Cervical spine syndrome: Symptoms, Causes, and Treatment

Brief overview

  • Symptoms: Tense neck, tingling in the fingers, pain in the shoulder, dizziness, headaches; less frequently drowsiness, nausea or difficulty swallowing.
  • Treatment: Depends on the cause; treatment options include stretching exercises, physiotherapy and medication; sometimes surgery is also necessary.
  • Prognosis: Usually easily treatable; depending on the cause, symptoms last from a few days to several weeks.
  • Causes: The possible causes of cervical spine syndrome range from poor posture, tension and physical work to vertebral damage.
  • Description: Cervical spine syndrome refers to complaints in the area of the cervical spine.
  • Diagnosis: Consultation with the doctor, physical examination (CT and MRI if necessary)

What are the symptoms of cervical spine syndrome?

The symptoms of cervical spine syndrome depend primarily on the cause. The most common signs of cervical spine syndrome are as follows:

  • Neck and back pain
  • Pain with head movements
  • dizziness
  • Tension
  • Muscle stiffness (myogelosis)
  • Tingling and numbness in the fingers

The pain often radiates from the cervical vertebrae to the arms and hands. Those affected also report burning or pulling neck pain. This is often accompanied by a stiff and hard neck (“tense neck”, “stiff neck”) (so-called cervical neuralgia).

Difficulty swallowing, tinnitus, dizziness

In the area of the cervical spine, the nerves are located close to the upper cervical joints, the shoulder girdle and the vertebrae. If a tense muscle in the neck presses on a nerve there, the brain sends incorrect signals to the balance center about the position of the head. This often triggers dizziness (cervical vertigo) and nausea in those affected. Sometimes people with cervical spine syndrome also experience ringing in the ears (tinnitus), palpitations or difficulty swallowing.

Sensory disturbances, tremors

If a slipped disc triggers cervical spine syndrome and nerve roots are damaged, patients complain of sensory disturbances, discomfort, tremors and weakness in the arms. The latter manifests itself, for example, when an object falls out of the patient’s hand. In the case of a severe slipped disc, people with cervical syndrome sometimes also have an unsteady gait and problems walking (gait disorders). In rare cases, bladder function is also impaired. Those affected then usually find it difficult to control their bladder and hold back their urine (incontinence).

Problems with vision

People with cervical syndrome may also have impaired vision. This happens, for example, when tense muscles pinch nerves in the head and neck area or inhibit blood flow to the optic nerves. This then manifests itself in the form of “flickering” in front of the eyes, among other things.

Doctors generally treat cervical spine syndrome depending on the underlying cause. If the symptoms are caused by tense muscles or poor posture, for example, the doctor will usually start with conservative treatment. This includes, for example, exercises to strengthen the muscles in the neck area, physiotherapy (physical and manual therapies) and medication to relieve the pain.

In some cases, the doctor may advise surgery. This is necessary, for example, if there is a severe slipped disc or an injury to the cervical spine. Before starting treatment, it is important that the doctor clarifies with you what you expect from the therapy and what you would like to contribute yourself. If you are motivated and get involved in the treatment, this will have a positive effect on your therapy.

Physiotherapy

Physiotherapy (physiotherapy) for cervical spine syndrome aims to provide lasting pain relief and make your body more flexible again. It includes exercises to strengthen your muscles, massages and physical measures (e.g. applications with heat, cold, light or electrical stimuli). For example, the therapist massages the affected muscles, irradiates them with red light or applies heat packs. In this way, tension and vertebral blockages are released so that the vertebral joints are no longer restricted in their mobility.

The physiotherapist also selects specific physiotherapy exercises that are tailored to your individual needs and state of health. They will instruct you exactly how to perform these exercises and, if necessary, correct any movements that you are performing incorrectly.

To ensure that the therapy brings the desired success, it is important that you do your exercises regularly at home.

