Pain in the cervical spine when turning the head

Neck pain: what is it like?

Neck pain
Neck pain is a common symptom. According to medical statistics, every third adult has ever experienced neck pain. Right now, one in ten people have neck pain.

As a rule, pain in the neck is constant and aching. Sometimes the pain is accompanied by dizziness, nausea, and tinnitus. In some cases, the pain radiates (spreads) to the arms. Along with pain in the neck, pain in the heart area may also be felt, especially with an uncomfortable position. Even with neck pain, there may be complaints of limited neck mobility or a crunch in the neck when turning the head.

Cervical spine treatment

Therapy for pain in the cervical spine when turning the head is prescribed depending on the cause of its occurrence. An integrated approach to treatment allows not only to eliminate pain in the cervical spine, but also to prevent complications and relapses. The following groups of therapy methods are distinguished:

1. Drug treatment - to relieve pain, inflammation, spasms, to improve blood circulation and metabolic processes.
2. Physiotherapeutic treatment: magnetic therapy, electrophoresis, ultrasound therapy, shock wave therapy.
3. Therapeutic gymnastics and physical education.
4. Manual therapy, orthopedics and massage.

Why does my neck hurt?

The reasons why your neck may hurt are quite varied. Most often, neck pain is due to one of the following reasons:

• staying in an incorrect position for a long time, for example, sleeping in an uncomfortable position, or working in which you have to maintain the same head position for a long time. For office workers, quite often the cause of neck pain is the incorrect position of the monitor on the desktop;
• long-term physical activity;
• stress, depression, anxiety;
• injuries and sprains;
• incorrect posture;
• hypothermia of the neck muscles. People still say in this case: “I got a cold in my neck.” A draft - a steady flow of cold air - leads to a local deterioration in blood supply, resulting in aching pain in the neck.
• The most common cause of neck pain is osteochondrosis. This is a group of diseases characterized by deterioration of the properties of the cartilage tissue of the spine, mainly due to age-related changes in the body or traumatic consequences. Cervical osteochondrosis often causes not only neck pain, but also headaches. A serious complication of cervical osteochondrosis is the appearance of intervertebral hernias. An intervertebral hernia is a protrusion of part of the intervertebral disc. In this case, compression of the nerve fibers occurs, which causes increased pain during exercise or in a static position. With an intervertebral hernia of the cervical spine, the pain radiates to the arms. Your fingertips may become numb.

Neck pain can be caused by other reasons, including some serious diseases that require emergency treatment. For example, neck pain and limitation of head movements are observed with meningitis, vascular, infectious and oncological diseases, injuries of the cervical spine, immune disorders (rheumatoid arthritis, ankylosing spondylitis, arthritis with inflammatory bowel diseases), as well as various diseases of the internal organs.

Types and causes of discogenic pathology in the cervical spine

Any problems with the integrity of the intervertebral disc with the contents moving beyond its boundaries is considered a disease. Protrusion and hernia form against the background of a critical increase in mechanical pressure on a certain area of ​​the disc. As a result, the nucleus pulposus, located inside, protrudes. The nucleus puts pressure on the annulus fibrosus tissue, which can lead to its rupture.

Doctors distinguish the following stages of the disease:

• A slight protrusion of the disc without damage to the fibrous ring with a displacement of a maximum of 2-3 mm. The clinical picture is mild.
• Development of disc protrusion, which is accompanied by more pronounced protrusion of the pulp up to 3-5 mm. The patient begins to complain of periodic pain. Most often, the ability to work at this stage of the disease is preserved.
• The formation of the hernia itself, which is also called prolapse or extrusion. At this stage, the fibrous ring in the intervertebral disc ruptures with the pulp falling out beyond the boundaries of the disc tissue, for example, into the spinal canal. This is due to the localization of the damaged area.
• At the last stage of pathology formation, the prolapsed fragment of the nucleus pulposus is separated from the disc tissues with possible displacement under pressure. The separated element can move along the spinal canal. This leads to damage to the nervous structure and serious complications in the form of compression of the spinal canal. This condition is called sequestration.

Naturally, as the pathology progresses, each of the listed stages is not always observed. Sequestration develops quite rarely, although the mechanism of formation of the pathology is the same. In any case, the producing factor is increased pressure, leading to the destruction of the discs. This is most often associated with injuries, falling in slippery weather and hitting the head.

The most common cause of herniated intervertebral discs in the cervical spine is an accidental blow to the head in a low doorway. Healthy discs will not erode immediately. This will require prolonged exposure to negative factors or a sharp increase in pressure, for example, when hitting your head. This can cause a severe “explosive” fracture of the spinal elements in the neck, damage to the spinal canal, leading to disability of the patient.

Neck pain: what to do?

