What are lymph nodes in the neck. How does neck dissection surgery work. What are the potential side effects of lymph node removal in the neck. How can patients manage complications after neck lymph node surgery.

Anatomy of Lymph Nodes in the Neck

Lymph nodes play a crucial role in our immune system, filtering lymph fluid and trapping harmful substances. The neck contains several groups of lymph nodes that are particularly important. Understanding their location and function is essential for both medical professionals and patients.

The neck region houses multiple lymph node groups, including:

• Submental nodes
• Submandibular nodes
• Superficial cervical nodes
• Deep cervical nodes
• Supraclavicular nodes

These nodes work together to filter lymph from the head, neck, and upper chest areas. They are often the first place where infections or cancers in these regions can spread.

Key Structures Associated with Neck Lymph Nodes

Several important anatomical structures are closely related to the lymph nodes in the neck:

• Sternocleidomastoid muscle: A large muscle running from the sternum and clavicle to the mastoid process behind the ear
• Accessory nerve: Controls shoulder movement
• Internal jugular vein: A major vein draining blood from the head and neck

Understanding the relationship between these structures and lymph nodes is crucial when considering surgical interventions in the neck area.

Types of Neck Dissection Surgery

Neck dissection is a surgical procedure to remove lymph nodes from the neck. It is often performed in cases of head and neck cancer to prevent the spread of the disease or to remove cancerous nodes. There are several types of neck dissection, each with varying degrees of lymph node removal and impact on surrounding structures.

Partial or Selective Neck Dissection

This procedure involves removing only specific groups of lymph nodes on one side of the neck. It is the least invasive form of neck dissection and is typically performed when the risk of cancer spread is low or confined to certain areas.

Modified Radical Neck Dissection

There are three types of modified radical neck dissection:

1. Removal of most lymph nodes between the jawbone and collarbone on one side of the neck
2. Removal of lymph nodes plus the sternocleidomastoid muscle
3. Removal of lymph nodes plus the sternocleidomastoid muscle and the internal jugular vein

The accessory nerve is typically preserved in all types of modified radical neck dissection to maintain shoulder function.

Radical Neck Dissection

This is the most extensive form of neck dissection. It involves removing:

• Most lymph nodes on one side of the neck
• The sternocleidomastoid muscle
• The accessory nerve
• The internal jugular vein

Radical neck dissection is usually reserved for cases of advanced cancer or when other structures are already compromised by the disease.

Potential Side Effects of Neck Lymph Node Removal

While neck dissection surgery is often necessary for treating or preventing the spread of cancer, it can lead to several side effects. These effects vary depending on the extent of the surgery and which structures were affected.

Shoulder Stiffness and Arm Weakness

If the accessory nerve is damaged or removed during surgery, patients may experience difficulty moving their shoulder. This can result in stiffness and weakness in the affected arm. In partial or modified neck dissections, this weakness is often temporary and improves over several months. However, if the accessory nerve is completely removed, the damage may be permanent.

Pain and Discomfort

Post-operative pain is common after neck dissection. Most patients can manage this pain with prescribed medications. If pain persists or becomes chronic, referral to a specialized pain clinic may be necessary.

Changes in Neck Appearance

Removal of the sternocleidomastoid muscle can lead to a thinner, shrunken appearance of the neck on the affected side. This cosmetic change is permanent but may become less noticeable over time.

Neck Stiffness

Surgical intervention and the removal of structures in the neck can lead to stiffness. This often improves with time and physical therapy, but some degree of stiffness may persist.

Lymphedema: A Common Complication

Lymphedema is a potential long-term complication of neck dissection surgery. It occurs when lymph fluid builds up in the tissues, causing swelling. This condition can develop due to the disruption of normal lymph flow following the removal of lymph nodes.

Symptoms of Lymphedema

Patients should be aware of the following signs that may indicate lymphedema:

• Swelling or a feeling of fullness in the neck or face
• Difficulty swallowing
• Changes in voice
• Swelling of the tongue or other parts of the mouth

Early detection and treatment of lymphedema are crucial to prevent its progression and manage symptoms effectively.

Managing Lymphedema

Treatment for lymphedema often involves a combination of approaches:

• Manual lymphatic drainage
• Compression garments
• Exercise
• Skin care

A lymphedema specialist can develop a personalized treatment plan to help manage symptoms and improve quality of life.

Rare Complications: Chyle Leak and Blood Clots

While less common, some patients may experience more serious complications following neck dissection surgery.

