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Neck ache

The neck pain (or neck pain) is a generic term that is used to indicate the neck pain. 
Certain diseases and neuralgias of cervical origin can also affect the arm with stitches, tingling and numbness, and also affect the head as they can cause tension headachewith pain inside the eyes .

To indicate the vertebrae of the neck, write “C” followed by the number of the vertebra, starting from above (for example, C3 is the third vertebra of the skull toward the back).

Neck flexion exercise

In cases of cervical neck pain at the level of C1 and C2, nausea , dizziness, and headache may occur  . 
Throughout life, about 80% of the population suffers from cervical pain. Statistically, it affects women more than men.

Patients who present themselves at the doctor’s office usually have contracturesof the neck and shoulder muscles, especially trapezius and splenius. 
It is an involuntary and persistent muscle contraction, palpable to the touch. 
A spasming muscle pulls a vertebra down, turning and tilting it to one side. 
This causes a misalignment of the spine . In fact, the vertebrae are blocked in rotation and lateral inclination, so they can not stay in line with the others.

Muscle tension in the neck and joint blockage cause inflammation of the cervical spine with limited movement and discomfort, thus decreasing the quality of life. 
The pain is not unbearable. 
Some young patients, when they move their neck, hear a click and the bones that “pop”, this can be caused by nitrogen bubbles that burst inside the joint capsule of the joints.


Radiography of a cervical spine with arthrosis, narrowing of joint space and oseophytes

Because of arthrosis (spondilar- throsis), in adults and the elderly the cartilage is thinned and the bones of a joint approach, so they can squeak during movement. In this case, it is easy to detect the inflammation of the cervical vertebrae. In young people the pain can be linked to muscle spasms of defense, a trauma or a sudden movement that caused a slight displacement of a vertebra. 
If neck pain or cervical pain is due to cold, it probably cures by itself in a few days.

If the disorder is at the level of the first two C1-C2 vertebrae,  dizziness or vertigo, migraine  and nausea may occur in some cases. 
If the disorder is at the level of the lower middle cervical, from C3 to C7, the symptoms can reach the arm and  hand . 
If the source is between the vertebrae C7 and D1, there is a delicate area of ​​the neck called  the cervico-dorsal junction  because it passes from a cervical vertebra with discreet mobility to a more stable and fixed dorsal. 
The most frequent disk hernias are between C6 and C7, C5 and C6 and C4 and C5.


What are the causes of cervical inflammation?

Neck pain, therefore, is not a diagnosis. The causes of cervical inflammation can be several, often due to poor posture, blocked vertebrae, exacerbation after old trauma and arthritis .

The most common causes of pain and loss of mobility of the cervical spine:

1. Cervical postural – Vertebral block 
2. Acute cervical tension (” whip stroke ” or “cervical spine sprain”) 
3. Cervical arthrosis
4. Torticollis
5. Herniated disk or protrusion
6. Inflammatory diseases (rheumatoid arthritis, ankylosing spondylitis ) 
7. Spinal fracture 
8. Malocclusion or visual field defects 
9. Subluxation of the lateral (alexis) and other vertebral subluxations 
10. Vertical dislocation of the odontoid process (tooth)

Less common pathologies

• Infection
• Metabolic diseases (osteomalacia, Paget’s disease) 
• Referred neck pain ( angina , aneurysm , Pancoast’s tumor ) 
• Ankylosing hyperostosis 
• Neoplasms 
•  Radiculopathy
• Myelopathy 
• Insufficiency of the vertebral circulation caused by compression of the bone


How to diagnose neck pain?

A postural type problem does not cause movement limitation, but only pain and muscle tension. 
A torticollis is characterized by the inability to tilt to one side and rotate the neck to the same side and has acute onset. 
The arthritis  can be seen in  radiographs .

To diagnose a spinal block, it is necessary to palpate the vertebrae to highlight where the dysfunction is. An X-ray is fundamental in the case of cervical inflammation because there are serious pathologies that may be a contraindication for certain therapies:


What to do? What is the treatment for neck pain?

Treatment for neck pain should be tailored to the cause, but all have joint posture correction, physical therapy, and rehabilitation in common . 
If the cause is arthrosis, the exacerbation of an old injury or a contracture, the physical therapies are very helpful: Laser and capacitive and resistive energy transfer  ® in particular. 
To mend a torticollis or a blockage of the spine it is useful to use manual mckenzietherapy or mobilizations of the spine. 
Place a neck cervical collar which locks the joint is unnecessary and counterproductive because it increases  the stiffness and pain.


