By the time the neck goes on strike, it has often already taken a lot of punishment – more than we realize, at any rate. The unpleasant pulling or probing pain: perhaps only the tip of the iceberg? Even if the cold draught the day before on the journey or the extra shift at the computer may be plausible triggers: We have probably overstrained ourselves for a long time, from head to toe.
Because: The main causes of neck pain are postural problems and overstrained muscles in the back, neck and shoulder area. In the long run, they shorten and harden, and are extremely painful when prere is applied to typical areas.
Already a small additional load, also stress, can be sufficient, and the laboriously maintained balance tips over. Pain can increase poor posture. These in turn solidify the pain – a vicious circle develops. A blockage like acute torticollis can even force you to pause.
Vicious circle: overload and pain
Pain needs to be treated. Also to prevent them from leading to nerve changes, creating a kind of pain memory (see graphic). There are many ways to intervene. What you yourself can contribute to this, you can read at the end of this article.
When pain takes on a life of its own, it becomes more difficult to get it under control. They can become chronic
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Neck pain: acute or chronic?
Acute are neck pains that last up to three weeks. If they flare up again after a symptom-free month, even repeatedly, they are considered to be recurring (recurrent) refers to. If neck pain lasts longer than about three months, it is considered to be chronic. As with back or low back pain, doctors also distinguish neck pain whether a specific cause is present or whether it is non specific complaints are concerned. Usually no further examinations are necessary here.
Brief overview neck pain
As many causes neck pain can have: A serious background is the exception with less than one percent.
Main cause: tense muscles and wear and tear
By far the most common cause is overworked legs, tense muscles – annoying, but mostly harmless. Sometimes the tensions can also cause psychological background Have. This may or may not be indicated, for example, by concomitant depressive mood (see below).
With increasing age Wear – technical language: degenerative changes – at the cervical spine. Then likewise or for the first time complaints are like pain. restrictions in movements of the neck possible.
Restrictively must be added however that a certain wear in the course of the life is normal. If, for example, the cervical spine of all people over the age of fifty were to be x-rayed, a great deal of pathology would emerge at first glance – even in those who feel well or have no complaints. Wear and tear on the skeleton is therefore by no means always synonymous with pain.
Rare: Serious physical illnesses as triggers of neck pain
With increased muscle tension, for example, neurological disease patterns such as the so-called cervical dystonia accompany. Dystonia means as much as "false tension". Are single If the dystonia affects any part of the body, it is a focal dystonia. Overactive neck muscles, for example, can lead to involuntarily triggered unusual head positions. Depending on the type and direction of the movements, different forms can be distinguished. The causes of these dystonias are quite different. More on this below in the section "Torticollis".
Neck pain: fibromyalgia, rheumatism, infections& Co.
A Fibromyalgia syndrome is accompanied by considerable (muscle) pain. The neck is only one of several pain zones on the body. The causes are still unclear (see below).
Infections in the head and neck area, rheumatic diseases as well as some Tumor- and Bone disorders on the other hand, are among the rare causes of neck pain. As a result, acute or chronic complaints may occur. Depending on the cause, there are usually other symptoms in addition to neck pain, such as fever, limited mobility of the head, a feeling of stiffness or instability of the cervical spine, pain in other areas of the musculoskeletal system, difficulty swallowing and more.
Acute neck pain: an emergency?
Acute severe pain in the jaw, arm, back or neck can sometimes also be signs of a Heart attack or an acute disease of the aorta (Acute aortic syndrome) his. A special type of stroke affecting the cerebellum (cerebellar infarction) can be accompanied by neck pain, severe dizziness and significant gait disturbances, among other symptoms. Important: In the event of such symptoms, as well as high fever, dizziness or sudden fainting with unusual pain in the head or upper body, immediately alert the emergency doctor (Emergency call rescue control center: 112). This is of course also true for injuries of the head and the (cervical) spine.
In fact, injuries of the cervical spine are quite often involved in neck pain. Complicated damage, sometimes with serious neurological consequences, is possible to the head and neck joints, the cervical vertebrae below them and their joints, ligaments and intervertebral discs.
In contrast, the uncomplicated Whiplash to the neck (also deceleration trauma or distortion) as a rule – despite initially often severe pain – to those injuries that are not severe and also have a very good prognosis.
More information on the triggers of neck pain below in the section "Neck pain: Possible causes" and in the following text.
