How does lifting heavy objects affect neck health. What are the common causes of neck pain from physical activities. How can proper form and technique prevent neck strain. What are effective strategies for relieving neck stiffness and pain. How do different exercises impact neck muscles.

Understanding the Link Between Heavy Lifting and Neck Pain

Neck pain resulting from lifting heavy objects is a common issue that affects many individuals, whether they’re engaged in regular workout routines or occasional physical labor. The connection between heavy lifting and neck discomfort isn’t always obvious, but it’s crucial to understand for maintaining optimal neck health.

Heavy lifting can strain the muscles and joints in the neck and shoulder area, leading to pain and stiffness. This occurs due to several factors:

• Overuse of neck and shoulder muscles
• Strain on the joints in the neck
• Potential pinching of nerves in the neck or shoulder region

One of the primary culprits behind neck pain during or after lifting is poor posture. Emily Roy, a physical therapist at the Sports Medicine Center at Harvard-affiliated Massachusetts General Hospital, emphasizes that many people unknowingly maintain incorrect posture during activities, which can result in neck strain.

The Role of Posture in Neck Pain During Physical Activities

Proper posture plays a crucial role in preventing neck pain during physical activities, including lifting heavy objects. When individuals maintain poor posture, such as keeping the chin forward and shoulders slouched, it creates tension in the neck and surrounding muscles.

The trapezius muscle, a large diamond-shaped muscle extending from the base of the skull to the shoulders and halfway down the back, often bears the brunt of this stress. This can lead to a dull, achy pain or even headaches due to the tightening of muscles at the base of the skull.

How to Maintain Proper Posture When Lifting

• Keep your chin tucked slightly towards your chest
• Engage your core muscles
• Keep your shoulders back and down
• Lift with your legs, not your back
• Avoid twisting movements while lifting

Common Activities That Can Cause Neck Pain and Quick Fixes

Various physical activities can contribute to neck pain if not performed correctly. Here are some common activities and quick fixes to help prevent neck strain:

1. Cycling

Leaning over to reach handlebars can cause rounding of the back and hunching of shoulders.

Quick fix: Bring shoulder blades down and back while leaning forward. Maintain a slight arch in the back and keep the chest open.

2. Gardening

Crouching, looking down, and lifting heavy objects can strain neck muscles.

Quick fix: Pull the chin back when looking down, take frequent breaks, stay close to the work area, and use leg muscles for lifting.

3. Swimming

Consistently turning the head to one side for breathing or using the breaststroke can strain neck muscles.

Quick fix: Alternate swimming strokes and breathing sides periodically.

4. Golf

Extending the neck during swings and carrying a golf bag on the same side can lead to muscle imbalances and pain.

Quick fix: Bring the chin towards the neck when looking at the ball and alternate shoulders when carrying a golf bag.

5. Yoga

Certain poses like “downward dog” can extend the neck, while excessive head turning can stress neck joints.

Quick fix: Maintain a neutral neck position by keeping the chin towards the neck and limit the range of head turns.

Effective Stretches and Exercises for Neck Pain Relief

Incorporating gentle stretches and exercises into your routine can help alleviate neck pain and prevent future issues. Here’s a simple neck stretching exercise recommended by experts:

Side-bending Range of Motion Exercise

1. Face forward and slowly bend your head to one side
2. Hold for three seconds
3. Repeat on the other side
4. Perform 10 repetitions
5. For an additional stretch, when your head is bent to the side, slowly roll it forward about 45 degrees and hold for three seconds

Remember to perform these exercises slowly and gently. If any movement increases pain, stop immediately and consult a healthcare professional.

Preventing Neck Pain: Strengthening and Proper Form

Prevention is key when it comes to neck pain from lifting heavy objects or engaging in physical activities. Two critical aspects of prevention are strengthening relevant muscle groups and maintaining proper form during activities.

Muscle Groups to Focus On

• Neck muscles
• Shoulder muscles
• Core muscles

Strengthening these muscle groups can provide better support for your neck during physical activities and reduce the risk of strain or injury.

Importance of Proper Form

Using correct form during physical activities is crucial for preventing neck pain. This includes maintaining good posture, avoiding overextension of the neck, and using appropriate techniques for specific activities like lifting, swimming, or golfing.

When to Seek Professional Help for Neck Pain

While many cases of neck pain from lifting can be managed with home remedies and preventive measures, there are instances when professional medical help should be sought. Here are some signs that indicate you should consult a healthcare provider:

• Persistent pain lasting more than a few days
• Pain that radiates down the arms or legs
• Numbness or tingling sensations
• Weakness in the arms or hands
• Severe pain that limits daily activities
• Pain accompanied by headaches or dizziness

A healthcare professional can provide a proper diagnosis and recommend appropriate treatment options, which may include physical therapy, medication, or in rare cases, surgical intervention.

Long-term Strategies for Maintaining Neck Health

Maintaining good neck health goes beyond addressing immediate pain or discomfort. Implementing long-term strategies can help prevent recurring issues and promote overall neck wellness. Consider the following approaches:

1. Ergonomic Adjustments

Ensure your work and home environments are ergonomically optimized. This includes adjusting computer screens to eye level, using supportive chairs, and maintaining proper posture during sedentary activities.