Chyle Leak

Chyle is a milky fluid containing lymph and fats absorbed from the intestines. A chyle leak occurs when the thoracic duct, which transports chyle, is damaged during surgery. This can lead to the accumulation of fluid under the skin.

Treatment for a chyle leak may include:

• Extended hospital stay
• Dietary modifications
• Surgical repair of the leak

Blood Clots (Hematoma)

Sometimes, blood can collect under the skin after surgery, forming a clot or hematoma. This may occur if surgical drains become blocked. Symptoms of a hematoma include swelling, pain, and discoloration of the skin.

Treatment for a hematoma typically involves:

• Reopening the surgical site
• Removing the clot
• Replacing or adjusting drains

Neurological Effects of Neck Dissection

Neck dissection surgery can potentially affect various nerves in the head and neck region, leading to neurological symptoms. These effects can range from mild and temporary to more severe and long-lasting.

Potential Neurological Complications

Patients may experience:

• Numbness of the skin on the affected side of the neck
• Altered sensation in the ear
• Changes in facial movement or expression
• Difficulty with certain neck movements

The extent and duration of these effects depend on which nerves were affected during surgery and the type of neck dissection performed.

Managing Neurological Effects

Treatment approaches for neurological complications may include:

• Physical therapy
• Occupational therapy
• Medications for nerve pain or regeneration
• In some cases, nerve reconstruction surgery

Patients should discuss any persistent neurological symptoms with their healthcare provider to develop an appropriate management plan.

Rehabilitation and Recovery After Neck Dissection

Recovery from neck dissection surgery is a process that requires patience, persistence, and proper care. A comprehensive rehabilitation program can significantly improve outcomes and quality of life for patients.

Physical Therapy

Physical therapy plays a crucial role in recovery, focusing on:

• Improving range of motion in the neck and shoulder
• Strengthening affected muscles
• Reducing pain and stiffness
• Preventing or managing lymphedema

Patients should start physical therapy as soon as their surgeon approves, typically within a few weeks after surgery.

Scar Management

Proper care of the surgical scar can help improve its appearance and reduce discomfort. Techniques may include:

• Gentle massage
• Silicone sheets or gels
• Sun protection

Emotional and Psychological Support

The physical changes and challenges following neck dissection can have significant emotional impacts. Many patients benefit from:

• Counseling or therapy
• Support groups
• Mindfulness and relaxation techniques

Healthcare providers should be prepared to offer referrals for psychological support as needed.

Long-Term Monitoring and Follow-Up Care

After neck dissection surgery, ongoing monitoring is essential to detect any recurrence of cancer and manage long-term side effects.

Regular Check-ups

Patients typically require:

• Frequent follow-up appointments in the first year post-surgery
• Regular imaging studies (e.g., CT scans, MRIs)
• Physical examinations of the neck and surrounding areas

Managing Chronic Issues

Some patients may experience ongoing challenges such as:

• Chronic pain
• Persistent lymphedema
• Difficulty with certain movements

Long-term management strategies should be tailored to each patient’s specific needs and may evolve over time.

Lifestyle Adjustments

Patients may need to make ongoing lifestyle adjustments to accommodate the changes resulting from neck dissection. These might include:

• Modifications to work or daily activities
• Adapting exercise routines
• Adjusting clothing choices to accommodate changes in neck appearance or lymphedema garments

Healthcare providers should work closely with patients to address these long-term considerations and ensure the best possible quality of life following neck dissection surgery.

Surgery to remove lymph nodes from your neck | Nasal and paranasal sinus cancer

Lymph nodes are also called lymph glands. Surgery to remove lymph nodes in the neck is called a neck dissection.

Neck dissection

You might need to have lymph nodes removed from just one side of your neck or you might need to have them removed from both sides. Removing the lymph nodes reduces the chance of the cancer spreading or coming back. 

There are different types of neck dissection, including:

• partial or selective neck dissection
• modified radical neck dissection and
• radical neck dissection

Partial or selective neck dissection

If you have a partial or selective neck dissection, your surgeon removes some of the lymph nodes in one side of your neck.

Modified radical neck dissection

There are 3 types of modified radical neck dissection.

With one type your surgeon removes most of the lymph nodes between your jawbone and collarbone on one side of your neck.

With the other 2 types your surgeon also needs to remove one or more of the following structures:

• a muscle at the side of your neck called the sternocleidomastoid
• a nerve called the accessory nerve
• a vein called the internal jugular vein

Radical neck dissection

If you have a radical neck dissection, your surgeon removes most of the nodes on one side of your neck. They also remove all of the muscle on that side of your neck (the sternocleidomastoid muscle), the accessory nerve and the internal jugular vein.