It is not surprising that persistent neck pain can affect the mood. However, in many cases depression is also accompanied by physical symptoms, such as pain in the musculoskeletal system, neck pain, sleep disturbances, fatigue and many other symptoms. Important: If you suspect depression, be sure to see a doctor you trust, because there is help available.
In advance: Who takes over diagnosis and therapy?
The first point of contact for neck pain is usually the Family doctor. If the pain radiates into the arm, if it tingles there, if the sense of touch and the mobility of the arm, hand or fingers, foot or leg are also impaired, a neurologist should be consulted immediately. If necessary, he will consult an orthopedist. The responsible specialists then decide on further diagnostic steps.
Treatment depends on the cause. So sore a "just stressed" Neck with acutely tense muscles can do, so foreseeable it recovers also again. Help relieve pain. Get advice on this also in the pharmacy. Follow the instructions in the package insert. You can also get advice on this at the pharmacy. Follow the instructions in the package insert. Doctors often recommend to start soon with gentle movement exercises to be started under physiotherapeutic guidance. It is absolutely advisable to design the workstation according to ergonomic principles.
The large back muscles extend to the neck (schematic drawing)
Partially Relaxation procedures may be helpful, for example in the case of stress-related muscle tension or tension headaches, which often begin in the neck (see below, section: "Neck pain: Therapy").
Persistent pain despite extensive pain treatment and/or signs of nerve damage in the neck, for example due to a herniated intervertebral disc (rather rare in this case) or a narrowing of the spinal canal in the cervical spine (spinal canal stenosis), make it advisable to consult an orthopedist Surgery often unavoidable. This also applies to instability of the cervical spine or upper cervical joints, for example as a result of rheumatic disease or injury.
regular loosening exercises can prevent muscle tension
Neck pain: Causes at a glance
Possible causes or medical conditions for neck pain include:
Very often or quite often:
– Muscle tension (by far the most common cause!), for example the "cell phone neck – Degenerative diseases of the musculoskeletal system: damage to the intervertebral discs and vertebral bodies (chondrosis and osteochondrosis) of the cervical spine, herniated disc, degenerative instability, wear and tear of the small vertebral joints (arthrosis, also facet joint arthrosis), formation of bony spurs on the vertebrae (spondylosis) or calcification of ligaments, resulting in narrowing of the spinal canal or intervertebral holes – Psychological factors – Diseases of internal organs: Coronary artery disease, including coronary heart disease (angina, myocardial infarction), diseases of the main artery of the body (aorta), esophagus, lungs – Fibromyalgia syndrome (chronic pain disease) – Injuries: Muscle strains, acceleration injuries such as whiplash or so-called deceleration trauma of the cervical spine; vertebral fractures or dislocations, torn ligaments, Damage / displacement of the intervertebral discs, trauma-induced instability
Rarely or very rarely:
– Focal cervical dystonia (rare movement disorder with involuntary head movements caused by prolonged muscle contractions, which can also be painful) – Neck-tongue syndrome (rare; triggered by wear-related changes in the cervical spine: pain in the neck and back of the head, sensations of discomfort and temporary furry feeling of one half of the tongue when suddenly turning the head) – Infections: of the vertebrae, intervertebral discs, soft ties of the neck (abscess) or meninges – rheumatism and other inflammatory diseases of the locomotor system such as Bechterew's disease (ankylosing or axial spondyloarthritis), a polymyalgia rheumatica, bone metabolic diseases such as osteoporosis – tumor and tumor diseases – cerebral hemorrhage (subarachnoid hemorrhage;
emergency: extremely severe headache and neck pain, neck stiffness, possibly unconsciousness with an increase in intracranial prere), cerebellar infarction – neck pain as a partial symptom of the so-called tension headache ; sometimes also possible in temporal connection with a migraine attack
Types of pain in the neck
According to the development, neck pain can be summarized in four major groups. This is followed by a description of the main types of neck pain. This is about:
Mechanically triggered neck pain
Non-mechanically triggered neck pain
Neck pain with psychological background
Constantly on the air? Also the cell phone can overstrain the neck muscles
Mechanically triggered neck pain
This large group of neck pain types is the most common, and pain in the neck by Muscle tension stand here in the first place. On the other hand Wear and tear and Injuries of the cervical spine, such as the Whiplash injury, as well as the torticollis (Torticollis) significant causes. However, wear and tear is a normal development to some degree. It by no means explains everything that ails the neck. More on this below in the section "Other causes of mechanically induced neck pain".