Pain in the muscles of the neck

Prolonged poor posture is the most common cause of neck pain. A medical history and careful clinical examination may be sufficient to make a diagnosis without further investigations and diagnostic tests.

Usually patients are no older than 40 years, an occupation of the sedentary type; work at least 8 hours a day in front of the computer or driving, in their free time they perform non-dynamic activities (reading or watching television for an extended period of time).


What are the symptoms of neck pain?

From a medical point of view, usually at the cervical level there is no rigidity or limitation of movement, only tension in the muscles of the neck and a contracture that feels good on the palpation. 
If you perform an x-ray you will not see any abnormalities. 
The discomfort is felt at the superficial muscular level. 
Generally, the palpation of the neck and shoulders encounters “harder” areas that correspond to contractures, usually occurring in the trapezius and splenius muscles. 
Sometimes patients feel one side of the neck different from the other. 
At night, the pain subsides, but often does not go away completely. 
Cervical pain is often associated with tension headache or headache , caused by muscle strain on the neck.
The pain is continuous, uninterrupted and very uncomfortable, but patients are able to work normally.


What are the causes of neck pain?

The most frequent incorrect postures that my patients present are: 
• Monitor the computer to the left in relation to the body, so to look it is necessary to have the head turned all day; 
• Hold the cell between the shoulder and the neck while driving or writing on the computer; 
• Sit without supporting the spine on the seat back but always slightly bent forward; 
• Sit in an “extended” position; 
• Monitor the computer very low, keeping the head bent forward to see well; 
• Sleep in dorsal decubitus with two pillows, head bowed forward all night. 
• Play guitar for hours without using the strap to support the guitar. 
• Hit the head ball in a football match.

Mothers should not forget the position of breastfeeding in the first few months after giving birth. Keeping your chest and neck bent for too long can cause pain in the neck; it is enough to place a cushion on the legs to raise the baby, not having to bend forward. 

In addition to the incorrect postures, be sure that deficiency in vision or hearing can change the position of the neck. A nearsighted person will keep the protruding neck forward while those who do not hear from one ear will keep their head turned to keep the good ear facing the other person.


What should I do in case of neck pain caused by poor posture? What is the cure?

Maneuvering massage, kneading.

We must distinguish pain from inflammation of muscle tension and contractures. 
The treatment of acute inflammation at the cervical level consists solely of rest, while in the post-acute and chronic phase it improves with the application of heat , but a simple bag of hot water does not solve the problem. 
In these rare cases, to avoid the use of medications that often leads to abuse, the most appropriate therapy is the laser therapy that has anti-inflammatory, muscle relaxant, analgesic and anti-edema effect. It has few contraindications: pregnancy , tuberculosis and cancer.

The  pain caused by the contracture is the  most frequent, especially among young people. It is relieved by the heat and the most appropriate treatment is the massage therapy which usually in the first three sessions returns a good mobility without pain.

Often, in addition to massage, the physiotherapist performs another therapy called pompage which consists of pulling the neck, maintaining the tension for at least 30 seconds and releasing slowly. 
The effect of this technique is to increase the intervertebral space, the patient feels a pleasant relaxation and a feeling of lightness in the neck and the head.

It is possible to apply the neuromuscular taping or kinesio taping , that is, elastic bandages widely used in the sport, that extend from the origin to the end of the muscle and are used to reduce the pain, to relax the muscles and to give a feeling of support . 
According to the applied tension, you can reduce muscle spasm on one side of the neck and shoulders by activating the muscles on the other side. 
The only downside is aesthetic, in fact during the day you see a colored stripe on the neck.

Therapeutic massage of the neck and trapezius

Unfortunately, the result of the massage is not eternal; anyone who suffers from neck pain due to poor posture should use a lumbar support when seated and when sleeping, are in all medical or orthopedic stores. 
Lumbar support serves to prolong the effects of treatment, and an exerciseprogram is recommended to be performed regularly at least 3 times a week.


How can I prevent neck muscle pain?

The postural gymnastics as the method  of  Mckenzie is right.

I advise doing 10 consecutive massages in these cases, since pain mainly affects the cold season. To have a healthy neck all year round, it is very helpful to do one every 2/3 weeks, do the Mckenzie exercises regularly and follow the postural advice.

In the case of cervical postural pain, therapeutic massage is indicated in the acute and chronic phase. A good prevention for people suffering from this disorder is sleeping in the supine or side position because the prone position keeps the neck muscles tense all night and causes painful contractures.

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