Possible side effects after removing the lymph nodes

The side effects depend on which structures have been removed or disturbed during surgery.

Shoulder stiffness and arm weakness

The accessory nerve controls shoulder movement, so if you have this removed, your shoulder will be stiffer and more difficult to move. If you have a partial or modified neck dissection, the weakness in your arm usually lasts only a few months. But if you have your accessory nerve removed, the damage is permanent.

Your doctor will refer you to a physiotherapist, who will show you some exercises to help improve the movement in your neck and shoulder. It is important that you do these exercises regularly.

If you are still having problems with pain and movement a year after surgery, your doctor may look into whether a further operation to reconstruct some of the muscles might help. But this isn’t suitable for everyone.

Pain

You may also have some pain. Taking painkillers can help. Physiotherapy exercises can also reduce pain. Your doctor can refer you to a pain clinic if the pain continues or is not controlled with painkillers.

A thinner, shrunken and stiff neck

Your neck will look thinner and shrunken if you have had the sternocleidomastoid muscle removed.

Your neck might be stiff after the operation and you might need physiotherapy.

Swelling (lymphoedema)

After surgery to remove some or all of the lymph nodes in your neck, the area can be swollen. This can be due to general swelling around the surgical wound. This usually goes down within a couple of weeks. But it can also be a sign of lymphoedema, this swelling doesn’t go away.

Lymphoedema means a build up of lymph fluid that causes swelling. It can develop because surgery interferes with the normal flow of lymph in the lymphatics.

Lymphoedema in the head or neck can also cause symptoms inside your mouth and throat. This may include swelling of your tongue and other parts of your mouth.

Tell your doctor or nurse straight away if you have:

• any swelling or a feeling of fullness or pressure
• find it difficult to swallow
• have changes in your voice

They will refer you to a lymphoedema specialist if they think you might have lymphoedema. It’s important to start treatment early to stop the swelling from getting worse.

Chyle leak

Chyle is tissue fluid (lymph) that contains fat after it has been absorbed from the small bowel (intestine). It gets transported through the lymphatic channels to the bloodstream.

Sometimes one of these channels, called the thoracic duct, leaks after the operation. When this happens, lymph fluid or chyle can collect under the skin.

You may need to stay longer in hospital and go back to the operating theatre to repair the leak.

Blood clot

Sometimes the tubes of the drain that the surgeon puts in during surgery can become blocked. This can cause blood to collect under the skin and form a clot (haematoma). If this happens, you might need to go back to the operating theatre to have the clot removed and the drain replaced.

Other possible effects

You might have other effects due to damage to some of the nerves that supply the head and neck area.

They include:

• numbness of the skin and the ear on the same side as the operation
• loss of movement in the lower lip
• loss of feeling or movement on one side of the tongue

Let your doctor or specialist nurse know about any side effects that you have so they can help you to cope with them.

• Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines 

  V Paleri and N Roland

  The Journal of Laryngology and Otology, volume 130, number S2, May 2016

• Improving outcomes in head and neck cancers 

  National Institute for Health and Care Excellence, November 2004 (updated June 2015)

• Overview of approach to long-term survivors of head and neck cancer

  Robert Haddad and others

  UpToDate website

  Accessed November 2020

Last reviewed: 

06 Nov 2020

Next review due: 

06 Nov 2023

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NECK DISSECTION – Dr John Chaplin Head and Neck Surgeon

Dr John Chaplin – Head and Neck Surgeon.

Auckland. NZ

A Neck Dissection is an operation designed to remove groups of lymph nodes from the neck for treatment of cancer that has actually or has potentially spread from a primary site in the head and neck to the regional lymph nodes.

Neck Lymph Nodes

The neck is divided into seven different levels of nodes as seen on the diagram below. Primary tumours spread (metastasise) to different nodal groups depending on their site. As cancer progresses metastases spread from primary eschelon nodes to nodes further afield.  For example, skin tumours from the lip and anterior face tend to spread to facial and sudmandibular/submental nodes (level I) intially. As the disease advances lower neck nodes tend to become involved.

The number, size and position of lymph nodes involved by tumor is prognostically important. ie. The larger and lower in the neck the nodes are the worse the prognosis. Cancer also has the ability to grow beyond the confines of the lymph node into surrounding soft tissue. This phenomenon is known as extranodal extension and it is also a bad prognostic factor. A larger node has a higher  chance of extranodal extension.

The levels of lymph nodes in the neck used for staging metastatic head and neck cancer.

