What are the symptoms of neck pain. How is neck pain diagnosed. What causes neck pain. How can neck pain be treated. What are effective prevention strategies for neck pain. Is Tylenol effective for neck pain relief. When should you see a doctor for neck pain.

Understanding Neck Pain: A Comprehensive Overview

Neck pain is a prevalent condition that affects millions of people worldwide. It can range from mild discomfort to severe, debilitating pain, impacting daily activities and quality of life. The cervical spine, consisting of seven vertebral bones supported by muscles, ligaments, and discs, plays a crucial role in neck function. When any of these structures are compromised, it can lead to neck pain.

What exactly constitutes neck pain? It’s typically characterized by discomfort in the area between the base of the skull and the top of the shoulders. The pain can be localized or radiate to other areas, such as the shoulders, arms, or head.

Common Symptoms of Neck Pain

• Persistent aching
• Stabbing or shooting pain
• Burning or tingling sensations
• Tenderness or sensitivity to touch
• Pain that worsens with prolonged neck positions
• Muscle tightness or spasms
• Headaches
• Numbness or tingling in arms or hands

How long can neck pain last? Neck pain can be acute, lasting for days to weeks, or chronic, persisting for more than three months. The duration often depends on the underlying cause and the effectiveness of treatment.

Unraveling the Causes and Risk Factors of Neck Pain

Understanding the root causes of neck pain is crucial for effective treatment and prevention. While some cases may result from simple muscle strain, others could indicate more serious underlying conditions.

Common Causes of Neck Pain

1. Muscle strain or sprain
2. Poor posture
3. Arthritis
4. Herniated or degenerative discs
5. Pinched nerves
6. Trauma or injury
7. Whiplash
8. Stress and anxiety

What factors increase the risk of developing neck pain? Several lifestyle and health factors can contribute to a higher likelihood of experiencing neck pain:

• Age (older individuals are more susceptible)
• Sedentary lifestyle
• Obesity
• Prolonged use of electronic devices
• Poor sleeping position
• Smoking
• Stress
• Previous neck injuries

How does occupation influence neck pain risk? Certain professions that involve repetitive neck movements, prolonged periods of sitting, or heavy lifting can increase the risk of neck pain. Examples include office workers, drivers, and healthcare professionals.

Diagnosing Neck Pain: From Symptoms to Medical Tests

Accurate diagnosis is key to effective treatment of neck pain. Healthcare providers employ various methods to determine the underlying cause and severity of the condition.

The Diagnostic Process

1. Medical history review
2. Physical examination
3. Neurological assessment
4. Imaging tests (if necessary)
5. Specialized tests (in some cases)

What questions might a doctor ask during a neck pain diagnosis? Expect inquiries about the nature and duration of your pain, any recent injuries or accidents, your daily activities, and any other symptoms you may be experiencing.

Imaging and Specialized Tests

• X-rays: To visualize bone structures and detect arthritis or fractures
• CT scans: For detailed cross-sectional images of bones and soft tissues
• MRI: To examine soft tissues, nerves, and the spinal cord
• Electromyography (EMG): To assess nerve function
• Blood tests: To check for signs of infection or inflammation

When are imaging tests necessary for neck pain? While many cases of neck pain can be diagnosed through physical examination alone, imaging tests may be recommended if the pain is severe, persistent, or accompanied by neurological symptoms.

Treatment Options for Neck Pain: From Self-Care to Medical Interventions

The approach to treating neck pain varies depending on its cause, severity, and duration. Many cases respond well to conservative treatments, while others may require more intensive interventions.

Self-Care and Home Remedies

• Rest and activity modification
• Over-the-counter pain relievers (e.g., Tylenol, ibuprofen)
• Ice or heat therapy
• Gentle stretches and exercises
• Proper posture and ergonomics
• Stress reduction techniques

How effective is Tylenol for neck pain relief? Tylenol (acetaminophen) can be an effective option for mild to moderate neck pain. It works by reducing pain signals in the brain and can be particularly helpful for pain associated with muscle tension or arthritis.

Medical Treatments and Interventions

1. Prescription medications (muscle relaxants, stronger pain relievers)
2. Physical therapy
3. Chiropractic care
4. Massage therapy
5. Acupuncture
6. Steroid injections
7. Surgery (in rare, severe cases)

When should you consider medical treatment for neck pain? If home remedies and over-the-counter medications don’t provide relief within a few weeks, or if your pain is severe or accompanied by other symptoms like numbness or weakness, it’s time to consult a healthcare provider.

Preventing Neck Pain: Strategies for Long-Term Health

While not all cases of neck pain can be prevented, there are several strategies that can reduce your risk and promote overall neck health.