2. Regular Exercise Routine

Incorporate neck-specific exercises and stretches into your regular workout routine. This can help maintain flexibility and strength in the neck and surrounding muscles.

3. Stress Management

Stress can contribute to muscle tension, particularly in the neck and shoulder area. Practice stress-reduction techniques such as meditation, deep breathing exercises, or yoga to help alleviate tension.

4. Proper Sleep Posture

Use a supportive pillow that keeps your neck aligned with your spine while sleeping. Avoid sleeping on your stomach, as this can strain the neck.

5. Regular Check-ups

Schedule regular check-ups with a healthcare provider or physical therapist to address any emerging issues before they become chronic problems.

By implementing these long-term strategies, you can significantly reduce the risk of neck pain from lifting heavy objects and other physical activities, ensuring better overall neck health and improved quality of life.

Advanced Techniques for Managing Chronic Neck Pain

For individuals dealing with persistent or chronic neck pain resulting from heavy lifting or other physical activities, more advanced management techniques may be necessary. These approaches often involve a combination of professional interventions and self-care strategies:

1. Physical Therapy

A physical therapist can design a personalized treatment plan that may include:

• Manual therapy techniques
• Targeted strengthening exercises
• Postural correction strategies
• Pain management techniques

2. Acupuncture

Some individuals find relief from neck pain through acupuncture, an ancient Chinese healing practice that involves inserting thin needles into specific points on the body.

3. Massage Therapy

Regular massage sessions can help reduce muscle tension, improve circulation, and promote relaxation in the neck and shoulder area.

4. Chiropractic Care

Chiropractic adjustments may help alleviate neck pain by improving spinal alignment and reducing nerve irritation.

5. Mind-Body Techniques

Practices such as mindfulness meditation, biofeedback, and cognitive-behavioral therapy can help manage pain perception and reduce stress-related muscle tension.

6. Advanced Pain Management

In some cases, more intensive pain management techniques may be recommended, such as:

• Epidural steroid injections
• Nerve blocks
• Radiofrequency ablation

These advanced techniques should always be pursued under the guidance of a qualified healthcare professional who can assess your specific condition and recommend the most appropriate treatment options.

Remember, managing chronic neck pain is often a multifaceted approach that requires patience and persistence. It’s essential to work closely with healthcare providers to develop a comprehensive treatment plan tailored to your individual needs and lifestyle.

Is your workout giving you a stiff neck?

Try these quick fixes to stay active and avoid neck pain.

Physical activity is important to feeling great and staying healthy. But the wrong execution of a particular move, such as a golf swing or swimming stroke, may wind up causing neck pain. “Often people don’t realize their activity is to blame,” says Emily Roy, a physical therapist with the Sports Medicine Center at Harvard-affiliated Massachusetts General Hospital.

Neck pain after working out: What goes wrong

Neck pain may result from overuse of muscles in the neck and shoulder (many shoulder muscles also attach to the neck), strain on the joints in the neck, or a pinched nerve in the neck or shoulder area.

Roy says one of the biggest contributors to neck pain is poor posture during an activity. “Instead of pulling the chin down for a neutral posture, some people keep the chin forward and shoulders slouched. That makes the chin stick out and creates tension in the neck and surrounding muscles,” Roy explains.

The trapezius muscle takes the brunt of that stress. It’s a large diamond-shaped muscle that starts at the base of the skull, widens at the shoulders, and reaches halfway down the back.

“It’s a dull, achy pain,” Roy says. “Or you may get headaches from the muscles at the base of the skull. In the extended neck position, they tighten and get irritated.”

Avoiding neck pain

Here are some ways in which common activities lead to neck pain, and quick fixes to counteract bad form.

Cycling. Leaning over to reach the handlebars of a road or mountain bike can cause you to round your back and hunch your shoulders up to your ears.

Quick fix: Bring your shoulder blades down and back as you lean forward. “It’s a subtle motion while still leaning forward. Get your shoulders away from your ears, slightly arch your back, and stick out your chest,” Roy explains.

Gardening. Crouching and looking down, reaching very far and lifting heavy objects all stretch your neck in a way that strains neck muscles.

Quick fix: Pull your chin back as you look down; take frequent breaks; stay close to the area you are working in; use your leg muscles to help lift heavy objects.

Swimming. When doing the crawl, always turning your head to the same side to breathe builds muscles on one side of the neck and shortens muscles on the other side; doing the breaststroke may strain neck muscles.

Quick fix: Alternate swimming strokes (crawl, breaststroke) periodically; when doing the crawl, alternate the breathing side occasionally.

Golf. Extending the neck while you swing causes tension; carrying a golf bag on the same side all the time leads to uneven muscles and pain.

Quick fix: Bring your chin toward your neck as you look down at the ball so your neck is not extended; alternate shoulder sides when you carry a golf bag.

Yoga. Looking up when doing a “downward dog” position can extend the neck; turning your neck too far when looking behind you can stress the neck joints.

Quick fix: Keep your chin toward your neck for a neutral position; limit how far you turn your head.

Neck pain relief and prevention

Gentle stretches may help relieve your neck pain (see “Move of the month”). “Slowly tip the head to the side — ear to shoulder — then do the same on the other side. But don’t do this if it increases pain,” warns Roy.

Remember that using the proper form during physical activity prevents neck pain— so does strengthening the neck, shoulder, and core muscles.