Primary Tumours

The types of Head and neck cancers that readily spread to neck lymph nodes include:

1. Skin Cancers and Melanoma
2. Thyroid Cancers
3. Mouth, Throat and Larynx Cancers
4. Some Salivary Gland Cancers

Principles of Neck Dissection

Neck Dissections are performed in two situations. 1. where neck lymph nodes are clinically or radiologically involved with cancer (Therapeutic Neck Dissection). or 2.  where there is high probability that lymph nodes will be involved even though there are no clinically or radiologically involved nodes (Elective Neck Dissection). Elective Neck Dissections are performed if the risk of occult metastatic nodes is 20-30% or greater. If the primary tumour extends towards the midline or if it involves an area that has a high risk of spread to both sides of the neck, bilateral neck dissections are performed. Adjuvant treatment with radiation or sometimes chemotherapy and radiation together is recommended if there is more than one lymph node involved on pathological review or if there is extranodal extension present.

Types of Neck Dissection

There are two types of Neck Dissection and several subtypes within these two groups:

Selective Neck Dissection

Level I-III (Supraomohyoid)

Level I-IV (Extended supraomohyoid)
Level II-IV (Lateral)
Level II-V (Posterolateral)
Level VI (Central)
Level VII (Superior mediastinal)

Comprehensive Neck Dissection

Comprehensive neck dissections invlove removal of all five lateral lymph node levels and are usually performed for clinically detectable neck metastases particulary if these are multiple, large or involve a number of levels. In thyroid cancer metastases this type of neck dissection would be reserved for nodal disease that invaded surrounding structures.

The Radical Neck Dissection described initially by George Crile in 1906 involves removal of lymph node levels I-V, the sternocleidomastoid muscle, the internal jugular vein and the spinal accessory nerve. The Modified versions of this operation involve sparing one or more of the non lymph node structures. This can only be done if it is oncologically feasible and it usually means sparing the spinal accessory nerve which is the only “functional” aspect of this procedure. The Extended Radical Neck Dissection refers to a similar operation but also involves removing other surrounding strucutres that are involved by tumour including skin, prevertebral muscle or mandible.

Right modified radical neck dissection performed in conjunction with a segmental mandibular resection for SCC of the right lower alveolus stage T2N2b.

Selective Neck Dissection

During the 1960’s there was a paradigm shift in the management of neck lymph nodal metastases. Bocca and others realised that the lymph nodes were arranged within fascial envelopes in the neck and were not present in the muscles , nerves or veins. It was demonstrated that the fascial envelopes containing the metaststatic nodes could be removed with preservation of the functional structures if those structures were not directly invaded by metastases. Recurrence rates were no different to more radical procedures but the morbidity of the “selective” procedures was shown to be less.
It also became evident that, with many head and neck cancers, positive nodal disease was present before it was clinically obvious. Each primary cancer site was demonstrated to drain to lymph nodes in predictable levels of the neck as shown in the above diagram. Treating these occult metastases before they became enlarged nodes was shown to improve survival.
Selective Neck Dissection is now the procedure of choice for treating occult or early clinical neck metastases.

Procedure

Neck Dissections are either performed in isolation or in association with resection of the primary lesion and the approach may vary depending on the site of the primary. Incisions are usually made from the region of the mastoid tip passing in a curved fashion below the jaw forward into the submental region. there is frequently a descending limb that passes from the mid point of the superior incision down towards the clavicle. Flaps are raised in the superficial muscle layer (platysma) of the neck. The lymph nodes and other structures are then removed with preservation of vital nerves and blood vessels. At the end of the procedure he wound is closed over suction drains.

Complications

It is important to remember that although there are many potential complications these are rare.

• Bleeding/Haematoma
• Nerve Injury
• Chylous Fistula
• Infection
• Serum

Computed tomography of the neck lymph nodes in Krasnodar – URO-PRO

Computed tomography is a modern research method based on the ability of X-ray radiation to pass through human tissues with different densities. It may be due to the use of a CT scanner or scanner.

It has a complex structure, including an arch or portal, detectors, X-ray tube, absorbers. CT images are 2D images. However, conducting this study also allows you to perform a 3D reconstruction of a given area.

This imaging method is modern, safe, non-invasive and affordable.

The implementation of computed tomography of the lymph nodes of the neck is carried out with suspicion of lymphadenopathy, a malignant process, autoimmune pathology, as well as for the diagnosis of tumors and an infectious disease. The results of the study are also needed for planning possible surgical treatment in people suffering from tumors of the neck and soft tissues of the neck and head.