Lifestyle Modifications for Neck Pain Prevention

• Maintain good posture
• Use proper ergonomics at work and home
• Take regular breaks from prolonged sitting or screen time
• Stay physically active with neck-strengthening exercises
• Use a supportive pillow and mattress
• Manage stress through relaxation techniques
• Quit smoking
• Maintain a healthy weight

How can you improve your posture to prevent neck pain? Focus on keeping your ears aligned with your shoulders, avoid forward head posture, and use ergonomic tools like standing desks or adjustable chairs to maintain proper alignment throughout the day.

The Role of Exercise in Managing and Preventing Neck Pain

Regular exercise plays a crucial role in both managing existing neck pain and preventing future occurrences. A well-designed exercise program can strengthen neck muscles, improve flexibility, and enhance overall posture.

Beneficial Exercises for Neck Health

1. Neck tilts and rotations
2. Shoulder blade squeezes
3. Chin tucks
4. Isometric neck strengthening exercises
5. Yoga and Pilates
6. Low-impact aerobic activities

How often should you perform neck exercises? Aim for daily gentle stretches and neck movements, with more targeted strengthening exercises 2-3 times per week. Always start slowly and gradually increase intensity to avoid exacerbating pain.

What precautions should you take when exercising with neck pain? Listen to your body, avoid movements that cause pain, and consult with a physical therapist or healthcare provider for a personalized exercise plan tailored to your specific condition.

When to Seek Medical Attention for Neck Pain

While many cases of neck pain resolve on their own or with conservative treatment, certain symptoms warrant immediate medical attention.

Red Flags for Serious Neck Conditions

• Severe pain following an injury or accident
• Pain accompanied by fever or headache
• Numbness, tingling, or weakness in arms or hands
• Difficulty with fine motor skills
• Loss of bladder or bowel control
• Neck pain accompanied by chest pain or shortness of breath

How quickly should you seek medical care for these symptoms? If you experience any of these red flag symptoms, seek medical attention immediately, as they could indicate serious conditions such as spinal cord compression, infection, or even heart problems.

What information should you prepare for your doctor’s visit? Keep a pain diary noting the intensity, duration, and any factors that worsen or alleviate your neck pain. Also, be prepared to discuss your medical history, current medications, and any recent injuries or changes in your daily activities.

The Impact of Technology on Neck Pain: “Text Neck” and Beyond

In our increasingly digital world, the excessive use of smartphones, tablets, and computers has led to a rise in neck pain cases, particularly among younger generations. This phenomenon, often referred to as “text neck,” highlights the importance of proper device usage and ergonomics.

Strategies to Mitigate Technology-Related Neck Pain

• Hold devices at eye level to avoid bending your neck
• Use stands or holders for tablets and phones
• Take frequent breaks from screen time
• Implement the 20-20-20 rule: Every 20 minutes, look at something 20 feet away for 20 seconds
• Use voice commands and dictation features when possible
• Invest in ergonomic office equipment

How long can you safely use digital devices without risking neck strain? While there’s no one-size-fits-all answer, experts generally recommend taking a 5-10 minute break for every hour of device use. During these breaks, perform gentle neck stretches and focus on proper posture.

What are the long-term consequences of ignoring “text neck”? Chronic poor posture from excessive device use can lead to premature wear and tear on the cervical spine, potentially resulting in chronic pain, headaches, and even early onset of degenerative disc disease.

By understanding the causes, symptoms, and prevention strategies for neck pain, individuals can take proactive steps to maintain neck health and overall well-being. Remember, while treatments like Tylenol can provide temporary relief, addressing the root causes of neck pain through lifestyle modifications and proper ergonomics is key to long-term neck health. If neck pain persists or worsens despite self-care measures, don’t hesitate to consult with a healthcare professional for personalized advice and treatment options.

What Is Neck Pain? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Neck pain is a common complaint that can be caused by a variety of different health conditions. It can range from mild to severe, with more severe cases possibly indicating a serious underlying problem.

Your neck and upper back (cervical spine) consist of seven vertebral bones that support your head. These bones are separated by vertebral discs, and are reinforced by a network of muscles and ligaments (connective tissue). A problem with any of these structures, or with nerves in or near your neck, can cause neck pain.

Mild to moderate neck pain can usually be treated at home and improves within a couple of weeks, but it’s important to seek immediate medical attention if you develop severe neck pain suddenly due to an injury, such as after a car accident or a fall. You should also consult a healthcare provider if, in addition to neck pain, you’re also experiencing numbness or loss of strength in your arms or hands, or a shooting pain down your arm.

Signs and Symptoms of Neck Pain

Neck pain may be characterized by the following symptoms:

• Persistent aching
• Stabbing pain
• Burning or tingling
• Tenderness or sensitivity to mild pressure
• Pain that gets worse when you hold your head in one place for a while
• Muscle tightness or spasms

Neck pain can be axial (limited mostly to the neck) or radicular (extending to areas such as the shoulders or arms). It may be accompanied by a headache, or by numbness or tingling in one or both arms.

