Cervical pain
Keywords:
cervical pain, muscular, mechanicalAbstract
The cervical spine is extremely mobile and is often traumatized. Numerous pain-sensitive structures are located in the neck. The etiology of pain is most often related to the musculoskeletal system and the apophyseal joints. Pain arises acutely and resolves spontaneously and is rarely chronic. Acute idiopathic (non-specific) neck pain is the equivalent of idiopathic low back pain and is of unclear etiology but of muscular origin. Apart from pain and spasm of the cervical muscles, no residual neurological symptoms are found. Whiplash injury syndrome is characterized by the whiplash injury occurring in a motor vehicle accident. It proceeds with neck pain, reflected pain in the head or upper extremities. Wearing a cervical collar has no proven effect. Regional myofascial syndromes involve the large muscles of the neck and shoulder girdle. They are characterized by trigger points in the neck muscles, muscle spasm, pain, and restricted movement in the neck and shoulder. Degenerative changes in the cervical region less commonly result in pain and nerve root compression due to the wider spinal canal. Disc herniation in the cervical region, in contrast to lumbar herniation, is not a predominant cause of root damage. Cervical spondylosis, apophyseal joint hypertrophy and osteophytosis are one of the most common causes of neck pain.
Pain is accompanied by muscle spasm, tightness and limited spinal mobility, with no residual neurological symptoms. Cervical apophyseal joint syndrome presents with pain in the upper neck, radiating occipitally, parietally and to the ipsilateral frontal region. Ankylosing spondylitis, rheumatoid arthritis and polymyalgia rheumatica are common causes of neck pain. Atlantoaxial instability presents with pathologically extensive range of motion due to damage to the transverse ligament of the atlas and both facet joints. Pain from the atlantooccipital joints occurs as a result of degenerative arthritis or traumatic injury associated with an abrupt acceleration or deceleration on movement. Neck-tongue syndrome presents with sudden unilateral sharp or stabbing and severe pain in the occipital or upper cervical region, accompanied by numbness, dysesthesia, abnormal sensations and/ or position of the ipsilateral tongue. Cervicogenic headache is pain reflected from the upper back of the neck to the head.
In conclusion, cervical pain has a different etiopathogenesis from lumbosacral pain.
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