Cautiously estimated at least ten percent of the population has at least once in life with tension-related neck pain to do, many sufferers several times or persistently. This sometimes also results in a more or less stiff neck. Because in their function disturbed muscles shorten themselves. Can severely affect the mechanics of the neck. We are also talking here about myofascial or functional, non-specific complaints. The pain is usually felt on one side. Often radiating to the back of the head, shoulder or upper back. Bad postures can be favorable, the muscles tense up even more. Thus a vicious circle develops easily.
Cell phone neck example: The typical forward-leaning posture when using a cell phone or tablet puts up to five times more strain on the cervical spine than normal body positions with the head raised. Up to 30 kilograms of extra load can quickly come into play. With an average cell phone use of about four hours per day, this means heavy work for the spine. Wear is programmed.
The physician usually makes the diagnosis clinically, i.e. on the basis of the medical history (anamnesis) and the physical examination findings. The pain sounds after simple measures (see section "Neck pain: Therapy") further down) usually subside again. Otherwise, the doctor will verify the diagnosis.
Sooner or later Signs of wear and tear (degenerative changes, partly calcifications) at the cervical spine in addition. They can, but do not have to, in turn trigger muscle tension or intensify it. Wear and tear often affects hard, bony structures, especially vertebrae and the small intervertebral joints, as well as soft parts of the musculoskeletal system: especially the intervertebral discs – which, by the way, begin to "age" at a young age -, ligaments, tendons, joint capsules.
Wear problems at the neck
With aging often add up posture-related Complaints, for example from years of desk (PC) or overhead activity (such as painting), then Muscle tension as well as Wear and tear on intervertebral discs (chondrosis and osteochondrosis) and vertebrae (spondylosis). The intervertebral discs lose elasticity and height. This can lead to latent instability. In turn, the edges of the vertebrae may become increasingly upturned or spurs may form – the newly attached bone is an attempt at stabilization.
However, this can also result in inflammatory changes at the various contact points within the spine: for example, between the intervertebral discs and vertebrae (activated osteochondrosis) or at the small joints between the vertebrae, the so-called facet joints. After periods of rest, for example, a feeling of stiffness is often felt in the neck. Important: If the feeling of stiffness in the back/neck persists for more than 30 minutes in the morning, a doctor should be consulted for a more detailed examination.
In addition, neck pain often occurs, which can also radiate into the shoulder. The doctor calls this pseudoradicular. This means that the complaints not ame irritated nerve roots on the spinal cord, which is still rather the favorable variant. Here's what it does: The nerve roots emerge from the spinal cord in pairs on both sides in the spinal canal. A root (motor) is located further forward and sends commands to organs, such as muscles, to be executed. The other root (sensitive) is located further back. Transmits sensations from the body to the brain. Both roots of one side unite to form Spinal nerve (spinal nerve). At the neck, spinal nerves form the C 5 to C 8 series for the shoulder, chest, hand and arm. C stands for cervical (also cervical). Refers to the corresponding floors or segments of the cervical medulla. Each of these C nerves is responsible for motor and sensory functions in a certain area of the shoulder, arm and hand.
Sometimes bony changes in vertebrae constrict the vertebral canal laterally. Then developing symptoms – sensory disturbances such as numbness, cold feeling, muscle weaknesses or paralysis, so neurological deficits or failures – are based on constricted nerve roots (= radicular). During the examination, the doctor can roughly determine whether a radicular symptom pattern is present (in the case of such constrictions in the cervical vertebrae, the pain can also be less pronounced than the other symptoms). But sensory disturbances such as tingling can sometimes accompany pseudoradicular pain.
The doctor's distinction between pseudoradicular and radicular is important, because especially if a radicular symptom is suspected, more detailed examinations must be carried out (see below: "Neck pain: Diagnosis").
Wear and tear can cause various problems. Often there are so-called syndromes, that is, several symptoms at the same time. Three examples:
1. Acute or chronic neck-arm or shoulder-arm syndrome (radiculopathy = nerve root disease, also cervical spine syndrome, cervicobrachial syndrome or cervical root syndrome): It triggers a "neck shot" (cervicalgia or cervicobrachialgia), the lumbago at the neck, from. This can go away relatively quickly, but sometimes it can be an unpleasant companion for a long time. If displaced disc tie is the trigger, this is usually found laterally and thus presses on nerve roots from C 5. However, herniated discs occur much less frequently in the cervical spine than in the lumbar spine.
! Attention: Short-term tingling and numbness in the arm, which soon subside, can sometimes be just a matter of the sleeping position. If it occurs constantly, a doctor should check it out.