Neck pain can also be acute, lasting days to weeks, or chronic, lasting longer than three months to several years.

Causes and Risk Factors of Neck Pain

Neck pain can be caused by various health conditions, including the following:

• Strained muscles
• Arthritis
• Herniated disc, disc degeneration
• Pinched nerves and bone spurs (nerve compression)
• Trauma or injury
• Growths, including tumors and cysts (in rare cases)

The following factors are known to increase the risk of developing neck pain:

• Older age
• Mental stress
• Strenuous physical activity
• Being overweight or obese
• Being a woman
• Driving or traveling long distances
• Working long hours at a computer
• Hunching your neck down often, such as to look at your phone
• Carrying heavy bags on shoulder straps
• Poor alignment while sleeping
• Smoking

How Is Neck Pain Diagnosed?

Your doctor will diagnose your condition on the basis of a personal medical history and a physical exam. During this exam, your doctor will check for tenderness, numbness, and weakness in your neck.

Your doctor will also ask about your regular activities, as well as any previous injuries that may have contributed to the problem, such as a herniated disc.

In some cases, you doctor may decide that imaging tests of your neck are needed, such as the following:

X-Ray This test can reveal degenerative changes that may be putting pressure on nerves.

Computed Tomography (CT) Scan This test combines X-ray images to create a detailed cross-section of structures in your neck.

Magnetic Resonance Imaging (MRI) Magnetic field and radio waves create detailed images of areas of your body.

Other tests that may help with diagnosis include:

Nerve Conduction Study This procedure measures nerve impulses when a small amount of electrical current is applied, in order to detect damaged nerves.

Electromyography (EMG) This test involves inserting a needle electrode into muscles to measure their electrical activity, to help detect damage to nerves leading to muscles.

Blood Tests Certain markers of inflammation or infection may help identify conditions that contribute to neck pain.

Prognosis of Neck Pain

How severe your neck pain is, how long it lasts, and how likely it is to resolve on its own will depend on the underlying condition causing your pain.

If your neck pain is due to a strained muscle, it will most likely respond to self-care and get better with time.

But more serious conditions may require sustained treatment, procedures, and possibly surgery to see significant improvement.

Duration of Neck Pain

Neck pain can be acute, lasting days to weeks, or chronic, lasting for 12 weeks or longer. How long your pain lasts will depend on the underlying cause and its severity.

If your neck pain lasts longer than a few days or gets worse, or if it interferes with your daily life, it’s a good idea to see your doctor.

Treatment and Medication Options for Neck Pain

Recommended treatments for neck pain vary with the cause of your pain. In general, the goals of treatment are to relieve pain and improve function.

Most forms of mild to moderate neck pain respond well to self-care and conservative treatments, usually within two to three weeks. If your pain still isn’t resolved, your doctor may recommend other treatments.

Self-care options that may help resolve neck pain include:

• Taking over-the-counter (OTC) pain relievers
• Using heat or ice packs, or alternating between both
• Gentle stretches and neck exercises
• Rest

When to See a Doctor

You should call your doctor if you have persistent neck pain that interferes with your work or daily activities.

While neck pain usually isn’t a medical emergency, you should seek immediate medical attention if any of the following applies to your pain:

• It develops after an accident or trauma.
• It occurs with numbness or tingling in your arms, shoulders, or legs.
• It occurs with weakness in your arms or legs.
• You experience a headache, dizziness, nausea, or vomiting.
• You experience loss of bladder or bowel control.
• You have chills, fever, or unexplained weight loss.

Medication Options

Common OTC medications to help relieve neck pain include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory medications (NSAIDs), such as aspirin or ibuprofen (Advil).

If OTC options aren’t strong enough for your pain, your doctor may consider prescribing or administering the following medications:

• Other NSAIDs
• Muscle relaxants
• Tricyclic antidepressants
• Steroid injections

Physical Therapy

Some conditions that cause neck pain, including strained muscles, may benefit from physical therapy.

A physical therapist can teach you exercises to help strengthen muscles in your neck, as well as help you correct your posture and alignment.

The following treatments may also be administered by a physical therapist or other therapist:

• Transcutaneous Electrical Nerve Stimulation (TENS) This therapy delivers electrical impulses through the skin to help relieve pain.
• Traction This therapy uses a specialized device to gently stretch your neck. It may help if nerve root irritation is the cause of your pain.

Surgery

Surgery is rarely needed for neck pain, but it may be recommended if you have nerve root or spinal cord compression. For these conditions, surgery involves removing tissue that is pressing against nerves.