Computed tomography is better tolerated by claustrophobic people than MRI.
Neck CT scans can be used in people with pacemakers, shunts, or pumps because CT scans do not alter or override previously set device settings.

Neck and lymph nodes

The neck is a complex anatomical region. It contains the initial sections of the respiratory system (trachea, larynx), the digestive system (esophagus), blood vessels that supply the brain and carry out venous edema, as well as many lymph nodes.

Lymph nodes are part of the lymphatic system. In addition to them, it includes: the spleen, lymphatic vessels, thymus gland, tonsils. The lymphatic system is essential for fighting infections and is involved in adaptive, innate immunity, in the filtration and drainage of interstitial fluid, and in the recycling of cells at the end of their life cycle.

Lymph nodes are located at the junction of large blood vessels. An adult has about 800 lymph nodes. Most of it is located on the neck, in the armpits, chest, abdomen and groin. They filter the incoming lymph and play an important role in the functioning of the immune system.

Lymph nodes are usually 1 to 2 cm in size and encapsulated in adipose tissue. The normal size depends on the location, usually the lymph nodes are about 1 cm in diameter. They are considered pathological if they lose their oval shape, if there is an asymmetric thickening or enlargement.

Lymph nodes of the head and neck are paired and widely divided into superficial and deep nodes.

Superficial:

• occipital lymph nodes,
• mastoid (behind the ear) nodes,
• preauricular (parotid) nodes,
• superficial parotid nodes,
• submental lymph nodes,
• submandibular nodes.

Deep:

• deep parotid knot,
• deep cervical nodes. They are located along the internal jugular vein. Depending on their anatomical position, they are called preglottal, pretracheal, pharyngeal, sublingual, jugular-bigastric, jugular-hyoid and supraclavicular nodes.

Virchow’s node, the left suprascapular lymph node, is located near the junction of the thoracic duct and the left subclavian vein, where lymph from most of the body drains into the systemic circulation. The drift of a tumor from the abdominal cavity (stomach cancer) and the pelvic organs (ovarian cancer) can cause an increase in Virchow’s node. This node is also called the guard node.

Carrying out computed tomography of the lymph nodes of the neck allows you to identify the defeat of various groups of lymph nodes.

Lymphadenopathy is the general name for conditions in which an increase in the size of the lymph nodes is detected. It may be secondary to bacterial, viral, or fungal infections, autoimmune diseases, and malignancies.

Lymph node enlargement may be localized or diffuse. About 75% of most lymphadenopathies are localized, with about 50% of them occurring in the head and neck region. Generalized lymphadenopathy, which affects two or more non-contiguous areas, occurs in 25% of cases.

There are several potential causes of lymphadenopathy: infectious, autoimmune, malignant, and lymphoproliferative.

The etiology can be determined by groups of lymph nodes. Mental and submandibular lymphadenopathy usually has an infectious origin, often manifesting as viral prodromal phenomena. Posterior cervical lymphadenopathy can result from localized bacterial and viral infections, as well as from lymphoma.

Cancer of the head and neck most often initially metastasizes to the cervical nodal pools.

As a result, removal of cervical lymph nodes is an important component of the standard of care for many head and neck cancers. A deep understanding of the critical structures, fascial layers and features of the outflow of the cervical lymph nodes in the neck is the key to correct diagnosis, evaluation of the obtained data and the conduct of a safe and oncologically sound operation. Carrying out dissection or removal of the lymph nodes of the neck is impossible without determining in detail their location and evaluation using computed tomography.

Features in the clinic

A Philips CT scanner is installed in the URO-PRO medical center.

CT has a number of important advantages:

• high examination accuracy,
• minimum dose volume,
• if necessary, it is possible to use a contrast study of the selected study area,
• the ability to quickly obtain test results,
• quick diagnostic procedure.

In our clinic, computed tomography of all areas of the human body is performed, with the exception of CT of the teeth.

The equipment is not the most important in diagnosing diseases using X-rays. The interpretation of the results of the study is carried out by radiologists of the clinic, who have extensive experience and work experience.

Indications

• suspected lymph node metastasis in a previously diagnosed tumor,
• suspected lesion of Virchow’s sentinel node (with ovarian tumor, stomach cancer),
• lymphadenopathy of unknown origin,
• suspected lymphoproliferative diseases (lymphoma, leukemia),
• systemic diseases of an autoimmune nature (systemic lupus erythematosus, sarcoidosis, rheumatoid arthritis, amyloidosis),
• infectious process of various localization.

Contraindications

There are no absolute contraindications to computed tomography of the neck lymph nodes.

