Understanding the condition: Neck PainWhether the neck is bent or proud and straight, you can tell how it feels by its posture. We perceive the neck as one of our most vulnerable places. The neck is a psychosomatic gauge. So it is not surprising if it reports with tension when we feel uncomfortable. But the neck is also a sensitive area from a mechanical point of view:
Definition
A chain is as strong as its weakest link
The neck is the weakest part of the spine. Strictly speaking, it only needs to balance the head. The neck is easily the victim of injuries and overstrain. Sometimes they also pull the vertebrae out of their natural position so that certain movements are blocked. Together with the pain this leads to the fact that one spares its neck and evades on other movements. Together, neck pain triggers thorough misfeelings. The correct medical name is cervical syndrome, in German one speaks of cervical spine disease, cervical spine syndrome or briefly HWS syndrome.
Misalignment and nerve disorder
It is not uncommon for abnormalities to affect the skeleton, starting with foot misalignments and working up through the ankles, knees, hips, lumbar spine etc. CERVICAL SPINE. Therefore good orthopedists look. Physiotherapists for neck pain on the entire skeleton. Therefore look good orthopedists. Physiotherapists with neck pain on the entire skeleton. In addition, disorders in the head itself cause incorrect neck position. Problems such as temporomandibular joint, tooth and sinus problems or tinnitus should be mentioned.
What can "break" in the neck?
In most cases and at a young age, the neck is mechanically perfectly intact. The control circuits of relaxation and tension, as well as the natural compensatory movements of the neck, are disturbed. Real damage is rare in young people. Often due to an accident. This can lead to tears in muscles and the retaining ligaments, which can be very painful. Extremely painful are also all conditions in which nerves come under prere or are pinched off. They first announce themselves with neck pain and tingling, in the worst case numbness and paralysis follow. If acted upon quickly, however, the nerve will not be permanently damaged.
How your neck ages
With increasing age, permanent damage to the neck is imminent: Mostly one speaks of "wear and tear". Not always the body can regenerate. The cartilage tie and the intervertebral discs are formed only once in a lifetime. Cartilages wear away and intervertebral discs lose elasticity. To make matters worse, the regeneration capacity decreases with age. Namely, there is a lack of "anabolic" (anabolic) hormones , especially estrogen and testosterone. They are not only responsible for sexuality, but also for strong muscles, bones, tendons and ligaments. Wrinkles appear on the face, neck pain in the neck. Fatal also the higher tendency to persistent inflammation, which leaves severe tie damage in the joints. In addition, malnutrition with a poor supply of vitamins becomes apparent. Minerals; more so in old age than in younger years. Well meant. Went wrong… When the ligaments and tendons calcify, you lose their flexibility. With bone decalcification, the vertebrae become susceptible to cracks. Here's how the cervical spine becomes less flexible with age and prone to instability, poor posture and spasms. Neck pain is one of the many consequences.
Shapes
Neck pain is divided into categories depending on its cause.
If another organ is diseased, the pain sometimes spreads to other parts of the body (sog. "transmitted pain," Head's zones). The neck and shoulder, for example, are places that can rarely even indicate a heart attack. Also lung diseases, infections, diseases of other internal organs and tumors etc. report so, also infections such as abscesses and dental foci.
Frequency
Neck pain? You are not an isolated case..
Neck problems are not only one of the most common musculoskeletal complaints after back pain, but even one of the most common reasons for consultations in the doctor's office. About 9-22 % of the population suffers from it. In the course of a lifetime about 33% of people make acquaintance with the symptom. But only 5-10 % develop chronic pain.
Indications for use: To improve the symptoms of acute inflammatory diseases of the bronchi, sinuses and draining urinary tract.
Cause
Neck pain has very different triggers. To determine the appropriate therapy, the analysis of the situation is required. Find your sore spot:
Figure 1:
Overload
Very manifest triggers are physical workloads such as lifting heavy loads and vibrations. One-sided work movements are particularly problematic. Forced posture positions (such as bending heavily at the neck). Painting on the ceiling, for example, is one of the very problematic movement patterns for neck pain.