For more ideas, you can check out the Harvard Special Health Report Neck Pain (/neck).

Image: © Goodluz/Getty Images

How to Treat Stiff Neck from Physical Work

Movement and exercise tend to be good for the neck, but overdoing it can lead to neck pain and stiffness. When a stiff neck develops as a result of overexertion during physical work, the symptoms might start immediately after the injury occurs or perhaps be delayed by a few hours or more. Starting treatment at the first sign of symptoms, rather than continuing the work or letting the pain get worse, may prevent further injury and speed the recovery process.

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How a Stiff Neck Can Develop from Physical Work

Whether working full-time as a construction worker or helping a friend move across town, doing physical labor that involves carrying heavy items or holding the neck at awkward positions can lead to neck strain and stiffness. Some common examples include:

• Lifting or carrying objects that are too heavy. When trying to lift or carry an object that is too heavy, a person is more likely to compensate by using poor posture or bending the neck awkwardly to maintain balance or momentum.
• Repetitive motions or overuse. Some tasks require the same motions over and over, such as looking up while painting a ceiling, or looking down while laying bricks. When a muscle or joint gets overused, it can become inflamed and stiff.
• Performing a new task or maneuver. A muscle is more susceptible to becoming strained when worked in an unfamiliar way. For example, carrying a long, bulky item might not be too heavy, but if it requires bending the neck at an unusual angle, it may cause a stiff neck later.

See Neck Strain: Causes and Remedies

If pain does not develop soon after the action or activity that caused the neck strain, the exact cause of the stiff neck may not be known. While it can be helpful to have this information, it is not needed.

In This Article:

• Stiff Neck Remedies Based on Cause

• How to Treat a Stiff Neck After Sleeping

• How to Treat Stiff Neck at the Office

• How to Treat Stiff Neck from Physical Work

• How to Treat Stiff Neck After Direct Trauma

• Stiff Neck Symptoms and Causes Animation

• Video: How to Prevent a Stiff Neck While Sleeping

• Video: 4 Best Stiff Neck Remedies After Sleep

Strategies for Treating a Stiff Neck from Physical Work

Some physical jobs require much more of the neck’s muscles and joints, so if a stiff neck develops, the job can become much more challenging or even impossible. Here are some steps to reduce pain and make a good recovery:

• Do not ignore the pain and stiffness. Taking a break from physical work is the best option when a stiff neck interferes with normal motions. Particularly when doing heavy lifting or working with dangerous machinery, ignoring painful neck flare-ups or reduced range of motion could lead to an even more serious injury due to overexertion or reduced coordination and concentration.
• See how the neck responds after applying pain relief. Remedies applied for a stiff neck can vary depending on what is available in the work environment, as well as personal preferences. Applying an ice pack to the neck can help reduce swelling, whereas a heat pack or warm, damp towel can help loosen and relax the muscles. Some people might experience some relief from stiff neck symptoms by taking an over-the-counter pain reliever, such as ibuprofen or naproxen.
• Test and work on range of motion. If a stiff neck is particularly tight and painful, it may not be worthwhile to attempt stretching. However, if gentle neck movements can be made without worsening the pain, it can help improve range of motion and may reduce pain. Gentle neck stretching can be done by slowly tilting the head forward/backward, bending side to side, and rotating from one side to the other. If pain starts to increase due to a specific motion, that motion should be stopped and the next motion can be tried. Applying a gentle self-massage to the sore area may also help loosen the muscles and reduce pain.

See Treatment for a Stiff Neck

Sometimes a stiff neck starts to improve after a short rest and applying some treatments, but it is more likely that the pain and stiffness persist for at least a day or two before significant relief is achieved. If neck stiffness has gotten so bad as to prevent turning the head to one side, driving may become dangerous. In such a case, it is better to get a ride home from work if needed.

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How to Avoid a Stiff Neck from Physical Work

Taking these basic precautions can reduce the risk for developing a sore and stiff neck at work:

• Be smart about lifting and carrying. Using good posture when lifting involves bending at the knees (not the waist) and keeping the head above the shoulders rather than leaning too far forward. If an item is particularly heavy, it may make more sense for 2 people to lift it.
• Take breaks. Taking regular breaks gives muscles and joints some time to relax and recover, which may enable more work to be done in the long run. Taking breaks is especially important when performing a task that is unfamiliar or new, such as learning to work new machinery or a different type of job.

Even when taking precautions, it is still possible for a stiff neck to occur. If neck stiffness keeps returning or is accompanied by more troubling symptoms, such as a headache or pain that goes into the arm, consult with a doctor.

See When Is a Stiff Neck Serious?

Dr. Grant Cooper is a physiatrist with several years of clinical experience, specializing in the non-surgical treatment of spine, joint, and muscle pain. He is the Co-Founder and Co-Director of Princeton Spine and Joint Center and the Co-Director of the Interventional Spine Program.

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Editor’s Top Picks

• Neck Strain: Causes and Remedies

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Treatment of lordosis of the cervical spine in Moscow at the Dikul clinic: prices, appointments

Cervical lordosis is a medical term for a change in the physiological curvature in the cervical spine. Physiological curvature in the cervical region is necessary for the proper functioning of the spine and a change in this curvature can lead to a violation of biomechanics and various pathological conditions. Curvature in the cervical spine can vary widely and result in a variety of symptoms. Sometimes the normal curve straightens out, making it difficult to move the neck or it becomes more curved than usual, sometimes it can deviate to the right or left and at the same time be excessively curved. Treatment of lordosis of the cervical spine depends on the severity of the deformity and genesis, and can be either conservative or surgical.