Surgery may be performed to repair damaged or compressed discs in your spine, or to fuse vertebrae when repairing discs isn’t possible.

Alternative and Complementary Therapies

Alternative therapies that may help with neck pain include:

• Acupuncture
• Chiropractic care
• Massage
• Yoga, tai chi, and other fitness regimens

One study from 2015 of 517 patients found that those receiving two types of complementary therapies — acupuncture and the Alexander Technique — reported significantly less neck pain a year later compared to those using more standard approaches.

In general, though, there is not a lot of high-quality research on alternative therapies for neck pain, especially around Internet claims about the “wonders” of certain herbs and supplements. It’s best to discuss any potential alternative approaches to managing your neck pain with your doctor, reviewing the potential risks and benefits.

Prevention of Neck Pain

Not all neck pain can be prevented, but maintaining good posture — keeping your shoulders straight over your hips and your ears right above your shoulders — can help reduce your chances of developing neck pain.

Other simple modifications can also help:

• If you work at a desk, adjust your setup so your computer monitor is at eye level and your knees are slightly lower than your hips when you’re sitting.
• Avoid carrying heavy bags over your shoulder.
• Sleep with your head and neck in alignment with the rest of your body. The Mayo Clinic recommends you try to sleep on your back with your thighs elevated on pillows in order to flatten your spinal muscles.

Complications of Neck Pain

Neck pain can make it difficult to accomplish daily tasks, from driving a car to typing on a computer or doing kitchen tasks.

While it’s unlikely that most forms of neck pain will lead to long-term damage, it’s a good idea to see your doctor if you have pain that lasts longer than a few days or gets worse over time. Your doctor can make sure you don’t have a serious underlying condition that requires treatment.

Research and Statistics: How Many People Have Neck Pain?

Neck pain is a common issue, affecting 10 to 20 percent of adults, and the risk increases with age.

Other estimates, though, have found neck pain to be somewhat less common. A study from 2020 found that neck pain affected 3.6 percent of people around the world in 2017, a number that hadn’t changed significantly since 1990. Norway had the highest rate of neck pain in the world, with a prevalence of 6.2 percent.

Another study, published in 2017, looked at a large sample of 600 adults age 20 and older from the general population. It found that 20.3 percent of participants reported neck pain, and that people who had lost a spouse or were separated were more than twice as likely to report neck pain. Other factors associated with an increased risk of neck pain included lower income and education level, sitting or leaning while working, or having two or more health conditions.

Related Conditions of Neck Pain

Neck pain is a common form of chronic pain. Other commonly reported forms of pain include:

• Back pain
• Arm pain
• Abdominal pain
• Leg pain

Resources We Love

American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM)

This medical association is dedicated to advancing treatment of neuromuscular and musculoskeletal conditions. Its website contains information on numerous disorders, including pinched nerves and neck pain in general.

American Academy of Orthopaedic Surgeons

This group, representing surgeons who specialize in the musculoskeletal system, provides information on specific disorders affecting the neck — including fractures, spinal cord compression, a herniated disc, and arthritis.

American Association of Neurological Surgeons

This organization of neurosurgeons provides an overview of common causes and treatments for neck pain, including when surgery may be warranted.

Arthritis Foundation

This leading arthritis research and advocacy organization provides information on joint conditions affecting the neck and spine, and also has detailed resources on managing pain.

Additional reporting by Quinn Phillips.

Editorial Sources and Fact-Checking

• Neck Pain: Symptoms and Causes. Mayo Clinic. August 25, 2022.
• Neck Pain: Diagnosis and Treatment. Mayo Clinic. August 25, 2022
• Anatomy of the Spine — Upper Back, Lower Back, and Neck. Arthritis Foundation.
• Neck Pain. Cleveland Clinic. December 9, 2022.
• Neck Pain and Problems. Johns Hopkins Medicine.
• Safiri S, Kolahi AA, Hoy D, et al. Global, Regional, and National Burden of Neck Pain in the General Population, 1990–2017: Systematic Analysis of the Global Burden of Disease Study 2017. BMJ. March 26, 2020.
• Genebra CVDS, Maciel NM, Bento TPF, et al. Prevalence and Factors Associated With Neck Pain: A Population-Based Study. Brazilian Journal of Physical Therapy. July–August 2017.
• Plastaras CT, Schran S, Kim N, et al. Complementary and Alternative Treatment for Neck Pain: Chiropractic, Acupuncture, TENS, Massage, Yoga, Tai Chi, and Feldenkrais. Physical Medicine and Rehabilitation Clinics of North America. August 2011.
• Complementary Therapies for Neck Pain. Harvard Health Publishing. November 3, 2015.

Show Less

The Consequence of Sleeping the Wrong Way

The best way to avoid neck pain when you sleep, is to find a pillow that keeps your neck in that neutral position.

