Causes of pain in the neck

The main causes of neck pain:

Spasmodic torticollis

In an adult, spasmodic torticollis can occur suddenly. There is a sharp pain in the neck, it becomes fixed in a certain position, which is caused by a spasm of the trapezius or sternocleamus-mastoid muscle.

Usually this condition passes by itself, but relief can bring heat, careful manipulation on the neck, wearing a hard collar, muscle relaxants and analgesia.

Babes torticollis

This condition is the result of damage during the delivery of the sternocleidomastoid muscle. In young children aged 6 months to 3 years, the disease manifests itself by the fact that the head is tilted to the side (on the affected side the ear is close to the shoulder). On the affected side, the growth of the face slows down, as a result of which there is some asymmetry of the face. In the early stages of the affected muscle, a tumor-like formation is found.

If these signs are fairly stable, then physiotherapeutic procedures aimed at lengthening the affected muscle may prove to be effective. When treated at a later date, the muscle is dissected (divided) at its lower end.

[1], [2]

Neck rib

Congenital development of the costal process of the VII cervical vertebra (C7) often occurs asymptomatically, but can cause compression of the upper aperture of the thorax. Similar symptoms, but without demonstrating anatomical disorders, are called stair-muscle syndrome or the syndrome of the first rib. When compressing the upper aperture of the chest squeezes the lowest trunk of the body of the brachial plexus and subclavian artery. The patient can feel pain and numbness in the hand and forearm (often on the ulnar side); weakness in the muscles of the hand and their atrophy (tenar or hypotenar) are noted. The pulse on the radial artery is weakened, and the forearm is cyanotic. The presence of the cervical rib is established in the X-ray examination. When arteriography is found compression of the subclavian artery.

With the help of physiotherapy, it is possible to increase the strength of the muscles lifting the humeral girdle, which softens the symptoms, but nevertheless, removal of the cervical rib may be required.

Prolapse of the intervertebral disc

Most often, discs between C5-C6 and C6-C7 prolapse. The protrusion (protrusion) of them in the central direction can cause symptoms of compression of the spinal cord (neurosurgeon consultation is necessary). Zadnelateralnoy protrusion can lead to a fixed neck, pain, irradiating in the arm, weakness of the muscles, corresponding to this nerve root, and a sharp decrease in reflexes. On the roentgenograms of the cervical spine, there is a decrease in the height of the affected discs.

Treatment is carried out with the help of non-steroidal anti-inflammatory drugs (NSAIDs) and a collar supporting the head. As the pain subsides with the help of physiotherapy measures, it is possible to restore the mobility of the neck.

Neck and compression of the spinal cord

Cervical spondylosis. (Osteoarthritis of the cervical spine.) Degenerative changes in the intervertebral discs of the cervical spine usually begin earlier than the lesions of the posterior intervertebral joints. Most often the discs between C5-C6, C6-C7, C7-Th1 are affected. The height of the corresponding discs is reduced. Osteophytes are formed in the central and posterior joints of the vertebrae with the spread of protrusions into the intervertebral foramen (and, consequently, with the defeat of the cervical intervertebral nerves). Sometimes central osteophytes can squeeze the spinal cord. Common symptoms are pain in the neck, neck stiffness, pain along the occipital nerve with spread to the head, pain in the shoulder, paresthesia in the hands. Muscular weakness is uncharacteristic.

When examining the patient there is limited mobility of the neck, accompanied by a crunch; as a rule, there is a decrease in the corresponding tendon reflex. Sensory and motor failure usually does not happen. Changes in the corresponding radiographs are rather poorly correlated with the patient's complaints. Treatment is usually conservative, because, despite the fact that pathological changes are permanent, the severity of subjective symptoms gradually weakens by itself. Relief in this case can bring NSAID. The patient should be recommended to wear a hard collar during the day, and put a rolled towel under the neck at night - prescribe physiotherapy procedures (heat, short-wave diathermy, cautious traction).

Cervical spondylolisthesis

This spontaneous displacement, slipping of the upper vertebra from the vertebra, located under it.

Causes

1. Congenital inadequate fusion of the tooth-like process with 2nd cervical vertebra or its fracture. At the same time, the skull, the first vertebra and the tooth-shaped process slip forward on the 2nd cervical vertebra.
2. Inflammatory softening of the transverse ligament I of the cervical vertebra (for example, as a result of rheumatoid arthritis or as a complication of nasopharyngeal infection, while C1 slides forward along C2).
3. Instability in the area of these vertebrae associated with trauma.

The most important consequence of this spondylolisthesis is the possibility of compression of the spinal cord. The treatment uses traction, immobilization with a gypsum "jacket", arthrodesis of the corresponding vertebrae.

[3], [4], [5]

Compression of the spinal cord

The compression of the spinal cord can cause displacement or spontaneous fracture ("subsidence", collapse) of the vertebra, prolapse of the disc, a local tumor or abscess. Radicular pain and motor disorders in the underlying motor neuron usually occur at the level of the lesion with disorders of the overlying motor neuron and sensory disorders below the level of the lesion (spastic weakness, lively reflexes, plantar abnormalities of the feet, loss of coordination, disruption of the positional feeling in the joints, disturbance of the vibratory sensation of the temperature and pain sensitivity).

The anatomical features of the spinal cord are such that the sensitivity of its posterior column (sensation of light touch, positional feeling in the joints, vibratory feeling) is usually broken on the side of the lesion, and a break in the spinal-thalamic tract disrupts pain and temperature sensitivity on the opposite side of the body at the 2- 3 dermatomes below the level of sensory involvement.

Due to the fact that the spinal cord ends at the level of L1, compression at the level of this vertebra leads to a violation of the transmission of nerve impulses (information) in the part of the spinal cord of the underlying dermatome. To determine the level of damage to the spinal cord, add to the number of the suspected vertebral column, mentally, the number of segments corresponding to the affected vertebrae: C2-7; +1, Th1-6; +2, Th7-9; 3. T10 corresponds to the level of L1 and L2; Th11-L3 and L4, L1-sacral and coccygeal segments. The defeat of the lower lumbar vertebrae can lead to compression of the horse's tail, which is characterized by muscle pain, sensory disorders in the affected dermatomes (if lower sacral dermatomes are affected, then anesthesia of the genitals is delayed urine and defecation).

With such symptoms, an urgent consultation of a neurologist is necessary.

[6], [7], [8], [9]