A relative contraindication is early pregnancy. The decision to conduct this non-invasive examination for pregnant women must be taken together with gynecologists. Diagnosis using computed tomography is carried out if the benefit to the woman is higher than the expected risk to the fetus.

How is a CT scan of the lymph nodes of the neck

The patient needs to come to the study in advance. During the study, you must lie on a special table. At a certain moment, sections or tomograms of the lymph nodes of the neck of various localizations are registered. To do this, the x-ray tube is moved at different angles. During the study, sections or scans are performed in various sections with a minimum step for a detailed assessment of the lymph nodes of the neck.

The received data is transferred to a computer. The radiologist evaluates the result of the study and issues his opinion.

Research results

The study allows you to accurately and in detail assess the structure of the lymph nodes, their changes and damage in malignant or any other processes. However, the result of this method is not a clinical diagnosis. It is necessary to obtain information about the morphological changes in the lymph nodes of the patient’s neck. Upon receipt of the study data, the attending physician may suspect the disease and begin the necessary treatment.

Complications

When performing computed tomography of the lymph nodes of the neck, complications may be associated with receiving a dose of X-ray radiation. Computed tomography is based on the use of X-rays, but the dose received is minimal. In one study using CT, the dose is equal to the radiation received in the natural environment for three to four months.

Study preparation

Computed tomography of the lymph nodes of the neck requires special preparation. It is recommended not to eat for 3 hours before the examination, and to remove all metal jewelry to avoid the appearance of artifacts on the received tomograms of the neck.

Entry

The clinic “URO-PRO” performs computed tomography of the lymph nodes of the neck by appointment. The conclusions of the study are issued to patients as soon as possible.

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Call 8 (861) 252-68-68 or sign up online

Neck hurts: what to do? | clinic of physical therapy 401 (Minsk)

Not every discomfort in the neck indicates a serious problem. The neck may be disturbed due to hypothermia, prolonged sitting or sleeping in an uncomfortable position, excessive physical activity. However, there are such painful manifestations and alarming bells that cannot be ignored. If you are reading this article, it means that the topic is relevant to you. So let’s break down the causes of soreness in the neck on the shelves, and also decide on the main approaches to the treatment of this pathology.

Anatomy of the neck

The cervical spine is represented by 7 vertebrae and 6 intervertebral discs located between them. These discs are limited by an outer, more rigid frame part, consisting of fibrous fibers, and an inner soft core, which creates the required cushioning for the spine.
There is no intervertebral disc between the skull and the 1st vertebra. As, however, it is not between the first two cervical vertebrae. Discs appear only between the 2nd and 3rd vertebrae of the neck.
Numbering starts from the top, from the head to the coccyx. The cervical vertebrae are designated by the letter “C” from the Latin “Cervix” (“neck”) and a number from 1 to 7 (that is, C1 – C7). The discs between them are labeled somewhat differently: the hyphen indicates which vertebrae the disc is located between (for example, C2-C3, C7-Th2). After the seventh vertebra, the cervical region passes into the thoracic (thoracic vertebrae can be recognized by the letters “Th” – from the Latin “Thorax”).

Why does the neck hurt

Why does the neck hurt

The neck, along with the lower back, takes on a significant movement load. This is one of the most mobile parts of the human skeleton, and perhaps its significance can only be fully appreciated when the movements in the neck become painful.

The most common causes of neck pain:

• Cervical injuries – due to falls, accidents or sports – in some cases cause complications such as retrolisthesis and antelisthesis of the vertebrae (their displacement).
• Violation of posture.
• Deformities in the cervical vertebrae.
• Protrusion of the intervertebral disc (posterior protrusion, dorsal median protrusion, symmetrical dorsal protrusion, circular and diffuse protrusions).
• Herniated discs (dorsal disc herniation, Schmorl’s hernia, paramedian disc herniation).
• Benign or malignant tumors (eg hemangiolipoma and hemangioma in the vertebral body).
• Infectious and endocrine diseases.
• Heart disease such as angina or heart attack radiates to the neck.
• Hypothermia, prolonged overexertion of the neck muscles cause a clinical picture of myositis.

Weak spot in the neck

The connection between C5 and C6 is the most vulnerable spot in the cervical region. The fact is that it is these vertebrae and this particular intervertebral disc that are the first to take the blows, get injured from unsuccessful falls. In addition, this part of the cervical region bears the brunt of the cranium day after day. No less merit of these vertebrae is that they provide head tilts – and quite large in amplitude.