By Chris Iliades, MDNovember 13, 2013

Driving Smart to Avoid Neck Pain

Driving can cause neck pain. To avoid these aches, learn about good body mechanics and healthy road rules, especially if you log a lot of commuter miles. ..

By Chris Iliades, MDOctober 25, 2013

How a Neck Brace Works to Relieve Pain

Neck braces, also called cervical collars, have been used to relieve neck pain for centuries. Learn how a neck brace can help you at EverydayHealth.com…

By Chris Iliades, MDOctober 25, 2013

When Arthritis Causes Neck Pain

Cervical spondylosis and rheumatoid arthritis are two types of arthritis that can cause neck pain. Learn how best to care for yourself to manage the pain…

By Krisha McCoyAugust 3, 2012

Cortisone Injections for Neck Pain

People with neck pain often can get relief with a cortisone injection. But a corticosteroid shot is just a quick fix for pain and it has major side effects…

By Dennis Thompson JrMay 7, 2009

Stress Management and Neck Pain

Stress is a proven contributor to neck pain. Learn how you can play a vital role in easing the pain by managing your stress.

By Chris Iliades, MDMay 7, 2009

When Surgery Is Needed for Neck Pain

Neck surgery is usually considered a last option for neck pain. Learn which conditions are most likely to benefit from neck surgery and how the surgery…

By Dennis Thompson JrMay 7, 2009

The Orthopedist & Neck Pain Specialist

An orthopedist is a medical doctor specifically trained to heal the musculoskeletal system. Learn about all the treatment options offered by the orthopedist…

By Dennis Thompson JrMay 7, 2009

Stiff Neck: A Look At Possible Causes

There are many causes of a painful stiff neck, from stress to arthritis to a serious infection. Learn about this common complaint and when to seek medical…

By Krisha McCoyMay 7, 2009

Cervical Disc Disease Medications for Neck Pain

Written by Stephanie Watson

Neck pain is one of the main symptoms of cervical disc disease, in which discs between vertebrae become herniated or deteriorate, sometimes pinching nerves.

Several different drugs, from pain relievers to anti-inflammatory drugs such as steroids, can help ease your neck pain while you heal. Depending on the extent of your neck pain and the type of cervical disc disease, you can either take these medications alone or use them together with physical therapy or other treatments.

Drugs typically used to treat cervical disc disease include:

Acetaminophen (Tylenol). Acetaminophen is usually among first-line drug treatments for pain. It can help with neck pain, but don’t fall under the common misperception that acetaminophen is completely harmless just because it’s readily available over-the-counter. Research shows that regular acetaminophen use can damage the liver, even in people who take the drug at the recommended dose. To make sure you’re using acetaminophen as safely as possible, follow the directions carefully and don’t take any more than the label suggests and your doctor recommends.

Avoid using alcohol while taking acetaminophen to minimize the risks to your liver. Also, acetaminophen could be an ingredient in some other over-the-counter medications you may be taking. Look at all drug labels to be sure you’re not taking too much acetaminophen.

Nonsteroidal anti-inflammatory drugs (NSAIDs).Ibuprofen (Motrin, Advil) and naproxen (Aleve) are staples in the treatment of cervical disc disease because they reduce both pain and inflammation. Like acetaminophen, many NSAIDs are available over-the-counter, but they also need to be taken carefully. NSAIDs can have some serious side effects, such as gastrointestinal bleeding, ulcers, and kidney damage, especially when used for long periods of time. NSAIDs have also been linked to an increased risk of heart attack or stroke.

Select Cox-2 inhibitors are a newer generation of NSAIDs that are available by prescription and may have fewer digestive side effects, but can also increase risk for heart attack or stroke.

It’s important to read the labels carefully and never exceed the doctor’s recommended dose. You’ll also want to avoid taking NSAIDs together with certain other medications because of the possibility of drug interactions. Talk to your doctor about all the drugs you take. Be especially cautious about taking NSAIDS if you are over 65, and/or you have kidney problems.

Your doctor will make the decision as to whether to put you on an NSAID after weighing the benefits against the risks.

Narcotic painkillers. Because of their increased risks, opioids are not a first-line therapy for pain. Opioids such as codeine (contained in Tylenol with codeine), hydrocodone (contained in Vicodin and Lortab), and oxycodone (such as OxyContin, and contained in Percocet and Percodan) can provide significant relief when neck pain is particularly intense and other non-narcotic pain medications aren’t sufficient for pain relief. So can tramadol, a narcotic-like analgesic. Although opioids are effective for pain, they should be used with caution because they can lead to drowsiness, nausea, constipation, and depressed breathing. These prescription painkillers also have the potential for abuse and addiction. Narcotic painkillers are best used over the short term (one to two weeks) and under your doctor’s guidance.

