Neck Pain
Learn more about common pain disorders, their development, and the pain mechanism.
Overview
Neck pain is a common problem among adults and can have various causes. The complex structure of the neck, particularly the cervical spine, is subjected to considerable daily stress. Age-related and degenerative processes of bones, joints, and connective tissues, as well as muscle tension, can lead to chronic pain. Persistent or severe symptoms require medical consultation to determine the exact cause and receive appropriate treatment.
Causes
The causes of neck pain are diverse, ranging from stress and poor workplace ergonomics, to accidents. Age-related degenerative changes in the cervical spine and traumatic events like whiplash can be triggers. The neck muscles are used extensively daily, often due to poorly set up workspaces or improper lying and sitting positions. Muscle and connective tissue tension leads to painful muscle cramps. Additionally, with increasing age, degenerative changes occur in various structures of the cervical spine. These degenerative changes, known as spondylarthrosis, can cause pain in the facet joints, nerve root compression, or spinal canal narrowing with spinal cord compression. Whiplash injuries can result from car accidents or falls. Less commonly, neck pain can be attributed to rheumatological, neurological, infectious, or oncological (tumor-related) diseases.
Symptoms
Symptoms vary depending on the cause of neck pain and can range from sharp or burning pain to numbness or restricted mobility. Causes similar to the underlying back pain can also result in these symptoms. Additionally, patients often suffer from headaches, dizziness, and hearing/visual disturbances.
Diagnosis
Accurate diagnosis typically requires a thorough review of the medical history, a physical examination, and sometimes imaging procedures (MRI, CT, or X-ray). Targeted diagnostic infiltrations with local anesthetics can also be useful.
Treatment
Treatment for neck pain may involve a combination of physical therapy, pain medication, muscle relaxation techniques, and in some cases, surgical intervention. Preventive measures such as ergonomic workplace design, regular breaks for relaxation, and specific exercises to strengthen the neck muscles can help prevent neck pain.
Chronic neck pain is often complex, requiring careful therapy planning. Coordinating various measures can improve the chances of successful treatment. Sometimes, parallel treatments can create synergies, while in other cases, it is advisable to perform treatment steps separately.
Treatment methods are varied and depend on the cause, including:
- Physiotherapy, mainly active and posture-optimizing
- Medications:
- Basic painkillers like NSAIDs, paracetamol, muscle relaxants, and metamizole
- Co-analgesic medications like tricyclic antidepressants, SSNRI antidepressants, and antiepileptics
- Opioids: Used sparingly and for a limited time under close medical supervision for severe, uncontrolled pain
- Interventional treatments:
- Steroid injection at the nerve root
- Pulsed radiofrequency treatment at the nerve root
- Thermoablation of medial branches of the facet joints
- Neuromodulative procedures:
- Transcutaneous electrical nerve stimulation (TENS)
- Spinal cord stimulation (SCS)
- Surgical procedures