Types of lordosis of the cervical spine

Hyperlordosis: more forward arching of the neck than normal. Visually, there is a feeling that the head has gone far frontally forward and possibly lowered below shoulder level. In fact, these patients have pathological extension of the neck.

Hypolordosis: also called cervical kyphosis or military neck. This anomaly is manifested by straightening of the cervical spine. When viewed from the side, the human neck looks straightened, without the normal physiological curvature of the neck.

Seven bones form the cervical spine. Although a slight curvature in the neck is normally needed to support the head, however, changing this curvature leads to various problems.

Causes

Although changes in the curvature of the cervical spine develop more often than adults, however, pathological lordosis can also occur in children. Both men and women get sick equally often; also, no dependence of this condition on ethnic group or race was found. The condition is known to be the result of years of poor posture and muscle spasms in the neck. The main causes of cervical lordosis:

Poor posture : Usually occurs in people who sit at the computer for a long time, and this can contribute to the development of pathological lordosis. Prolonged tension of the muscles to hold the head induces them to involuntarily stretch the neck forward. Such long-term static loads and posture disorders can lead to misalignment of the cervical spine.

Trauma: Direct trauma to the cervical spine can result in loss of cervical lordosis, which means the neck cannot be in its natural position. Such changes usually occur after whiplash injuries of the neck.

Osteoporosis : a disease that occurs in the elderly, in which there is an increase in bone porosity and, as a result, bone strength is reduced. Due to the fact that the head weighs a couple of kilograms, this weight affects already fragile bones, which leads to the development of deformities of the cervical spine.

Diseases of the musculoskeletal system : There are diseases of the muscles and skeleton, which are often congenital in nature, and as the body grows, various pathologies develop, such as achondroplasia, kyphosis and scoliosis . Also pathological conditions affecting the intervertebral discs, such as discitis, disc herniation or prolapse , or changes in the position of the vertebrae, such as spondylolisthesis , can also lead to lordosis. In addition, lordosis can be caused by various systemic connective tissue diseases.

The importance of a healthy curvature of the cervical spine

The Homo Sapiens spine consists of 24 bony formations (vertebrae). The spine is a kind of weight support rod, it keeps the body upright and helps in the performance of various motor functions of complexity. In addition, the spine also serves as a kind of protective sheath for the spinal cord, which starts at the end of the brain and extends to the distal spine. The spinal cord is a bundle of nerves that transmit nerve impulses to the brain and from the brain to the periphery.

The cervical spine is part of an important structure and geometry changes can affect various aspects of health.

Symptoms of cervical lordosis

Abnormalities in the structure of the cervical vertebrae and the shape of this part of the spine can lead to variability in symptoms. Considering that important nerve bundles (afferent and efferent fibers) are located in the neck area, which are involved in the exchange of information between the brain and the periphery, problems with the neck can lead to some unwanted symptoms, for example:

Pain/discomfort in the neck : These symptoms are most commonly experienced by individuals with abnormal curvature of the cervical spine and are usually the result of a forward head position. The pain may feel like a stabbing or sharp pain and is often accompanied by difficulty in turning the neck. In some cases, pain may not be felt, but the excess curvature may continue to limit daily activities. The muscles around the neck, shoulders, and upper back are usually tense and may be painful to the touch. Muscle spasms are also commonly noted, which can also reduce range of motion in the neck, difficulty lifting arms, or lifting heavy objects.

Spine compression . If the nerve root is compressed due to abnormal curvature of the spine or instability of the motor segments, this can lead to symptoms associated with effects on the nerve structures. Patients may notice sensory disturbances (numbness and tingling).

As a rule, adequate treatment allows you to get rid of symptoms. But if the treatment of lordosis is not carried out properly, the symptoms will only progress over time.

If the patient develops weakness in the hands and fingers, or difficulty in maintaining movement control, then immediate medical attention may be required. In addition, changes in the curvature of the spine can lead to further changes in adjacent joints, structures, and cause additional health problems.

Most common symptoms in pathological lordosis:

• Muscle spasm / weakness
• Disability
• Fatigue
• Headaches
• Dizziness
• Back pain
• Bad posture

Diagnosis

Diagnosis of lordosis of the cervical spine is based on the history of the disease and clinical examination data.

To verify the diagnosis, the following examination methods can be used:

• Radiography
• MRI
• CT (MSCT)
• PET
• Laboratory diagnostics

Treatment

Depending on the underlying cause of a particular case of curvature anomaly, the treatment of cervical lordosis may vary.

Basic treatments

Medicines. Medication is required only if pain and stiffness are present. Painkillers and muscle relaxants can help relieve pain and muscle spasms in the neck. They allow you to relieve discomfort and increase the range of motion of the neck.

Physiotherapy . Various physiotherapy methods can be used to treat cervical lordosis. Physiotherapy can reduce pain and relieve inflammation.

Traction therapy . Traction is useful in the presence of compression. Traction therapy can reduce root compression and thus reduce symptoms.