Steroids. Steroids such as prednisone (Deltasone, Orasone, Sterapred) work by reducing inflammation. Although they can be taken orally, steroids given for neck pain are sometimes delivered directly to the spine via an injection to the area. Research shows that steroid injection does relieve neck pain over the short term, although its effectiveness for chronic pain is unclear.  The most common side effects of short-term oral steroids are an increase in blood sugars, water retention and stomach ulcers. For the epidural, the risks are infection, headache, and bleeding. Side effects of oral steroids, which are not generally used, include weight gain, and, less often, high blood pressure and osteoporosis.

Muscle Relaxants.Baclofen and other muscle relaxants calm muscle tightness, and some research suggests they can relieve neck pain within the first few days of an acute injury. When using these drugs, watch out for side effects such as drowsiness, dependence, and urinary retention. These drugs are best used short term under a doctor’s guidance.

Anticonvulsants. Although they are approved by the FDA to treat seizures, anticonvulsant drugs such as gabapentin (Neurontin), carbamazepine (Tegretol), and pregabalin (Lyrica) may help with nerve-related neck pain. How exactly anticonvulsants work on neck pain is unknown, but they are believed to affect the way the brain perceives pain. Side effects include dizziness, sleepiness, vision problems, and vomiting. Patients who take these drugs may be at a greater risk of having thoughts or actions of suicide. The risk may be greater in people who have had these thoughts or actions in the past. Call the doctor right away if signs like low mood (depression), nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.

Tricyclic Antidepressants. TCA  are used off-label to treat chronic pain, especially nerve pain. Examples include amitriptyline and nortriptyline may help with chronic pain and with sleep. It may take several weeks to see an effect. Side effects include drowsiness, dry mouth, constipation, and urinary retention. 

Top Picks

Paracetamol for back pain

Purpose of investigation

Find out how effective paracetamol is in the treatment of non-specific low back pain. Nonspecific low back pain or low back pain of unknown etiology is pain in the lower back for which there is no clear definition of the disease or condition.

Relevance

Paracetamol is one of the most commonly prescribed medicines for people with low back pain. It is recommended by clinical guidelines for various diseases (diagnosis and treatment protocols), which are published to help the doctor. However, the results of recent studies have raised the question: how effective is paracetamol really?

Search date

Evidence is current to August 2015.

Study profile

We included three trials in this review with a total of 1825 patients, two of which included people with recent onset of pain (acute type), and the third included participants with pain that lasted more than six weeks (chronic type) . The majority of people in this study (90%) were middle-aged and entered the study from a single trial that looked at acute back pain. All three trials compared the effect of paracetamol to a placebo (a dummy that contains nothing that could act as a drug). Patients were given a variety of treatments ranging from a single intravenous injection of one gram of paracetamol (1 g intravenously) to oral administration of four grams taken over a 24-hour period for up to four weeks. The follow-up period for participants ranged from one day to twelve weeks. The main outcomes we studied were: pain and disability; we also looked at quality of life, whether patients were able to carry out their daily activities without difficulty, whether there were any unpleasant or unwanted side effects, how participants themselves rated their improvement, sleep quality, whether medication was taken as prescribed, and whether there was a need in an emergency intake of another analgesic – a rescue drug – due to the fact that paracetamol did not work. We combined the results from two trials into one analysis (meta-analysis) comparing paracetamol with placebo; the third study did not report placebo results and therefore could not be included.

Main findings and quality of evidence

We found high-quality evidence that paracetamol (4 g daily) is no better than placebo for acute low back pain in either the short or long term. In other aspects of the study (quality of life, quality of sleep), paracetamol also did not show better results than placebo. Approximately one in five patients reported side effects (although there were few serious cases). Thus, no difference with the control group was also found. Since most of the participants were middle-aged, it is not certain that the results would have been the same in other age groups.

Paracetamol and placebo also showed no difference in immediate relief of symptoms of chronic low back pain in one very low quality study that was retracted by the journal.

If you found this evidence helpful, please consider donating to Cochrane. We are a charity that produces accessible evidence to help people make health and care decisions.

Donate

Translation notes:

Translation: Xenia Belyakova. Editing: Ziganshina Lilia Evgenievna. Project coordination for translation into Russian: Cochrane Russia – Cochrane Russia (branch of the Northern Cochrane Center on the basis of Kazan Federal University). For questions related to this translation, please contact us at: [email protected]; [email protected]

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

Treatment of osteochondrosis of the cervical spine in Moscow at the Dikul clinic: prices, appointments | Center Dikul

We use cookies to improve the site and its user experience. By continuing to use the site, you consent to the use of cookies. You can always disable cookies in your browser settings.

