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What is it about ?
Neck pain (neck pain) can be specific or nonspecific.
- Neck pain is said to be “specific” if it has a cause, such as a hernia between the vertebrae in the neck (cervical hernia). This is a condition that is accompanied by neck pain.
- Neck pain is said to be “nonspecific” if no bodily abnormality has been found as a cause.
Pain can be acute or chronic.
Neck pain is usually mild and goes away on its own. In most cases, it is nonspecific neck pain, which means that the cause has not been found. The pain subsides spontaneously after a few weeks.
Neck pain is the second most common complaint of the musculoskeletal system, after back and shoulder problems. Two in three people experience neck pain from time to time during their lifetime.
Warning symptoms
In the case of nonspecific neck pain, the direct cause cannot be found. This does not mean that there is no pain. It is sometimes a harmless overwork.
But pain can also be a sign of an underlying condition (specific neck pain). There are a whole host of symptoms that you need to watch out for, because they can indicate serious conditions. These symptoms are called warning symptoms. Serious illness is more likely in people who:
- have neck pain for the first time and are under 20 or over 55;
- have muscle weakness in different muscle groups;
- have untreatable or increasing pain.
The warning symptoms are as follows:
- Symptoms that may indicate spinal cord compression:
- gradual worsening of complaints;
- neurological abnormalities such as paralysis, loss of feeling, decreased muscle strength, loss of control of urine or stool;
- sensation of electric current flowing through the back and limbs when the neck is bent;
- abnormal reflexes.
- Symptoms that may indicate cancer, infection, or inflammation:
- general malaise, fever, inexplicable weight loss;
- increasing and continuous pain, also at night;
- swollen glands;
- painful tenderness on a particular vertebra;
- history of cancer, serious infections, damage to the immune system such as AIDS, joint infections, drug use.
- Symptoms after trauma:
- a recent accident with cervical injury (in people with osteoporosis, it may be a mild trauma);
- recent surgery in the cervical region;
- increased risk of osteoporosis, such as during menopause or if cortisone is taken for a long time.
- Symptoms due to poor blood circulation:
- dizziness or visual disturbances when moving the neck;
- sudden fall with or without loss of consciousness (drop attack).
How is the diagnosis made?
It can be very difficult to arrive at a correct diagnosis. Often, the doctor cannot draw a conclusion based solely on the complaints.
Examination of the neck can give some indications, but it requires a great deal of experience.
Often times, x-rays do not add clarity, and can even put the doctor on the wrong track. The establishment of a diagnosis of osteoarthritis, for example in the cervical vertebrae, does not prove that the neck pain is due to this condition. From a certain age, everyone has a little bit of osteoarthritis.
It is therefore necessary above all to rely on the warning symptoms, for which additional examinations will always be carried out.
Processing
Non-drug treatments
A physiotherapist can advise and reassure you. It is important to keep moving.
In the case of nonspecific neck pain, few treatments have been shown to be effective in studies.
What seems to give the best result in cases of chronic nonspecific neck pain is an exercise program under professional supervision, combined with manual therapy consisting of manipulations and mobilization of the cervical vertebrae. Physiotherapy treatments have an effect on the pain, and also affect your general functional state.
A neck brace has no effect and can even lead to weakening of the neck muscles. Ergonomic cushions (for example in the chair or in the bed) provide pain relief. Trigger point acupuncture can provide short-term pain relief.
Drug treatments
Paracetamol, anti-inflammatory drugs, and opioids work in the short term, but they do not cure. Eliminating the pain can however be useful to move better and therefore maintain cervical function. Pain can also be relieved with topical injections of lidocaine around painful areas. Botulinum toxin has not been proven effective in studies.
Want to know more?
- Neck and nape: against pain, get moving! – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Torticollis and neck pain – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- Physical activity – Eat Move – Health question
- Move at any age… After 50 too! – Eat Move – Health Question
- Paracetamol – CBIP – Belgian Center for Pharmacotherapeutic Information
- Non-steroidal anti-inflammatory drugs – CBIP – Belgian Center for Pharmacotherapeutic Information
- Opioids – CBIP – Belgian Center for Pharmacotherapeutic Information
- Botulinum toxin – CBIP – Belgian Center for Pharmacotherapeutic Information
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