Massage. This type of treatment allows you to relax spasmodic neck muscles, relieve pain and restore flexibility of the neck.

• Corsetting . In severe forms of cervical lordosis, it may be necessary to use a corset during the day and a special orthopedic pillow during sleep. This fixation helps to fight the abnormal curvature of the cervical spine.

Acupuncture. This method of treatment is used in the presence of pain manifestations, sensory disturbances, especially when there are signs of compression of the nerve structures.

• Exercise therapy . Exercise is an extremely important part and the most effective treatment for cervical lordosis. Exercise therapy helps to correct bad posture, strengthen muscles and increase the range of motion and flexibility of the cervical spine. Regular neck exercises recommended by a physiotherapist help to strengthen the neck muscles, and gradually the patient can move his neck without pain. During treatment, the person should avoid lifting heavy objects.

Cervical lordosis exercises can be an excellent way to reduce pain and improve mobility, but should be done with caution. Ideally, exercises for the treatment of lordosis of the cervical spine should be selected with a qualified exercise therapist.

Prevention of cervical lordosis

Having chronic neck pain can be very uncomfortable and prevent you from doing the simplest daily activities.

Most neck anomalies develop over a long period of time, and the patient usually understands that complications may develop over time.

Key Prevention Recommendations:

• Always Be Mindful of Posture: Poor posture is a major source of spinal pain, as most of us spend most of our days sitting or standing with poor posture. Over time, this can lead to changes in the curvature of the spine, especially the cervical spine.
• Sleeping on your back : Sleeping on your stomach can cause changes in the curvature of your cervical spine over time. If you find this too difficult, there are different types of orthopedic pillows that can help with proper sleeping posture. In addition, you can consult with an orthopedic doctor who can give additional advice.
• Workplace Optimization: Many jobs today require the use of a computer, which can lead to head posture problems. It is recommended that the monitor be raised approximately three inches above eye level, as looking down at the screen can adversely affect the neck over time. Also, keeping your feet on the floor while you work on the computer will help keep your shoulders steady.
• Don’t keep your wallet in your back pocket : Big bulky wallets in your back pocket can create an imbalance in your posture when you are sitting.

Vertebrogenic cervicalgia: symptoms and treatment

18 October 2022

24737

3.9 of 5

Table of contents

• 1 Causes of development
• 2 Symptoms
  • 2.1 Muscular tonic syndrome
  • 2.2 Radiculopathy with cervicalgia
  • 2.3 Vertebral artery syndrome
• 3 Possible complications
• 4 Diagnosis
• 5 Treatment
  • 5. 1 Pharmacotherapy
  • 5.2 Physio therapy
  • 5.3 Exercise therapy
  • 5.4 Manual therapy and therapeutic massage
• 6 Surgery for cervicalgia

Cervicalgia is one of the most important problems of modern medicine, as it very often leads to disability and is very often observed in young people. This term refers to pain in the neck, the causes of which can be completely different. Most often, it is caused by vertebrogenic disorders, especially degenerative-dystrophic changes in the cervical spine. According to statistics in different countries of the world, from 12 to 71% of people seek medical help with this problem. And in the next 1–5 years, it reappears in 50–85% of patients.

Causes of development

Cervicalgia is not an independent disease, but only a manifestation of existing vertebrogenic and non-vertebrogenic disorders. However, most often they lie in the spine. In the vast majority of cases, most of the neck is due to the occurrence of degenerative-dystrophic changes in the intervertebral discs, facet joints. Following this, the bodies of adjacent vertebrae, ligaments and muscles are involved in the pathological process. Violations in them provoke irritation and compression of the nervous structures, which leads to the appearance of pain radiating to the hands or head.

Therefore, the most common causes of cervicalgia are:

• facet joint dysfunction;
• myofascial syndrome;
• osteochondrosis;
• protrusions and herniated discs;
• spondylosis;
• arthrosis of the facet joints.

Provoke these diseases:

• obesity;
• sedentary lifestyle;
• heavy physical labor;
• microcirculation disorders;
• developmental anomalies and hereditary factors;
• malnutrition and other causes.

Neck pain is often considered a component of the so-called “office syndrome”, in which there are disturbances in the work of many organs and systems due to the adverse effects on the body of a long stay in a sitting position.

Also provocateurs of cervicalgia can be injuries of the intervertebral joints, discs, muscles, ligaments and the vertebrae themselves. Much less often, it becomes a manifestation of rheumatic diseases and neoplasms.

Nevertheless, the main role in the development of pain in the neck belongs to chronic microtraumas of the cartilaginous structures of the spinal column. They can occur not only with a sharp lifting of a heavy object or constant physical labor, but also against the background of prolonged sitting or standing, as this also creates increased stress on the spine and provokes a violation of microcirculation.

As a result, the course of metabolic processes in the cartilaginous tissue is disturbed: the processes of decay begin to prevail over the processes of synthesis of new cells. This leads to a decrease in the amount of glycosamines contained in cartilage, distortion of the structure of collagen fibers and other undesirable changes. All this causes a weakening of the fixation of the intervertebral disc to the end plates and provokes inflammation. It, in turn, causes irritation of the nervous structures and triggers a whole cascade of changes in the body, which leads to pains of varying intensity in the neck, arms, and head.