Exercises

The following exercises will help you to stretch your neck and alleviate the symptoms of cervical spine syndrome:

  • Turn your head to the right and nod slowly several times. Then turn your head to the left and nod again several times. Keep your back as straight as possible.
  • Bring your chin towards your chest and slowly turn your head in this position in a semi-circle towards your right and then your left shoulder.
  • Push your head as far forward as you can (long neck) and then back again until you have a double chin.
  • Interlace your fingers on the back of your head. Press your head against it for 10 seconds. Then relax again. Make sure that your body is upright and your neck is stretched.
  • Tilt your head to the right and reach over your head to your left temple with your right hand. Now tilt your head further to the right and at the same time stretch your left arm out towards the floor until you feel a stretch in your left neck muscle. Hold each side for three times 30 seconds.

If the exercises make the pain worse, please ask your doctor or physiotherapist for advice.

Medication

If symptoms occur acutely or the exercises do not help sufficiently, the doctor will also treat the cervical spine syndrome with medication.

Painkillers

If necessary, the doctor will treat cervical spine syndrome with pain medication. For example, he prescribes anti-inflammatory substances such as diclofenac or ibuprofen. These switch off the pain for a while and enable those affected to move their head and neck better.

Medication for muscle relaxation

Pain-relieving and muscle-relaxing medication is not free of side effects. You should therefore only take them for a short time and after consulting your doctor!

Ointments and plasters

Ointments or plasters from the pharmacy that have a warming and pain-relieving effect (e.g. warming plasters, gels and ointments with pain-relieving active ingredients) also alleviate the symptoms of cervical syndrome.

Minimally invasive injection therapy (MIT)

Surgery

If conservative treatment for cervical spine syndrome is unsuccessful, the doctor will consider surgery. This is the case, for example, with a slipped disc if the patient suffers from very severe pain, symptoms of paralysis or incontinence. Nowadays, the operation is usually performed microsurgically, i.e. via a small incision in the back. The doctor removes the disc tissue (e.g. using a milling machine or laser) that is pressing on the nerves and causing the symptoms. The procedure is usually short (approx. 30 to 60 minutes). As a rule, the patient is under general anesthesia during the operation and remains in hospital for about three days for observation.

Self-help

You have the option of alleviating your symptoms yourself and preventing tension in your neck. The following measures are possible:

Exercise and sport

Heat

Heat helps to relieve tension in cervical spine syndrome and alleviate discomfort. To do this, wrap a hot water bottle in a cloth and place it on your neck for ten to 20 minutes. A red light lamp at home also has a beneficial effect on your tension. To do this, irradiate the affected area for a maximum of 15 minutes up to three times a day. To avoid burns, please follow the device manufacturer’s instructions for use! A warm bath (approx. 38 degrees Celsius) also helps to relax tense muscles.

Avoid stress

What causes cervical spine syndrome?

There are many causes of cervical syndrome. It is often triggered by tense muscles and/or fascia (elastic connective tissue), heavy strain on the back, one-sided movements and incorrect posture as well as wear and tear on the spine (degenerative cervical spine syndrome).

Causes at a glance

Possible causes of cervical spine syndrome are

  • Tense neck muscles
  • Stuck or hardened fascia (e.g. due to lack of exercise)
  • Incorrect and permanent strain on the cervical spine (e.g. due to sitting incorrectly in front of the computer or lying incorrectly while sleeping)
  • Degenerative changes, e.g. osteoarthritis (wear and tear) of the cervical spine (spondylosis)
  • Changes to bones and cartilage (osteochondrosis)
  • Wear and tear of the vertebral joints (spinal arthrosis, facet joint arthrosis)
  • Herniated disc (prolapse)
  • Inflammatory diseases (e.g. rheumatism, rheumatoid arthritis)
  • Injuries to the spine (e.g. whiplash caused by a traffic accident or during sport)
  • Blocked joints in the spine (e.g. due to inflammation or cartilage damage)
  • Inflammation of the vertebral bodies (spondylitis)
  • Cancer (e.g. bone cancer or metastases in the spine)
  • Infections of the spinal cord

People who constantly look at their smartphone or tablet are often prone to neck pain and headaches (so-called “cell phone neck”). You can read more about this in the article “Mobile phone neck”.