Figure 2: Monotony
But overuse is not the only cause, motion rigidity is also a cause. In the monotony of immobility, the muscles unlearn the game of tension and relaxation. Persistent neck pain can follow. Postural deformities are also on the increase. The body forgets the "natural" posture and the muscles break down. After long years, the muscle can no longer hold the correct position and the skeleton also changes.
Figure 3: Grief and stress
Psychological complaints quickly affect the muscles of the neck. Have you ever observed it in yourself? When you expect a blow, you automatically pull your head between your shoulders. In this case, the muscles not only react to an indicated blow, but also quite invisible stressors such as deadline prere, high demands and lack of encouragement have an effect. Then tension headaches or neck pain quickly set in.
Figure 4: Draught
Of course, a convertible or a motorcycle can be cool … if your neck doesn't get a draft. The cold cools down the muscles. Leads to disturbances of the muscle play. This manifests itself the next day with a stiff neck and neck pain. There it is called to keep warm. Take precautions next time.
Figure 5: Whiplash (cervical spine distortion) and injury
The terms acceleration trauma or whiplash trauma are also commonly used. During rapid deceleration movements, the cervical spine is subjected to considerable stress: The heavy head moves forward and backward very quickly. The spine overbends. This causes injuries to muscles and ligaments, rarely the cervical spine. Until this cervical spine distortion heals, you have to cope with neck pain for a long time.
Figure 6: Wear and tear
The ravages of time, at some point it strikes. Not only in the face do we get wrinkles, but also the skeleton ages. Then there are also signs of wear and tear in the neck area. This affects not only the intervertebral discs in the neck, but also the vertebral bodies, tendons and spinal column. Ligaments and intervertebral discs grow old. In addition, the regeneration performance decreases. Bone decalcification (osteoporosis) does not stop at the neck either. In the case of neck pain, "old age" is often the real cause.
Figure 7: Inflammations
Just as rheumatic inflammation of the hands and feet, the focus of inflammation can also be in the vertebral joints. Characteristic are the "start-up pains" after periods of rest.
Figure 8: Infection
Infection en in the head area can also radiate to the neck. And anyone who feels neck pain in addition to headache and pain in the limbs during a bout of flu will hardly be surprised. It becomes problematic with meningitis, here too the neck muscles cramp up and become stiff, accompanied by severe headaches and frequent vomiting. Without a doctor, this can be life-threatening.
Image 9: Torticollis and spinal curvature
Here the muscles pull the neck into a crooked position. This can be congenital or can happen due to a disorder, such as a misuse or massive pain. The nerves also compensate for defective vision or one-sided hearing loss with a crooked neck. When were your eyes last checked? Neck pain can be a reason for a comprehensive inventory.
Figure 10: New tie formation
A benign or malignant tumor in the tie sometimes constricts nerves and triggers complaints in the neck. In addition, the body sometimes responds to wear and tear and poor posture with bone remodeling, bulges or spurs. They are usually not very functional and cause pain, depending on the location also in the neck.
Most of the time, one or more of the above categories apply to neck pain.
Prevention
Rule of thumb: Upright and dynamic
Just as with therapy, the following applies to the prevention of neck pain: Exercise alone is like a drop in the bucket. What counts is the daily lifestyle.
Evolution has led to the balancing of the head on a mobile spine. We have to act according to this. The body dislikes kneeling or overhead work just as much as it dislikes rigid tension.
Make sure you have a back-friendly workplace. The desk, chair and monitor should be optimally adjusted to each other. For people who work physically, work with your employer to optimize work steps. Provide for breaks, compensatory gymnastics and relief, then not only the neck pain but possibly also the working atmosphere improves.
Keep moving: Monotony harms the neck. Therefore, change sitting positions or get a desk chair whose seat tilts. The spine reacts. A standing workstation, a sitting ball and other alternations can also be useful as supplements.