Alas, the anatomical features of the muscular skeleton of this area contribute to the formation of protrusion of the C5-C6 discs. The muscles here are small in size and often do not provide sufficient support for the spinal column. With age, the muscles become denser, this worsens the blood supply, which disrupts the nutrition of the vertebrae and discs – osteochondrosis occurs, and then – protrusion of the C5-C6 discs.

What areas of the neck do our patients most often worry about?

Causes of pain in the neck on the right

Common name for neck pain is cervicalgia. If you are concerned about one half of the neck, be aware that this may be a sign of various pathologies of traumatic, infectious, neurological origin. The causes of pain in the neck on the right are many-sided, and an experienced orthopedic doctor will help to understand them.

The tactics of treating pain on the right side of the neck directly depends on the diagnosis and the degree of development of the pathology. And with timely treatment, the result of treatment, as a rule, is very good. For example, neuralgia responds well to treatment. But if you ignore the symptoms and endure pain, then neuralgia goes into a stage in which critical structural changes occur in nerve cells. This is already fraught with much more serious consequences.

Causes of pain in the neck and shoulder on the right back

As a rule, patients complain of the following types of pain in the neck:

• aching (endocrine diseases, neoplasms),
• acute (occurs with a sharp pinching of nerve endings due to protrusion, hernia),
• pulling (with developing inflammatory process),
• dull pain (with hypothermia or neuralgia).

One of the most common causes of such localization of pain is diseases of the cardiovascular system. If the pain sensations are concentrated behind the neck and spread to its right half, then it will not be superfluous to sign up for a consultation with a cardiologist. A specialist will check you for angina, coronary heart disease, or cardiosclerosis.

Causes of pain in the back, front and sides of the neck

Pain in various parts of the neck can be triggered by enlarged lymph nodes (lymphadenitis). On the neck there are lymph nodes that are responsible for the teeth, ears, tonsils. By localizing the enlarged, painful lymph nodes, the doctor can determine which organ is the causative agent – and refer to the appropriate doctor for specialized care. You will be surprised, but neck pain can even lead you to the dentist’s chair, for example, to remove a wisdom tooth or treat periodontitis of the lower molar.

Therefore, the answer to the question: “What should I do if my neck hurts on the right, behind, in front?” can be very detailed and extensive. We recommend that you consult a doctor for a more detailed diagnosis.

Causes of simultaneous pain in the neck and shoulders, ways to eliminate it

The simplest and most common causes of pain in the neck and shoulders are muscle spasm due to nervous overstrain, irrational physical activity or a long stay in an uncomfortable position.
For example, in case of injury, accompanying symptoms will be swelling of the shoulder region, hematoma, or bruising. Movement in the damaged joint becomes sharply painful.
Another common cause is osteochondrosis. With this disease, the cartilage between the vertebrae is first affected, and then the damage passes to the tissues surrounding them.
In the initial stages of osteochondrosis, the symptoms are almost invisible. With the development of pathology, dizziness, headache, and a feeling of “flies” before the eyes join mild pain in the neck. If nothing further is done to treat the disease, then there is a loss of sensitivity in the hands, weakness in the limbs, and hypertension develops. It is equally important that osteochondrosis can lead to atherosclerosis of cerebral vessels – which is very dangerous.

Neck pain radiating to other parts of the body

As you understand, everything is interconnected in the human body. And if one organ or part of the body is damaged, pain symptoms can spread to neighboring areas. Of course, this can make diagnosis somewhat difficult, but at the same time, it can be a key sign of a particular disease.

A striking example is the ventral wedge-shaped deformity of the vertebral body. This is a disease that can be either congenital or acquired. And despite the fact that this pathology rarely affects the cervical regions, it has a tremendous impact on the functioning of the whole organism.

Deformation of the vertebrae causes compression of the nerve endings that come out of the spinal cord. The pain that occurs in this case radiates not only through the arms, but also through the legs, to the abdomen and groin area. This leads to a violation of the sensitivity of these zones, paresthesia (burning, goosebumps, tingling). But the most unpleasant thing is that active movements are disturbed, the patient is haunted by a constant feeling of weakness.

If it is the cervical vertebrae that are affected by the wedge-shaped deformity, fainting, impaired attention and memory occur. In some cases, the situation comes to paresis and paralysis. Treatment of this disease is long, complex and difficult.