Certain risk factors also promote the development of cervical syndrome. These include

  • Pathological overweight (obesity)
  • Heavy, physical work (e.g. construction work or nursing work in hospital)
  • Physical changes during pregnancy (e.g. weight gain, altered center of gravity)

Chronic stress and mental tension also frequently trigger psychosomatic complaints such as neck or back pain.

How long does a cervical spine syndrome last?

In most cases, however, cervical spine syndrome can be treated well with conservative means. These include, for example, exercises to strengthen the back and neck muscles, physiotherapy and/or medication to relieve pain. In chronic cases of cervical spine syndrome, surgery is sometimes necessary to improve the symptoms in the long term.

If those affected do not carry out their exercises regularly and/or do not pay attention to their posture, the symptoms often return.

What is cervical syndrome?

Cervical spine syndrome or cervical syndrome (ICD-10 code M54; international classification of diagnoses) refers to a wide range of often non-specific symptoms that occur in the cervical spine, neck, shoulders and arms.

Cervical syndrome can be classified according to where the pain occurs:

  • Upper cervical syndrome: pain in the area of cervical vertebrae one to two
  • Lower cervical spine syndrome: pain in the area of cervical vertebrae six to seven

Cervical spine syndrome can also be classified according to when the pain occurs:

  • Acute cervical spine syndrome: The symptoms occur suddenly and only last for a short time (a few days); the cause is usually an acute injury due to overloading of the cervical spine (e.g. so-called cervical whiplash caused by a traffic accident).
  • Chronic cervical spine syndrome:The symptoms last longer than three months; the pain cannot usually be pinpointed.

Cervical spine syndrome can also be categorized according to where the pain radiates to:

  • Local cervical spine syndrome: The pain only occurs at a specific point (localized); the pain does not radiate.
  • Pseudoradicular cervical spine syndrome: The pain is non-specific and localized, it radiates recurrently to one side of an arm or a leg.

When does cervical syndrome become dangerous?

Although cervical syndrome is very unpleasant, in most cases it has no cause that requires immediate medical treatment. However, if you have neck pain, consult a doctor as soon as possible if:

  • You have previously injured yourself, e.g. in an accident or fall (possible whiplash).
  • You have a fever of over 38.5 degrees Celsius.
  • You have night sweats.
  • Your neck pain worsens considerably.
  • A sudden onset of “annihilation pain” (extremely severe pain that may cause fear of death).
  • You have symptoms of paralysis (e.g. no feeling in your arms).
  • Your sense of strength, pain or touch is impaired (e.g. no strength in your arms).
  • You have osteoporosis (bone loss).
  • You are affected by cancer.
  • You suddenly lose weight without wanting to or without having an explanation for it.
  • You have a rheumatic disease (e.g. rheumatoid arthritis).

How do you recognize a cervical spine syndrome?

The first point of contact for neck pain is the family doctor. After examining the patient, the doctor will decide whether to refer the patient to a specialist (e.g. orthopaedist or neurologist). The doctor will first have a detailed discussion (anamnesis) with the patient. He then carries out a physical examination.

Interview with the doctor

During the consultation, the doctor will first ask a few questions about the diagnosis of cervical spine syndrome, including

  • What symptoms do you have?
  • When did the symptoms occur?
  • Do you have any other physical complaints, such as tingling in your arms or legs or dizziness?
  • Do you have any pre-existing conditions (e.g. rheumatism, osteoarthritis, slipped disc)?
  • What are your lifestyle habits? Do you exercise regularly?
  • Do you have a job that requires you to stand or sit a lot?

Physical examination

As the doctor often cannot immediately find a clear cause for the tension and pain, the physical examination is the most important part of the diagnosis of cervical syndrome. The doctor will palpate the shoulder and neck muscles. He examines whether touching the inner edges of the shoulder blades is very painful. He also checks the reflexes in the muscles and the mobility of the joints. For example, he places a thumb on the tendon of the biceps (muscle in the upper arm) of the affected person and hits it with a reflex hammer. If the forearm bends reflexively, injuries to the nerves involved are unlikely.

Further examinations