Maintaining healthy interaction: Muscles need daily physical activity and compensatory sports. The muscular interplay of tension and relaxation must be constantly trained, otherwise the elements of the musculoskeletal system practically "rust". Every muscle has a counterpart. It's easy to imagine what happens when the antagonist atrophies.
Daily mental hygieneBody care is a matter of course, but take care of your soul as well? Only then do constant stress and anger stand no chance. That's when it's time to ask for help or address injustices. Actively complete a relaxation program! Change something!
Progression and complications
Only sometimes can the patient name a clear starting point for the complaints; as a rule, neck pain develops slowly and over a long period of time. Sometimes they disappear as stealthily as they came. Unfortunately, this is not always the case; in about one in two cases, the complaints become chronic, then they last longer than twelve weeks at a time or they return after a brief improvement.
Some factors have an unfavorable effect on the course:
– Advanced age, poor posture, obesity, and physical inactivity are the typical risk factors for chronic neck pain.
– Pain is rarely as bad as when anxiety and depression are involved. Patients who believe in the powers of self-healing and have a positive outlook on the future clearly have a better chance of recovery.
– A high pain level or previously experienced episodes of neck pain are factors that have a particularly unfavorable effect on the prognosis.
– Manifest damage may or may not contribute to permanent complaints.
Complications
If you don't move certain muscles due to pain posture, they break down and simply aren't available anymore. This leads to permanent postural damage and overload in other parts of the musculoskeletal system. A "stiff neck" quickly sets in. This hinders in everyday life (such as road traffic) and causes accidents.
Severe degenerative damage of the cervical spine triggers permanent complaints. The body cannot heal this damage, only compensate for it. Rheumatic diseases of the spine also damage the structures and are not easily treated. Whenever nerves are constricted, the situation becomes critical. This often has to be eliminated surgically. But even operations are no guarantee for freedom from pain, so the recovery process often drags on for years. Also, the problem often merely shifts to another area. It is to be expected that health insurance companies will be much stricter in their reimbursement practices for surgery. When neck pain is indicated, get another opinion before surgery if in doubt. 1. German Society for General Medicine. Family medicine: DEGAM guideline no. German Society for General Medicine. Family medicine: DEGAM guideline no. 13: Neck pain. Status June 2009
2. Ebenbichler B: Physical medical modalities for neck pain. Manual Medicine. 2015, 53:121-126
3. Eckert, A: The Tao of Acuprere and Acupuncture, 3. Edition, Haug Verlag, Stuttgart 2005
4. Henkel J. et al: Effect of selected preventive concepts on functional health in individuals with nonspecific, chronic recurrent neck pain. Manual Medicine. Manual Medicine. 2008, 47:57-66
5. Hil (author abstract): Health insurer recommends multimodal pain management for low back pain. Physicians Journal, Wednesday, 29. August 2012
6. Hillienhof, A: Health insurance company recommends multimodal pain therapy for back pain.
7. Jensen IB et al: A 3-year follow-up of a multidisciplinary rehabilitation program for back and neck pain. Pain. 2005 Jun;115(3):273-83
8. Leiner L: Paracetamol does nothing for back pain. arzte Zeitung, 27.04.2015
9. Pool JJM et al: An acknowledged evidence of the effectiveness of conservative treatments for acute and chronic neck pain. Manual medicine. 2005, 43:297-3
10. Popovic, A et al: Chronic pain from a psychiatric perspective. Manual medicine. 2013/1, 51:47-52
11. Sauer H: Massage of the neck muscles: Less is more. ENT News, 3, 2003, 35-37
12. Schilcher, H., Kammerer, S., Wegener, T.: Guide to phytotherapy , 4. Edition, Reprint, Urban& Fischer Publishing House, Munich-Jena, 2010
13. Schmiedel, V. and Augustin, M.; The great practical book of naturopathy, Gondrom Verlag, Bindlach, 2004
14. Simmenroth-Nayda A: CME DEGAM guideline neck pain. Applied pain therapy. Palliative medicine. 2010;8 (3):32-36
15. uberall MA: NSAIDs in pain therapy, CME 2016/1-2
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