Diagnosis and course of neck pain
The possibilities of diagnostic examination are also very numerous due to the variety of causes of neck pain. In order to make the correct diagnosis of neck pain, some information from the patient’s medical history is important (anamnesis), as it gives a first indication of the causes. The physical examination of the cervical spine with regard to local pain points, muscle tension and hardening as well as the assessment of mobility provides further indications of possible causes.
Likewise, trigger points (points of irritation whose touch triggers pain) can be examined. To rule out the possibility that the cause of neck pain is a nerve entrapment, a neurological examination may be necessary under certain circumstances. Imaging procedures such as these allow further insight into the painful neck area.
If meningitis is suspected, a cerebrospinal fluid puncture is also performed to examine the cerebral fluid. Neck pain due to muscular tension in particular usually has a positive course and subsides after a short time. If the causes of neck pain lie in signs of wear and tear, conditions after cervical spine injuries, neurological or rheumatic diseases, it often takes a chronic course with phases of relative freedom from symptoms and acute pain phases.
- Ultrasound (sonography)
- X-ray
- Magnetic resonance imaging (MRT, nuclear spin) or
- Computed tomography (CT)
Therapy of neck pain
The treatment for neck pain is always directed against the cause of the complaints, with physiotherapeutic and physical-therapeutic measures being the main focus. Tension-related neck pain usually subsides on its own after a few days or weeks. In the acute stage, symptomatic treatment with painkillers (NSAIDs, e.g. Voltaren®), cold or heat packs and temporary relief of the cervical spine are usually necessary.
The affected person can often help to alleviate the symptoms or even disappear completely with the help of active movement and muscle strengthening. Physiotherapy, active muscle strengthening, acupuncture, TENS treatments or the direct administration of anti-inflammatory drugs to the neck area can also be used to relieve pain. Physical current or ultrasound treatments promote blood circulation and metabolic processes in the tissue and can have a relaxing effect.
Chirotherapy or manual medicine should be used very cautiously in the neck area due to the risk of nerve damage. A relief of the neck area (e.g. after a whiplash injury) can be achieved, for example, with a neck cuff made of foam (Schanz ́sche tie) or a more stable neck collar made of plastic. At night, the cervical spine can also be relieved by a neck roll or an appropriately shaped neck cushion.
Depending on the cause of the neck pain, surgical treatment options may also be considered.Through modern spinal surgery up to microsurgical and less stressful surgical techniques, there is now a wide range of therapeutic options. With a gymnastic ball or a gymnastic roll an effective exercise can be performed to loosen the neck muscles. The balls or the roll are placed under the patient’s back just above the buttocks.
The legs are adjusted. The stretched body can now be moved forward and backward with the legs. During the forward and backward movements the neck must remain stretched backwards, the gaze should be directed upwards towards the ceiling and the neck should be kept straight.
Several repetitions should be performed. After a short pause for relaxation, the exercise should be repeated again. The purpose of the exercise is to straighten the cervical spine and to decongestion.
A further exercise can be performed while sitting. With the back stretched, both arms are angled to the right and left and the hands are folded behind the head. With slightly springy, gentle movements, the right elbow is now to be pulled to the left.
The upper body of the sitting patient also turns to the left, while the left elbow is pulled behind the head to the right side. This exercise should also be repeated several times. Here too, the cervical spine is gently decongested.
The third exercise can be performed on a wall. The affected person sits on a chair, both elbows are bent and the hands are crossed at the back of the head. The head is brought close to the wall until the elbows touch the wall.
The patient should remain in this position for a moment. Then try to pull the back towards the wall, keeping the cervical spine straight. Again, the exercise should be performed gently.
Also here some repetitions should be done. All exercises can also be easily integrated into everyday life, e.g. also during a work break. Another exercise should also be done sitting.
The right ear should be grasped with the left hand over the head. The head should now be pulled gently to the left side and held for a few seconds. Then move the other way around and pull the head (left ear) to the right with the right hand.
Many people who suffer from neck pain are helped by taping the painful region. It is especially effective for pain caused by tense muscles in the neck area. The tissue is exposed to a kind of massage by the pulling of the tape bands.
This tension is increased by moving the neck, as the taped skin is stretched. The whole thing happens without exerting too much pressure on the neck. This allows the affected structures to be gently loosened and tensions released.
The tapes can also be worn in everyday life and are therefore a clever way to loosen the neck as long as possible. However, if the pain is severe, additional exercises should be performed to relax the muscles, if necessary as part of physiotherapy. In order to perform the taping with the greatest possible effect, it is recommended to seek advice in a store or from a physiotherapist.
There are various globules that can be helpful for neck pain. However, depending on the severity of the pain, they should not be used as the sole remedy. Rhus toxicodendron can relieve the pain in the joints.
Ruta is often used for neck pain when migraine also occurs. Colocynthis is especially helpful in cases of muscle tension. Ledum is also a possible option for tension and pain caused by inflammation, such as rheumatism.