Very often with prolonged pain there is a reflex muscle spasm, especially short occipital muscles, scalene and extensors of the neck. This leads to a smoothing of the cervical lordosis and aggravation of pain. Mechanical compression or inflammatory irritation of the nerves provokes a powerful pain syndrome. And when deformed or displaced structures of the cervical spine infringe on the spinal roots that pass through each vertebra, a radicular syndrome or radiculopathy develops with vivid neurological disorders. The vertebral arteries passing through the cervical vertebrae are also capable of succumbing to compression, which causes complications of cervicalgia with manifestations of the vertebral artery syndrome.

Symptoms

Since many vertebrogenic diseases are capable of provoking the appearance of cervicalgia, neck pain can be of a different nature and be accompanied by various accompanying symptoms. This directly depends on the nature of the pathological changes that have arisen, their severity, the involvement of nearby anatomical structures and structural features of the cervical spine.

To be precise, distinguish:

• directly cervicalgia, ie isolated pain in the neck;
• cervicobrachialgia – pain in the neck, supplemented by muscular-tonic, vegetative-vascular and neurodystrophic manifestations;
• cervicocranialgia – neck pain radiating to the head.

In general, they can be considered as stages in the progression of one problem, since often initially there is only mild discomfort in the neck, which is subsequently complicated by musculo-tonic disorders, radiculopathy and vertebral artery syndrome. And often in one patient, especially in advanced cases, there are signs of each of them.

Muscular tonic syndrome

Muscle-tonic syndrome is the most common first manifestation of arthrosis of the facet joints, hypertrophy of the ligamentous apparatus. Long-lasting cervicalgia provokes a reflex spasm of the muscles of the upper shoulder girdle, cranial muscles, especially with a tendency to be subjected to static or dynamic loads for a long time. This is associated with the addition of already muscle pain. They are usually aching or pulling, but tend to get worse when the neck muscles are stretched. As a result, a vicious circle is formed: “pain-spasm-pain”. This is complicated by the addition of mobility restrictions. When trying to massage the neck, you can find local areas of compaction in the muscles, which are very painful when pressed.

The tension of individual muscles leads to a forced position of the head. It deviates forward or to the side, and attempts to restore a normal position lead to a sharp increase in pain. Spasmodic muscle fibers can cause compression of the nerves passing through them, which leads to pain that radiates to the arm or head. But the characteristic difference from radiculopathy is the absence of symptoms of loss of sensitivity and a slightly different nature of the pain syndrome.

On average, the duration of pain is about 10 days. But for many, they are observed for a month, less often – more than 3 months.

Radiculopathy with cervicalgia

Nerve roots run through the cervical vertebrae, branching off in pairs from each segment of the spinal cord. They are responsible for the innervation of the skin, muscles and other structures of the neck, shoulder girdle, upper limbs, cranial muscles. With their mechanical compression by a hernia or irritation against the background of aseptic inflammation, microcirculatory disorders, edema, and ischemia occur, which causes neuropathic pain.

Anatomical and biomechanical features of the cervical spine cause a greater tendency to develop pathological changes in the lower cervical vertebrae, which experience the greatest load. Therefore, in advanced cases, with the development of radicular syndrome due to nerve compression, roots C5-C7 are more likely to suffer.

Therefore cervicalgia can be supplemented:

• burning, sharp, shooting pains in the shoulder, arm down to the fingers, shoulder blades;
• sensitivity disorders of various kinds from numbness and goosebumps to burning, etc. in areas innervated by the affected root;
• stiffness of movements, a sharp limitation of the mobility of the neck, arms;
• weakening of reflexes.

If the pathological process is not intervened at this stage, in the future pain sensations arise even without the action of provoking factors, which is explained by the peculiarities of the functioning of the nervous system.

Localization of pain and other disorders directly depends on which root is damaged. So, at:

• Damage to the C4–C5 disc (C5 root) causes pain and sensory disturbances in the neck, shoulder, anterior surface of the forearm. This is associated with weakness of the biceps, brachioradialis muscle.
• In C5-C6 disc (C6 root) lesions, pain and numbness are present on the lateral surface of the shoulder and the back of the forearm, as well as in the thumb. There is a decrease in the tone of the brachioradialis muscle.
• Damage to the C6-C7 disc (C7 root) causes shooting pains and sensory disturbances in the back surface of the forearm, index and middle fingers of the hand. The tone of the triceps muscle, flexors and extensors of the hand, extensors of the fingers is associated with the root of C7. Therefore, with the defeat of its motor fibers, weakness of these muscles is observed.

Vertebral artery syndrome

A distinctive feature of the cervical vertebrae is the presence in them of transverse processes that form a specific bone canal on each side of the vertebra. One of the largest blood vessels, the vertebral arteries, pass through them. They provide blood flow to the brain and can also suffer from the development of pathological changes in the cervical spinal motion segments, leading to a narrowing of the intervertebral foramen. In such cases, vertebral artery syndrome is diagnosed. It can develop due to direct compression of the vessel stem or its narrowing as a result of reflex spasm, damage to the autonomic plexus, which is responsible for regulating the tone of the walls of the vertebral arteries.

Regardless of the mechanism of development, there is a violation of blood flow to the posterior parts of the brain with the appearance of manifestations of hypoxia. In this case, a whole complex of cerebral, vascular and vegetative symptoms arises.

