are non-steroidal anti-inflammatory drugs, but the doctor may prescribe opioid analgesics. Sometimes they also add drugs that reduce muscle tone – muscle relaxants.

Physiotherapy in the context of physiotherapy exercises is the basis for the treatment and prevention of back pain. The main attention is paid to postural correction, functionally advantageous positions, increasing muscle strength, preserving and increasing the volume of motor activity.

Manual therapy, in particular manual practices, are not considered first-line treatment for pain in the neck – this is associated with the risk of complications and effectiveness similar to home gymnastics.

Methods of physical physiotherapy do not have a significant positive effect in the treatment of back and neck pain, the need for their appointment is doubtful and carries risks of increasing the cost of treatment.

Massage of the cervical-collar region can reduce muscle tone and indirectly reduce neck pain.

Traction or traction of the spine does not confirm its effectiveness in clinical practice and is not recommended for use.

Prevention of neck pain

In most cases, back pain is associated with improper posture in combination with degenerative changes in the spine.

Here are some suggestions:

  • Watch your posture. Make sure your shoulders are above your hips and your head is centered.
  • Take breaks. If you travel long distances or work a lot at the computer, get up and warm up.
  • Adjust the table, chair and computer so that the monitor is at eye level. The knees should be located just below the hips.
  • Do not hold the phone between your ear and shoulder while talking, use a headset or speakerphone.
  • Do not carry heavy bags over one shoulder, in addition to direct pressure, this creates an asymmetric load on the neck muscles.
  • Sleep in a comfortable position.  Head and neck should be flush with the body. Use a small pillow.
Curvature of the cervical spine

A person is asymmetric, as equal possession of the right and left limbs does not create significant advantages. In most cases, we are either right-handed or left-handed. Under such conditions, it is difficult to expect symmetrical muscle development from our body. Moreover, the physiological bends of the spine have a shock absorbing function. However, in approximately 5% of the population, these bends are excessive, which is most often due to a genetic predisposition. They have an increased risk of developing pain in the neck and back, the treatment in this case depends on the reasons. In each case, physiotherapy is used to correct posture, less commonly used stabilizing corsets and surgical designs.

Orthopedic collars

In the event of pathological changes or pains in the musculoskeletal system, the body tends to immobilize (immobilize) the cervical spine, since without understanding the extent of damage it is evolutionarily more profitable not to risk damage to the spinal cord. Indeed, with vertebral fractures, ligament ruptures, there are risks of life-threatening injuries, therefore, when providing first aid and established injuries of the neck, stabilizing structures are imposed.

However, after the exclusion of significant spinal injuries, the need for them disappears, moreover, prolonged immobilization postpones recovery and becomes a prerequisite for the development of degenerative processes of the musculoskeletal system, which increases the risk of repeated episodes of neck pain.

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