Causes of pain in the neck

Possible causes of pain in the neck and their manifestation:

MRI diagnosis	Symptoms
Protrusion (protrusion) of the intervertebral disc C1/C2, C2/C3, C3/C4, C4/C5 vertebra	Pain, constant or aggravated by holding the head still
Posterior disc protrusion C1/C2, C2/C3, C3/C4, C4/C5, C5/Th2	Causes severe pain symptoms. It is the most severe type of protrusion, because. can cause nerve root compression.
Dorsal (posterior) median protrusion of C1/C2, C2/C3, C3/C4, C4/C5, C5/Th2 discs	Asymptomatic as long as the anulus fibrosus does not involve nerve endings when stretched.
Symmetrical dorsal protrusion of C1/C2, C2/C3, C3/C4, C4/C5, C5/Th2 discs	Throbbing in the head, dizziness, pain in the neck, numbness of the arms and shoulders.
Circular protrusions of C1/C2, C2/C3, C3/C4, C4/C5, C5/Th2 vertebrae	Develops slowly, has chronic sluggish symptoms. May cause asymptomatic disability.
Diffuse protrusions of C1/C2, C2/C3, C3/C4, C4/C5, C5/Th2 vertebrae	It is considered more dangerous, as it often leads to an inflammatory process.
Median disc protrusion C1/C2, C2/C3, C3/C4, C4/C5, C5/Th2	Local pain in the neck, muscle weakness, pain radiating to the arm.
C1/C2, C2/C3, C3/C4, C4/C5, C5/Th2 herniated discs	Dull or aching pain in the neck, between the shoulder blades, numbness of the arms and shoulders, tingling in the upper limbs.
Dorsal disc herniation C1/C2, C2/C3, C3/C4, C4/C5, C5/Th2 vertebrae	The pain begins in the head, and over time spreads to the neck, shoulders, arms, gives under the shoulder blade.
Schmorl’s hernia C1, C2, C3, C4, C5, C6, C7	A rare form, occurs in osteoporosis, is asymptomatic and is discovered incidentally.
Paramedian disc herniation C1/C2, C2/C3, C3/C4, C4/C5, C5/Th2	Loss of sensation, numbness, soreness, decreased muscle tone.
Hemangiolipoma and hemangioma in the body of C1 (C2, C3, C4, C5, C6, C7) vertebra	Does not manifest itself for a long time. The first symptom is mild pain after exercise or at night.
Retrolisthesis and antelisthesis C1 (C2, C3, C4, C5, C6, C7) vertebra	Violation of range of motion, neurological symptoms worsen at advanced stages of the disease.
Ventral-wedge-shaped deformity of the body C1 (C2, C3, C4, C5, C6, C7) of the vertebra	Pain after sudden movements, heavy lifting. With the progression of the disease becomes constant.
MR picture and signs of degenerative-dystrophic changes (osteochondrosis) of the cervical spine	Dizziness, headache, increased blood pressure.
Osteochondrosis of the cervical spine 1 (2, 3 degrees)	Pain in different parts of the body, weakness in the hands, low sensitivity of the hands.
Spondylarthrosis of the cervical spine 1 (2, 3 degrees)	Severe pain attacks when tilting and turning the head, tinnitus, nausea.

Diagnosing the causes of neck pain

It is important to understand that an article on the Internet is not the best way to diagnose yourself, but rather a hint. After all, for a correct diagnosis, a full-fledged external examination, an anamnesis (that is, you tell the doctor about your complaints, past diseases), the doctor analyzes, suggests and differentiates various pathologies with often similar symptoms, is necessary.

If necessary, the specialist prescribes an X-ray image in at least two projections. This allows you to determine violations in the position of the vertebrae or suspect osteochondrosis.

If the patient complains of neurological manifestations such as dizziness, blurred vision or hearing, an MRI (magnetic resonance imaging) will be required.

Examination of the neck blood vessels (angiography and vascular ultrasonography) can provide important additional information.

General and biochemical analysis of blood allows to exclude infections and diseases of adjacent organs. A blood test for hormones and tumor markers makes it possible to refute thyroid diseases or the presence of malignant neoplasms in the neck.

No wonder they say that the correct diagnosis is already half the success of the treatment.

How to relieve pain and tension in the neck

How to relieve pain and tension in the neck

After the diagnosis is made, the doctor determines the treatment plan. The patient is most concerned about how to relieve pain, so the first thing the doctor prescribes is medication aimed at reducing inflammation, relieving muscle hypertonicity and pain syndrome.

When selecting drugs, a specialist must take into account the severity of the disease and the diagnosis itself – at what level the problem occurred.

Prescribing drugs to yourself can lead to unpleasant complications, because if some certain pills helped your girlfriend or brother with neck pain, this does not mean that they will become a panacea for you too. All medications must be prescribed by a doctor!

After the elimination of the acute phase of the disease, special attention should be paid to physiotherapy exercises and massage.