Neck pain caused by some mechanical cause may go away within a few days. If you are sure that the pain in your case is due to the fact that your neck was simply cold or you turned it sharply, try holding your neck in gentle warmth. It is also recommended to ensure a reduction in static load on the neck muscles and a comfortable head position during sleep. However, if the pain is prolonged or severe, you should consult a doctor. Self-medication will be ineffective, because before starting treatment, it is necessary to make a diagnosis. For neck pain, it is very important to undergo instrumental examination methods, in particular, radiography or, even better, computed tomography of the cervical spine. This will make it possible to distinguish “banal” osteochondrosis, for example, from tumor diseases.

Risk factors for exacerbation

The formation of an exacerbation during protrusion and hernia in the cervical spine is most often observed against the background of:

• Poor posture, stooping, flat feet or walking in uncomfortable shoes. The spinal column has a powerful compensating mechanism that protects the brain from shock during walking and running. However, any uncompensated shock is transmitted upward with amplification. The occurrence of the greatest amplitude and traumatic potential is observed at a considerable distance from the place where the vibration is localized. As a consequence, poor posture, dehydration in the intervertebral discs with possible destruction form in the cervical region.
• Tonic tension in the deep muscles of the dorsal and cervical region, which is accompanied by muscle spasm with the formation of a protective posture. Due to the increased load on the head and neck muscles caused by wearing high hairstyles in women and heavy winter fur hats, blood circulation in the muscle tissue of the cervical region is impaired. As a result, the nutrition of the intervertebral discs deteriorates and their tissues become dehydrated.
• Over time, osteochondrosis develops and progresses, and osteophytes appear on the elements of the spine. This causes poor blood circulation and the development of muscle spasms with limited motor function in the neck.

As a result, a rapid increase in pressure on the spinal tissue leads to its transmission to the intervertebral disc. Against the background of uneven, eccentric and undistributed pressure, a destructive process in the disc begins. This provokes the formation of a protrusion or a hernia itself.

Therapy methods

Typically, patients diagnosed with cervical intervertebral hernia suffer from the pathology for more than one year, and exacerbations and remissions are regularly observed. Often, painful sensations weaken over time or disappear on their own a couple of weeks after a subsequent exacerbation.

Conservative methods of therapy will not help to completely get rid of the problem; it helps to cope with the consequences of the hernia’s impact on the soft tissue, muscles and nerve endings. Often, as a residual phenomenon, the presence of a vegetative reflex effect on the tone of vascular tissue - neurovascular symptoms - is observed.

Complex therapy involves taking the following pharmaceuticals:

• non-steroidal anti-inflammatory drugs (COX-2 inhibitors);
• muscle relaxants with central action;
• As auxiliary methods, medicinal electrophoresis using vitamins and aminophylline is prescribed.

When the exacerbation subsides, the use of physiotherapeutic procedures is indicated. To activate blood circulation in muscle tissue, it is recommended to perform physical therapy and massage of the cervical-collar region (movements must be extremely careful).

Treatment of cervical intervertebral hernia with relatively crude methods, such as manual therapy, traction, can cause a significant aggravation of the condition. This will lead to the development of serious negative consequences.

As an emergency measure, it is recommended to wear a Shants collar if pain occurs. The device is used to support the head and helps prevent sudden bending and turning of the head, which can lead to the development of compression symptoms and sometimes fainting.

After the collar is applied, it is better to immediately consult a neurologist and have an MRI of the neck performed; then you may need to consult with a neurosurgeon. This will help to assess the possible risk for a similar location of the pathology and determine the choice of treatment regimen.

Which doctor should I contact?

With complaints of pain in the neck, people usually turn to a vertebrologist, and if he is not on staff at the hospital, to a neurologist. If you suspect an injury, it is advisable to make an appointment with a traumatologist. Rheumatoid arthritis is treated by a rheumatologist. You can also contact a therapist, who, after the examination, will refer the patient to a specialist doctor.

Possible complications

Due to the lack of medical intervention, pathologies of the cervical spine provoke the development of complications. With osteochondrosis and intervertebral hernia, vertebral artery syndrome and radicular syndrome occur. The severe course of the disease leads to sad consequences: complete or partial fusion of joint spaces, the appearance of ankylosis - pathological stiffness or immobility.

Diagnostics

To identify deformation of bone structures in osteochondrosis, polyosteoarthrosis, and spondylosis, radiography is the most informative. Destructive and degenerative changes in cartilage tissue, including intervertebral hernias, as well as the ligamentous-tendon apparatus are detected using ultrasound, MRI, and CT.

Rheumatoid arthritis is diagnosed by complex serological tests - the level of C-reactive protein, rheumatoid factor, and antinuclear antibodies is determined. Histology is indicated for suspected tumor formation to identify their malignancy.

MRI of the cervical spine.