Neck pain is a common pain condition that affects patients of all ages. When patients have neck pain, they are most afraid of having a cervical disc herniation. However, a significant portion of neck pain is not caused by a hernia, but by pain in the muscles around the neck.
The neck region, located between the head and body, connects these two regions. The vessels going to the brain, the spinal cord and the nerves coming out of the spinal cord pass between the cervical vertebrae. The muscles, ligaments and joints around the neck contain a large number of receptors that adjust the spatial position of our body. Therefore, in neck problems, complaints such as pain radiating to the arms, balance disorder, and dizziness may be observed.
A significant portion of neck pain is caused by muscle pain. Muscle groups related to the neck can be listed as the muscles that enable the movement of the head, the muscles located between the shoulder and neck, and the muscles associated with the shoulder blade. Muscle spasms that develop in all these regions related to the neck appear as pain. In some soft tissue rheumatism, the neck area is the most affected area. In "myofascial pain syndrome", which is regional muscle rheumatism, areas with impaired blood circulation resulting from contraction within the muscle cause serious pain. It is common for pain to radiate from these points, called "trigger points", depending on the location of the muscle. All these mentioned regional pains are confused with cervical disc herniation and the distinction must be made carefully.
One of the most common findings regarding the presence of cervical disc herniation is pain radiating to the arm. Usually the pain radiates to one arm. It can spread to the elbow or hand. Numbness and tingling may also be added along with the pain. Patients may experience night pain. The patient says that he can sleep by placing his head in a suitable posture. Pain in the neck and arm increases in situations that increase pressure, such as coughing and straining. Some patients say they feel comfortable by placing their hands on their head. Because this posture provides comfort to the patient by allowing the root of the nerve coming from the neck to expand.
The pain in the neck may be dull and burning. The patient notices that the pain increases both when he bends his head forward and when he looks up. Pain radiating to the arm increases with some neck postures. Loss of dexterity in hands and dropping what you are holding may report complaints.
Possible sources of pain in patients presenting with neck and arm pain may be the neck, nerves coming out of the neck, muscles related to the neck, muscles around the shoulder blade and shoulder problems. The physician examines all these areas and can obtain information about the source of pain. With a good nerve examination, an idea about the affected nerve root can be obtained.
Direct radiographs, MRI and EMG can be performed as auxiliary diagnostic methods. If the neck curvature reverses on plain radiograph, it may be thought that there may be a hernia in that segment or in a lower or upper segment. There is no clear data that neck flattening is a symptom associated with cervical disc herniation. MRI examination is the best method to show herniation. However, it should not be forgotten that a hernia image can be obtained when an MRI is performed in people who do not have neck pain. What is correct is that the examination findings match the MRI image. During the EMG examination, information can be collected about whether there is compression in the area where the nerve root exits and how severe the compression is.
Should every cervical hernia require surgery? There is no such obligation. However, if partial paralysis occurs in the muscle fed by the compressed nerve root, surgery must be performed as quickly as possible and the compression must be removed. For this reason, it is essential to perform the neurological examination of a patient with neck pain with great care.
If there is no need for surgery, edema-relieving treatments should be used to reduce the pressure on the nerve and relieve muscle tension. While medications can be used, methods such as physical therapy methods, acupuncture, electroacupuncture, neuraltherapy, and prolotherapy can be used. In the presence of pain radiating to the arm, short-term neck corsets may be recommended. As soon as the pain is under control, exercises to strengthen the muscles around the neck and stretching exercises should be started immediately. Thus, a natural corset can be created. Another step is for the patient to maintain appropriate posture while working. One should avoid movements that will put pressure on the neck. For example; Such as working fixedly for long periods of time looking forward or upward, talking for long periods with a phone stuck between the ear and shoulder, lifting heavy items, playing computer/tablet/phone games or work for long periods of time.
Hope you stay in good health.
Read: 0