Thus, cervical pain syndromes are often accompanied by neurovascular and trophic disorders. This results in:

• headaches, dizziness;
• tinnitus;
• loss of consciousness;
• changes in the skin of the hands, etc.

Possible complications

Vertebrogenic diseases, the symptom of which is cervicalgia, if left untreated, can lead to many dangerous complications. Among them:

• paresis and paralysis of limbs;
• respiratory failure;
• rapid deterioration of visual acuity and hearing;
• stroke.

Diagnostics

The occurrence of cervicalgia of any type is a reason to consult a neurologist or vertebrologist. The first stage of diagnosis is the collection of an anamnesis, which involves finding out the nature of the existing complaints, the timing of their occurrence and the features of changes over time. The doctor also clarifies whether the patient has chronic diseases, what lifestyle he adheres to, etc.

The second step is inspection. During it, neuroorthopedic methods are used. They make it possible to assess the functional state of the spine, in particular the features of gait, existing postural disorders, etc. Muscular-tonic reactions are necessarily investigated, i.e. the nature of the change in the statics and dynamics of the spinal column, muscle tone, the presence of smoothing of the physiological curves of the spine, its curvature, having limited movement. The examination is supplemented by neurological tests, which allows you to detect signs of radicular syndrome, determine the degree of damage to neurological structures, identify motor, sensory and other disorders.

But in order to accurately determine the cause of the development of cervicalgia, the degree of pathological changes in the structures of the spine, planning treatment tactics and assessing possible risks, instrumental diagnostics is mandatory. Mainly used:

• X-ray of the cervical spine in two projections. This is the simplest and most accessible research method that allows you to detect a number of direct and indirect signs of degenerative-dystrophic changes in the spine and differentiate them from other diseases. The images clearly visualize bone structures, osteophytes, but soft tissue elements, in particular intervertebral discs, are not visible.
• CT. The method allows you to get more detailed information about the changes found on x-rays, especially the vertebral bodies, small joints, and examine intervertebral discs that are invisible to x-rays.
• MRI. This is the best existing method for diagnosing pathological changes in cartilage, spinal cord, cervical roots, large blood vessels and other soft tissue structures. It is he who allows to determine with high accuracy the presence and type of hernia, its size, the degree of influence on other parts of the spinal column.
• Doppler ultrasound. The method is used to assess the quality of blood flow in the vertebral arteries and detect organic changes in their walls, which is necessary in the presence of headaches and other vegetative-vascular disorders.

In disputable cases, myelography, discography, electroneuromyography, densitometry and other types of diagnostic studies may be additionally prescribed.

Treatment

In each individual case, the tactics of treating cervicalgia is selected individually. In this case, first of all, the diagnosis, the degree of changes detected, the potential risks and the severity of the pain syndrome are taken into account. Based on this, a decision is made on the possibility of conservative therapy or surgical intervention.

In most cases, in the absence of a direct threat of irreversible changes, patients are prescribed conservative treatment. It is predominantly complex in nature and implies the inclusion of not only drugs, but also non-drug methods. In this case, the latter play an even greater role than pharmacotherapy.

First of all, all patients are given individual recommendations for lifestyle correction. Most often, it is necessary to reduce weight, since each extra kilogram greatly increases the load on the spinal column. Patients leading a sedentary lifestyle, working in offices, it is recommended to increase the level of physical activity, go in for swimming, yoga, other non-traumatic sports or at least walk in the fresh air daily, take breaks from work to warm up.

Those who are engaged in heavy physical labor, traumatic sports are advised to consider changing jobs and switching to more gentle types of physical activity. It is especially important to abandon sports activities associated with sharp neck movements, in particular gymnastics, martial arts, and wrestling.

In case of exacerbation of cervicalgia, a sparing regimen is indicated. Bed rest or wearing a Shants collar is prescribed for several days. But sticking to it for longer than 1-2 days is not recommended due to the high probability of aggravating the situation.

The conservative treatment of cervicalgia usually includes:

• pharmacotherapy;
• physiotherapy;
• LFC;
• manual therapy and therapeutic massage.

Pharmacotherapy

The main goals of drug therapy is to relieve pain and prevent its chronicity. Therefore, almost all patients are prescribed NSAIDs. Many patients often begin to use them on their own at the first episodes of cervicalgia, but this is fraught with negative consequences. The drugs of this group have a number of side effects that manifest themselves with long-term use, especially in the presence of concomitant diseases. Therefore, only a specialist can choose the drug necessary in each individual case, its dosage and duration of administration.

NSAIDs are produced in almost all existing dosage forms. For severe pain that persists for more than 3 days, injectable NSAIDs are used. But still, with pain in the neck, tablets and capsules are most often prescribed. Initially, it is recommended to take them for a certain period of time, and then on demand, since most of them irritate the mucous organs of the gastrointestinal tract. Therefore, their irrational use can lead to the development or exacerbation of gastroenterological disorders. If they are already diagnosed, patients are prescribed the latest generation of NSAIDs – COX-2 inhibitors. Such drugs have practically no effect on the mucous membranes of the digestive system, but are very expensive.

As pain subsides, oral formulations are replaced with ointments, gels, or transdermal patches. They can also be used if there are contraindications for the use of systemic NSAIDs.

