Diagnosis | Pain in the cervical spine

Diagnosis

If the pain persists and does not improve, a visit to a doctor is recommended. The doctor will first examine the muscles and cervical spine for mobility and functionality. Psychosocial risk factors can also be assessed during the interview, e.g. professional and family situation, stress exposure and depressive mood.

In addition, pre-existing conditions that could contribute to the development of the symptoms, such as osteoporosis, herniated discs in the cervical spine, malignant diseases, etc. If during this examination things are found that suggest a serious cause, the doctor will arrange for further examinations. This could be an X-ray, CT or MRT examination of the cervical spine, for example. In this way it is possible to detect e.g. slipped discs or bone metastases.

Frequency distribution

A total of about 15% of the population is affected by complaints in the area of the cervical spine. In 2/3 of all people they occur at some point in their lives. In general, women are affected more often than men, especially if they have a predominantly sedentary occupation, e.g. office jobs.If the pain has serious causes, i.e. if it is caused by the patient’s underlying disease, the frequency distribution is based on the frequency of the corresponding disease in the population.

Symptoms

The cervical spine comprises vertebrae 1-7, which corresponds to the area between the occipital bone and the shoulder base. Often the pain radiates into the back of the head, shoulders and arms. Headaches and dizziness can also occur.

Frequently, a tension of the muscles near the spinal column can be observed already when the neck is palpated (muscle hard tension). Typically, pain can be triggered by applying pressure to the hardened areas. Also, certain movements of the head are only possible under pain. For example, the head can often not be turned or tilted much without being perceived as painful for the patient.

Therapy

The therapy of neck pain depends on its cause. If the cause is a serious illness, the first step is to treat the illness, which will then lead to an improvement of the neck pain. If muscle tension and stress are the cause, there are several methods that can lead to an improvement of the symptoms.

Strengthening exercises: In general, immobilization has a negative effect on the pain symptoms in the spine area. Rather, especially in the case of muscular causes, care should be taken to maintain or restore normal mobility. The posture should be corrected and improved.

Especially people who perform a predominantly sedentary activity benefit from this. Mere immobilization should be avoided, as this leads to a reduction in muscle mass, which in turn increases the susceptibility to pain in the cervical spine. However, guided strengthening exercises that are performed regularly, e.g. with a physiotherapist or with qualified personnel from a fitness facility, can improve or even prevent pain in the long term.

Heat: Heat promotes blood circulation and can help to relax tense muscles. Placing a hot-water bottle or a heat plaster on the tense neck muscles can therefore help the pain to subside more quickly. Electrotherapy: Newer methods try to relieve pain by stimulating nerves.

For example, electrical currents can be emitted through electrodes glued to the skin, which lead to nerve excitation. These can then no longer pass on the original pain stimuli as well. In the case of chronic pain in the cervical spine that cannot be controlled in any other way, nerves in the vertebral joints can also be specifically sclerosed, provided that they are the cause of the symptoms.

This allows the patient to achieve lasting freedom from pain. However, this therapy represents one of the last possibilities that can be exhausted. Trigger point massage: Trigger points are hardened areas in the musculature that trigger pain when pressure is applied.

By means of targeted massage of these points, e.g. using specially designed trigger rolls or trigger balls, the tension can be released. As a result, the pain in the neck area often improves promptly. Alternative methods: Especially in chronic pain conditions, alternative healing methods can provide relief for some patients.

This includes acupuncture, for example. In several sessions, small needles are placed at various points on the patient’s body. According to traditional Chinese medicine (TCM), these needles activate the body’s self-healing powers and relieve tension.

Chinese medicine also uses various mixtures of medicinal herbs. Preparations containing qishe and nux vomica have proven to be potentially effective in the treatment of neck pain. Relaxation Techniques: Also in chronic pain, it can be helpful to provide the patient with specific exercises that enable him to relax consciously.

Yoga and autogenic training can provide such guidance and prevent unconscious tension. Medication therapy: Supportive therapy with medication can be helpful, since the patient can better perform his original movement patterns again when he is free of pain. Otherwise, the patient often has to adopt relieving postures, which can make the pain even worse.

However, the cause of the neck pain is not eliminated by taking pain-relieving medication. Only the symptoms are improved, but this can have a positive secondary effect on the healing process.The injection of local anaesthetics into the neck muscles has proven to be effective in this respect. The local anesthetic lidocaine is often used for this purpose.

The doctor injects small amounts of the drug into the muscles at various points in the painful area. This can relieve tension, ease the pain and prevent a relieving posture. Alternatively, pain-relieving medication in tablet form can be taken.

Suitable are, for example, paracetamol, acetylsalicylic acid, ibuprofen or diclofenac. For stronger pain, weak opioids can also be administered. Muscle-relaxing drugs, so-called muscle relaxants, can also contribute to pain relief in the short term, but can only be administered for a short time due to the high risk of dependence.