Neck pain, or cervicalgia, is a common complaint. It can have many causes: osteoarthritis of the neck, stiff neck, cervical sprain, consequences of trauma… Faced with the pain and stiffness often induced, solutions make it possible to calm the symptoms and regain freedom of movement.
What is neck pain?
Among the most common musculoskeletal disorders 1 is neck pain, which often results in stiffness that limits neck movement. This cervical pain, at the back of the neck, is common among the French. Although there are no official figures corresponding to the number of cases, according to the French Chiropractic Association 2, they affect 30 to 50% of adults. According to this same source, 67% of the population suffers from a neck pain episode during their life.
Generally, neck pain is spontaneous and mechanical in nature: neck pain occurs without an obvious cause and has the characteristics of mechanical joint damage.
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Causes of neck pain
Cervicarthrosis
This is cervical spondylosis. This chronic condition is characterized by the degradation of the cartilage in the joints of the neck 3. It is common and mainly affects women from the age of 35, more rarely men who are affected later around the age of 50.
Torticollis
The pain in the neck is sharp and comes on suddenly. Most often, torticollis is due to contracture of a sternocleidomastoid muscle, of traumatic or inflammatory origin.
In common acute torticollis, the onset of contracture and pain is sudden, preventing most neck movements. The condition usually lasts only a few days.
Cervical sprain
A cervical sprain is an immediate reaction following an event where the neck has been subjected to too much stress, such as whiplash during a car accident, for example.
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Symptoms
In cervical spondylosis, the symptoms consist of pain which is posterior and can radiate towards:
- The nape of the neck, the back of the head and the forehead
- Shoulders and arms
- Upper back
- Towards the arm: we then speak of cervicobrachial neuralgia.
Clinical examination shows neck stiffness, with other associated symptoms such as:
- Pain on the back of the neck
- Neck stiffness
- Decreased range of motion of the neck
- Headaches
- Eye fatigue
- Radiation or tingling in the arm or hand.
There are often also associated phenomena of the sympathetic vascular system due to disruption of arterial circulation in the neck, such as:
- Dizziness
- Changes in head position;
- A ringing in the ears;
- Minor vision problems.
Exams
An x-ray is requested to show, in the case of cervical osteoarthritis, disc pinching between the cervical vertebrae.
If the sedimentation rate is normal and therefore there is no inflammatory syndrome, the usual treatment of osteoarthritis involves physiotherapy sessions, which are always very effective.
During the consultation for torticollis, the doctor may suggest an x-ray to observe or not a disharmony of curvature of the cervical spine without disco-vertebral lesion. The sedimentation rate is normal.
Treatments
In cases of acute pain, resting the neck with a removable cervical collar is combined with non-steroidal anti-inflammatory drugs.
In cases of chronic pain, intermittent wearing of a cervical collar (neck brace), an American pillow and cervical suspension tractions are very useful.
We also recommend isometric rehabilitation of the cervical spine and crenotherapy offered as a spa treatment.
For the treatment of torticollis, in addition, it consists of:
- Taking painkillers;
- Anti-inflammatories;
- Muscle relaxants
The doctor may possibly offer the patient physiotherapy sessions.
Origin of pain
Pain of inflammatory origin
Neck pain can be of inflammatory origin if:
- The pains are severe even during sleep
- The pain occurs gradually
- There is no improvement even with treatment
- That the subject suffers from fever
The spine is stiff. Biologically, the sedimentation rate is accelerated.
When the stiffness is limited to one vertebral level, the doctor suggests infectious or rheumatic spondylodiscitis (damage to the intervertebral disc), a spinal tumor 4.
When the stiffness affects the entire spine, it may rather be ankylosing spondylitis, multiple metastases of cancer or Kahler’s disease.
Accompanied pain
Painful radiation in the arm is part of cervicobrachial pain (cervicobrachial neuralgia).
Painful radiation to the neck with dizziness, headaches, visual disturbances (pseudoscotomas, nystagmus) prompts the search for vertebro-basilar arterial insufficiency.
Barré-Liéou syndrome (posterior sympathetic cervical syndrome) combines signs of osteoarthritis, from dizziness to changes in head position with ringing in the ears and sensations of flying flies. It is a disorder of blood circulation in the vertebral artery. It is not at all certain that there is a cause and effect link between neck osteoarthritis and these ischemic disorders. Atherosclerosis of the vessels of the neck is more often involved.
Post-traumatic pain
Automotive pathology (whiplash) is becoming more and more common. Muscle contracture is inconstant, limitation of neck movements is often found.
Special images of the atlo-axial joint (between the atlas and the axis) are essential. The search for neurological signs is fundamental.
Dizziness and neck pathology
Cervical osteoarthritis could cause circulatory discomfort through compression of the vertebral arteries facing an osteophyte and, consequently, dizziness. Atherosclerosis of the basilar trunk is most often the cause. Atherosclerotic stricture causes decreased blood flow and Barré-Liéou syndrome.
Very often, the dizzy sensations attributed to cervical spondylosis are the expression of benign paroxysmal positional vertigo which mainly affects women in their fifties and is always triggered by the same abrupt positioning of the head. This dizziness disappears within a few weeks.
A depressive syndrome can also frequently cause dizziness.
Finally, in the case of neuro-vegetative dystonia or neurotonia, depressive syndromes cause progressive muscular pain of variable timing. The clinical examination is normal.
Exercises and tips to relieve pain
Treatment is based on simple home remedies.
To relieve tension and muscle contractures in the neck and shoulders, you can apply a hot water bottle wrapped in a cloth to the neck and shoulders for 15 minutes, 3 times a day. Hot showers also relieve tight muscles.
Massages are also a good way to relax your muscles, so it can help you get relief more quickly. You can self-massage for ten minutes 2 to 3 times a day, with an anti-inflammatory oil or ointment. Finally, on a daily basis, posture is essential. It is essential to stand up straight and straighten your shoulders, whether you are standing or sitting. And when faced with a computer, there are precise rules for adjusting your screen and standing up straight during working hours, with your head in alignment with your spine.