• Main
• Treatment of the back
• org/ListItem”> Everything about osteochondrosis
• Treatment of osteochondrosis of the cervical spine

Degenerative disc disease (osteochondrosis) in the cervical spine is the main cause of pain in the neck and radiating pain in the arms. Pain manifestations begin to appear when one or more intervertebral discs in the cervical spine begin to collapse due to degeneration.

The predisposition of some people to develop osteochondrosis may have a genetic component. Trauma can also accelerate and sometimes cause degenerative changes in the cervical spine.

Treatment of osteochondrosis of the cervical spine gives good results only when it is regular and consistent and systematic. Osteochondrosis of the cervical spine is included in the list of the most common causes of symptoms in patients of working age who sit at the computer for a long time. Often patients do not pay attention to pain and do not seek medical help, which leads to complications.

Risk factors for osteochondrosis of the cervical spine

While almost all people develop involutional degenerative changes in the cervical spine sooner or later, there are some factors that can make it more likely that osteochondrosis develops early or symptoms appear. These risk factors may include:

• Genetics. Some studies of twins show that genetics play a larger role than lifestyle in the early development of osteochondrosis in the cervical spine and the rapid onset of symptoms.
• Obesity. Weight is associated with the risk of developing degenerative disc disease (osteochondrosis).
• Smoking. This habit can interfere with the supply of nutrients to the discs and speed up their hydration.
• In addition, trauma to the spine can sometimes start or accelerate the process of degeneration in the cervical spine.

Symptoms

Symptoms of osteochondrosis of the cervical spine can vary widely from person to person.

When osteochondrosis becomes symptomatic, pain may develop gradually or appear suddenly. Symptoms can range from some discomfort in the neck to debilitating severe pain radiating to the arm, numbness, and/or muscle weakness.

Main symptoms:

• Neck pain. Low-intensity pain against the background of stiffness in the neck is the most common symptom of osteochondrosis of the cervical spine. However, sometimes the pain can increase dramatically and last for several hours or days.
• Neuralgia. This type of pain tends to be sharp or electric shock radiating down the shoulder to the arm, arm and/or fingers. As a rule, neuralgia is felt only on one side of the body.
• Neurological symptoms in the arm, hand and/or fingers. There may be needle-tingling sensations, numbness and/or weakness that may spread throughout the upper extremity. These types of symptoms can interfere with daily activities, such as typing, dressing, or holding objects.
• Pain is aggravated by movement. In general, the pain caused by the degenerative disc itself tends to increase with movement and decrease with rest.
• If the pain comes from the degenerative disc itself, then it will most likely disappear on its own within a few weeks or months. However, other symptoms of osteochondrosis of the cervical spine are more likely to become chronic and require treatment, for example, if the facet joints in the neck also begin to degenerate and / or nerve root compression occurs.

Less common symptoms

The more the cervical spine degenerates, the more likely it is that the spinal canal will narrow and increase the risk of spinal cord compression. If spinal cord compression occurs, myelopathy will develop and symptoms such as:

• Difficulty moving arms and/or legs
• Problems with coordination and/or balance
• Loss of bowel and/or bladder control
• Weakness and/or numbness anywhere below the neck
• Shooting pains in the limbs, which may be aggravated by stooping forward

Cervical myelopathy is a serious condition that requires immediate medical attention. This condition usually occurs in people over 50 years of age.

Diagnosis

The diagnosis of osteochondrosis of the cervical spine can be made on the basis of such data as:

• Medical history. First, the doctor needs to study in detail the symptoms and medical history.
• Physical examination . The doctor will then perform a physical examination by palpating the neck and checking the range of motion in the neck. During the tests, patients may be asked to perform certain movements and report whether the pain in the neck is increasing or decreasing.
• If the pain is severe, or if neurological symptoms are present, such as pain, tingling, or weakness in the shoulder, arm, or hand, then the doctor will likely order medical imaging.
• Medical imaging techniques (X-ray, CT, MRI, PET). If the doctor determines that images of tissues (disks) are needed to determine the exact genesis of the symptoms, then an MRI will most likely be ordered. An MRI, X-ray, or possibly a CT scan can confirm if there are signs of degeneration, as well as identify other conditions (such as osteoarthritis or stenosis) that may be causing the symptoms.
• After confirming an accurate diagnosis of osteochondrosis of the cervical spine, as well as any other related conditions, it is possible to understand the genesis of the symptoms and determine an effective treatment program.

