CAUSES OF NECK PAIN
There are many reasons that cause pain in the neck. We can group these under 3 headings.
1- NON-SPINAL NECK PAIN: There are some pains that do not originate from the spine but are felt around the neck. Pain that compresses the muscles and nerves coming out of the ribcage is called "Thoracic Outlet Syndromes" and may occur for 3 different reasons.
a) Jeans Cervical; Union of the cervical spine and the first rib
b) Scalenus Anticus; muscle compression syndrome
c) Pectoralis minor; muscle compression syndrome
2- NECK PAIN CAUSED BY SPINE: There are several subgroups.
A) NECK PAIN DUE TO TRAUMA: We know that life-threatening problems are encountered in some traumas to the neck. It should not be forgotten that our neck is easily affected by traumas, from small impacts to larger accidents that we encounter in daily life.
TRAFFIC ACCIDENTS; When a vehicle is hit somewhere other than the front in an in-car accident, a problem called whiplash occurs in the neck.
Hyperflexion trauma; The head of the person who is hit shakes rapidly like a whip, first forward and then, on the contrary, backward.
Hyperextension trauma; If the car is hit from behind by another car, the opposite situation occurs. During the movement of the head in 2 different directions, excessive load is placed on the neck. This problem, which is not well understood in the first few hours due to the heat of the incident, then begins to escalate over the next few days with neck stiffness and pain. It continues with decreasing severity for several months.
SPORTS INJURIES: Injuries to the neck are often encountered during sports. While some of them are mild, some may last for many years. Serious events, including paralysis of arms and legs, may occur when jumping into shallow waters. football ba There may be some injuries to the cervical vertebrae, especially in sports performed with competitors, especially at work.
INDUSTRIAL ACCIDENTS: Various problems may arise in work accidents that may cause neck pain. Some occupational groups are always at risk of trauma. It is essential to take protective measures in those lines of business and train employees on this subject. The treatment approach is not much different from traffic accidents.
B) NECK PAIN DUE TO WEAR: The most mobile parts of the neck are between the 4th and 6th vertebrae. Therefore, signs of wear and tear begin to occur between these vertebrae after the age of 40. The first disorders start from the discs between the vertebrae. The amount of fluid contained in the discs decreases and they gradually begin to dry out and lose their elasticity. Undoubtedly, over time, the discs that act as shock absorbers cannot do this duty and cause the vertebrae to come closer to each other. Of course, as a result of this, the nerve roots passing through narrow and sensitive channels are subjected to various pressures from the worn disc tissue. Other joints in the neck may show various degrees of wear and tear, just like calcification in other joints of the body.
C) Occupational-related NECK PAIN: Undoubtedly, some occupational groups and misuse of our neck can accelerate this wear and tear. Long-distance drivers, painters who have to work with their heads up, ceramicists who work squatting, and professional groups that have to sit at a desk or in front of a computer all the time are at high risk of neck pain. It occurs between the 5th and 6th vertebrae. In this case, pain radiating to the arm is at the forefront. In hernias, symptoms include increased pain when coughing and straining (Valsalva test), pain in the neck when pressing down from the top of the head. (compression test) It is typical for this pain to decrease when the head is lifted by holding the chin upwards (distraction test). Depending on the severity of the hernia, reflexes may be lost, numbness, significant muscle strength may be decreased, or arm circumference may be weakened. With treatment initiated as a result of early diagnosis, successful results can be achieved without the need for multiple surgeries.
3-PAIN REFLECTED TOWARDS THE NECK
Although the cause is not in the neck, the neck may be where the pain is felt. We call this referred pain. These are;
a- STRESS-RELATED NECK PAIN
b- MUSCLE DUE
c- IMPROPER POSTURE DISORDERS
d- DUE TO EYE DISEASES
e- RHEUMATISM
f- NECK PAIN RESULTING FROM INTERNAL ORGANS
STRESS-RELATED NECK PAIN: Those under intense stress make some organs, but mostly the cervical spine, pay the price. All muscles, including the stomach, intestines and especially the back, suffer from this stress. In such people, who are constantly angry and tense, when neck pain settles, it no longer leaves the body easily. It is easy for those who stand incorrectly and cannot relax their neck and surrounding muscles properly to suffer from "neck tension" disease. Many external factors, from changes in weather conditions to incorrect posture and even stress, can cause tension in the neck muscles. An uncomfortable position of the neck during a trip or a night's sleep may again be a cause of pain.
NECK PAIN DUE TO IMPROPER POSTURE DISORDERS: Most of us; Due to the weakness of the abdominal and waist muscles, we exhibit poor posture as a result of leaving ourselves slack, especially when standing or sitting. As a sign of this bad posture, the curve of the waist has increased and my belly The forehead is forward and the shoulders are slumped down. As a result, an increasing "hunchback" develops on our back. This humpback, which we can initially correct whenever we want, turns into a permanent shape that cannot return to its previous state over many years. For this reason, we need to start keeping our posture correct in our youth. Young people who lean excessively on the table while studying and cannot keep their neck in the ideal position are candidates for being one of the patients with neck pain in the future.
NECK PAIN DUE TO EYE DISEASES: Head and neck pains occur in people who have vision defects in their eyes and do not relieve it by using glasses. can come out. The reason for this is that the eye muscles remain contracted longer and longer as a result of the effort to see clearly. Those who face this problem, perhaps due to lack of vision in their eyes or due to non-ergonomic desks, tables or chairs, must be noticed in advance. Mothers, fathers and teachers have important duties here. It is also natural for people who watch television and stay in front of the computer for long periods of time to have eye problems. The precautions that people who pursue this profession should take have recently been published in a circular. It is recommended to take breaks from work at regular intervals, use screen protectors and rest the eyes.
NECK PAIN DUE TO RHEUMATIC CAUSES: Rheumatoid arthritis; If it rarely occurs in the upper parts of the neck vertebrae, it can cause life-threatening problems. In such a doubt, the neck must be stabilized and wrong movements must be avoided. Neck stiffness in bamboo disease (ankylosing spondylitis) can lead to permanent disabilities.
Referred neck pain
Myofascial pain syndromes: Hypersensitive points on the neck and back. . In this case, there may be severe local pain and limitation of movement. Local injection and cooling spray are used in the problematic area. Then, exercise and physical therapy practices are performed. Tender points in the sterno-cleido-mastoid muscle may cause neck and headache. These are sometimes very common throughout the body and are called trigger points. In cases where it is suspected that the pain originates from the shoulder, the shoulders should be evaluated. Although there is no problem in the neck, there may be numbness in the hand in "Carpal Canal Syndrome."
NECK PAIN REFLECTED FROM INTERNAL ORGANS: Problems in our internal organs can sometimes spread to the neck. Therefore, patients should be evaluated in detail and surrounding organs should be examined carefully. A rare tumor in the lung (Pancoast tumor) or infection in the lung may be the cause of pain reflected in the neck.
Referred pain may radiate to the neck or arm due to cardiovascular diseases. Many times, coronary heart pain may cause pain radiating to the left arm. To avoid this confusion, it is necessary to consult a cardiologist. Stomach ulcers can rarely cause pain in the neck and especially in the arm. In such cases, consultation should be sought from specialist doctors if necessary.
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