Also used to treat cervicalgia:

• muscle relaxants – help to eliminate muscle spasms that cause increased pain and limited mobility;
• anticonvulsants and antidepressants – prescribed for persistent chronic pain;
• vitamins, especially of group B – help to improve nerve conduction and potentiate the action of other drugs used;
• corticosteroids – used to relieve very severe inflammation and associated pain;
• chondroprotectors – contain natural cartilage metabolites, which allows you to activate the natural mechanisms of its renewal and regeneration.

Physiotherapy

Physiotherapeutic procedures are widely used in the treatment of cervicalgia of various origins. They are prescribed outside the period of exacerbation, but they are able to have a pronounced effect on the leading links of pathogenesis and, in general, improve the performance of the body. Mainly assigned courses:

• electrophoresis with the introduction of drugs;
• laser therapy;
• magnetotherapy;
• UHF;
• ultrasound therapy and phonophoresis;
• darsonvalization.

LFK

Therapeutic exercise is the basis of non-drug treatment of cervicalgia. For each patient, the training program is compiled separately in accordance with the detected deviations from the norm, age, level of physical fitness and other factors. In the acute phase, static exercises performed in the supine position are recommended. As you feel better, they are supplemented with dynamic passive movements. Then they move on to full-fledged exercise therapy. Initially, they are recommended to be carried out under the supervision of an instructor and only after fully mastering the correct methodology for performing each movement independently.

The effectiveness of therapeutic exercises largely depends on the regularity of classes. They should be carried out daily, avoiding sudden movements and overexertion. It is optimal to supplement exercise therapy with swimming, stretching.

Manual therapy and therapeutic massage

Manual manipulation techniques are often used to improve the effectiveness of conservative therapy. With vertebrogenic disorders, manual therapy is preferred, as it allows you to effectively work out not only the skin and muscles, but also the spine. Therapeutic massage is mainly used to consolidate the result. Thanks to properly selected techniques and types of exposure, it is possible to eliminate functional blocks, activate blood flow, tone overly relaxed muscles and relax spasmodic ones. Experienced chiropractors are able to act on the cervical spine, restoring the correct position of the vertebrae, increasing the distance between them, which helps to eliminate or reduce neurological disorders.

Surgery for cervicalgia

When diagnosing cervicalgia caused by vertebrogenic diseases, there is often a need for surgical intervention. As a rule, it is recommended if the complex conservative therapy carried out for 6–12 months failed to achieve a significant improvement in the patient’s well-being and the preservation of cervicalgia. But in some cases, the operation must be done earlier, namely at:

• persistent neurological deficit;
• sequestered cervical disc herniation;
• fractures of the vertebrae, in particular after whiplash;
• the risk of developing cervical myelopathy, etc.

In each case, the choice of a specific method of surgical treatment is carried out individually. First of all, it is influenced by the diagnosis and the degree of pathological changes. But the general condition of the patient, the presence of concomitant diseases and other factors are also taken into account.

But always operations on the cervical spine require high care and professionalism of the spinal surgeon. To minimize risks in modern clinics, they are performed using a neuromonitoring system. It represents the fixation on the patient’s body of a large number of sensors that read the bioelectric impulses transmitted from the spinal cord. This allows you to assess the quality of their conduct at any time and exclude the possibility of injury to the nervous structures. This, as well as the introduction of advanced technologies, makes operations on the cervical spine ten times safer than a few decades ago.

So, in case of vertebrogenic diseases accompanied by cervicalgia, the following can be performed:

• Microsurgical discectomy is the “gold standard” of decompression operations indicated for pinched spinal roots, vertebral arteries, and spinal canal stenosis. Surgical intervention involves excision of a hernia, and sometimes the entire intervertebral disc. This is done through an incision on the posterior or anterolateral surface of the neck under microscope control. The method provides the surgeon with a fairly wide view, which dramatically minimizes the risk of intraoperative complications and expands its capabilities.
• Endoscopic surgery is a less traumatic decompression surgery than microdiscectomy, but it is not always possible. It involves excision of the intervertebral hernia through miniature punctures, through which special manipulators and a video camera are inserted.
• Laminectomy is a traumatic operation, which is performed only in the most difficult cases, when resection of bone structures is required: the entire vertebral arch, processes only, etc.

After removal of the entire intervertebral disc or bone elements of a vertebra, as well as in case of pathological mobility of the cervical vertebrae, stabilizing operations are indicated. Most often performed:

• Spinal fusion – the method involves fixing the vertebrae in the desired position with metal structures, so that over time they are firmly fused together. This excludes the possibility of movements in the operated spinal motion segment, but is a guarantee of the absence of a recurrence of a number of diseases.
• Transpedicular fixation is a stabilizing operation during which the vertebrae are fixed with a special system of screws and rods. The method is used very widely in a variety of cases.
• Replacing a removed disc with an artificial prosthesis – performed after discectomy and refusal of fusion. The method involves the installation of a special cage in place of the resected cartilage. Today, there are prostheses that completely repeat the biomechanics and properties of a natural disc, as well as simpler but affordable implants.

Rehabilitation is indicated for patients after any operation. In fact, it largely repeats conservative therapy, but the difference is that the intensity of physical activity increases gradually, and drug therapy performs only an auxiliary function.