Conditions associated with osteochondrosis of the cervical spine

Disc degeneration is often accompanied by other pathological conditions that develop either at the same time, or in some cases one causes the other. The most common conditions are:

• Cervical herniation occurs when disc degeneration disrupts the integrity of the fibrous annulus and protrusion of the contents beyond the annulus occurs. But a disc herniation can appear after an injury, which ultimately accelerates disc degeneration and leads to the development of osteochondrosis of the cervical spine.
• Cervical osteoarthritis. As the disc degenerates and the disc space inside the spinal column begins to shrink, the facet joints can move abnormally and cause cartilage wear and also stimulate the formation of osteophytes in the cervical spine.
• Cervical spinal stenosis. This is a condition that occurs due to osteophytes or disc herniation and narrowing of the spinal canal (where the spinal cord passes) or the foramen (where the nerve root passes) occurs.

But we must understand that sometimes some people already have a narrowing of the spinal canal from birth and the development of symptoms is not associated with osteochondrosis.

Cervical radiculopathy – symptoms of pain, tingling, numbness and/or weakness radiating to the shoulder into the arm and hand may occur when one or more nerve roots become pinched or irritated. If compression of the spinal cord by disc herniation or osteophytes occurs during stenosis, then myelopathy may develop. Possible symptoms of pain, tingling, numbness and/or weakness may be felt at this level in the neck and anywhere below the compression level. For example, a person may have tingling or weakness in the legs, balance problems, or even difficulty with bowel and bladder control.

If symptoms of myelopathy are present, it is important to seek medical attention promptly, as the condition may progress and, if left untreated, paralysis and dysfunction may eventually develop.

Treatment

As a rule, when symptoms appear due to osteochondrosis of the cervical spine, therapeutic actions are taken to reduce symptoms. First of all, non-surgical methods of treatment are used in the treatment of osteochondrosis of the cervical spine.

In rare cases where pain and symptoms persist or worsen despite several months of treatment, or if there is a risk of spinal cord injury, then surgery is considered.

Conservative Treatment Options

To treat neck pain caused by osteochondrosis, your doctor will usually recommend one or more of the following treatment options:

• Rest or lifestyle changes . Some activities may be more painful for the neck, such as stretching the neck forward while working at a computer. Abstinence or changing certain activities for a few days or weeks usually reduces pain. In addition, it is recommended to maintain proper posture (instead of slouching when sitting or bending the neck forward while driving, etc.). Eating healthy foods, staying well hydrated, and not smoking are also good for disc health.
• Treatment of pain with drugs or injections. Over-the-counter pain relievers such as acetaminophen (eg Tylenol), ibuprofen (eg Advil, Motrin) or others may be helpful. If the pain is severe, a stronger pain reliever may be prescribed, such as oral steroids or muscle relaxants (such as Vicodin) or even opiates.

Injections such as facet injections, nerve or epidural blocks. These may include injecting corticosteroids into a specific structure to reduce local inflammation:

• Caudal epidural injections
• Facet joint injections
• Interlaminar caudal epidural steroid injections
• Transforaminal epidural injections
• Selective nerve root blocks
• Medial branch blocks
• Ice and heat can be used in the treatment of osteochondrosis of the cervical spine.
• exercise therapy. Most non-surgical programs for the treatment of osteochondrosis of the cervical spine will include some kind of exercise program, both isometric and stretching. In addition, exercises should be selected taking into account the individual characteristics of a particular person. In general, increasing strength and flexibility in the neck can reduce the risk of pain and, to some extent, slow down degenerative changes in the discs.
• Manual therapy . The cervical spine can be manually adjusted by a qualified healthcare professional to improve range of motion and/or reduce pain. Depending on the individual patient’s symptoms, a physical examination and/or imaging should be performed prior to manual manipulation of the neck.
• Physiotherapy
• Massage
• Acupuncture
• Corsetting

Cervical osteochondrosis surgery

Cervical osteochondrosis surgery is usually considered in two cases:

• Neurological symptoms are present, such as persistent hand numbness and/or weakness, or problems with walking or bowel control. If neurological symptoms are caused by osteochondrosis of the cervical spine, there is a risk of permanent nerve damage, and surgery may be recommended to relieve pressure on the nerves.
• Chronic pain is severe and unresponsive for at least six months of non-surgical treatment, and daily activities become difficult. Better surgical outcomes are predicted for patients with chronic pain in association with other conditions such as neck motion instability and/or radiculopathy.

The main surgical methods for the treatment of osteochondrosis of the cervical spine are:

• Anterior cervical discectomy and fusion (ACDF).
• Replacement with an artificial disc.

In addition, there are a number of other surgical procedures for the treatment of osteochondrosis of the cervical spine:

• Endoscopic decompression
• Endoscopic Foraminotomy
• Percutaneous decompression
• Intradiscal Electrothermal Therapy
• Selective endoscopic discectomy
• Spinal cord stimulation
• Radiofrequency ablation
• Epidural adhesion lysis

Neck surgery aimed at decompressing the nerve roots and/or spinal cord and thus reducing neurological symptoms such as arm pain or weakness tends to have good long-term outcomes – a positive prognosis is between 80% and 90 %.