Sitting at the computer for long periods of time, a strenuous car ride, an uncomfortable bed: neck tension has many causes, usually occurs unexpectedly and can be very annoying. The pain in the neck can radiate into the shoulders and the back of the head. Sometimes neck tension disappears quickly on its own, but sometimes the pain is more persistent and a visit to the doctor becomes necessary.
What is neck tension?
Neck tension is one of the most common painful experiences. When people speak of neck tension, they are mostly referring to neck pain in the region of the neck-shoulder-spine onset. Restricted mobility and aching muscles are the basic symptoms of neck tension. Free movement of the head in all directions is no longer possible, sometimes even the mobility of the chest-shoulder region is impaired. Rotational movements of the upper body are impossible or limited and associated with neck pain. Doctors refer to the pain in the neck as cervical syndrome or cervical spine syndrome. All manifestations of neck pain are grouped under this term. Depending on the duration, a distinction is made between an acute (lasting up to three weeks), a subacute (lasting up to twelve weeks) and a chronic (lasting longer than twelve weeks) course. The longer the pain lasts, the more likely it is to result in damage to the affected structures, chronic expression of existing symptoms, or secondary damage.
Causes
In most cases, the strain has built up over a long period of time and has been announced by omens such as headache, burning eyes or fatigue. The sooner treatment for neck tension begins, the sooner the symptoms disappear. There may also be an unpleasant tingling sensation in the neck, a dull, pulling pain, migraine-like headaches or numbness in the fingers. The manifestations of neck tension are as varied as its causes. Cramps in the neck muscles and the associated nerve irritation can occur without a clearly apparent cause or in connection with another illness, often a cold. One-sided strain in combination with lack of exercise, uncomfortable sleeping or sitting positions as well as stress and drafts are also seen as causes. Overloading, heavy carrying or lifting, jerky movements or drafts can also be causative. Sometimes, however, the reason lies deeper: experts cite wear and tear on the extremely mobile and very susceptible cervical vertebrae and their intervertebral discs as a rare cause of neck tension. Previous illnesses, whether known or not, are also triggers of cramped neck muscles. In connection with meningitis, rheumatic or neurological diseases, inflammation of the vertebral bodies, in case of misalignment of the spine or vascular diseases, the neck may also stiffen. Other triggers can be osteoporosis, infectious diseases such as listeriosis or a salmonella infection, but also bone tumors and lymphomas. If neck strain occurs after an accident, it is often whiplash. Caution is advised here: It could also be a fractured vertebra that needs immediate medical attention. Rarely, a congenital malposition such as torticollis is the cause of the pain.
Symptoms, complaints and signs
In addition to tension in the muscles of the neck, back of the head and shoulders, other symptoms may occur. Restricted mobility of the head and cervical spine is possible, and pain in the shoulders and shoulder joints is frequently mentioned. Nausea up to vomiting, headaches up to migraine and associated visual disturbances often occur in connection with neck complaints. However, ringing in the ears, shortness of breath, dizziness and fatigue are also symptoms associated with cramped neck muscles. Weakness in the legs occurs only occasionally. Many of the complaints are attributed to the increased pressure of the muscles on the nerve pathways. Excessive muscle tone is felt more uncomfortably the longer it persists. If an accident or a sudden event is the cause of the muscle hardening, if the pain occurs in a flash, or if it is accompanied by a brief loss of consciousness, immediate consultation with a physician is recommended.In all cases, the following applies: The restriction of mobility carries an increased risk of accidents. Doctors advise against activities that require a great deal of cervical spine mobility in the case of such complaints. Driving should be avoided. Carrying and lifting heavy objects or one-sided strain on the neck muscles can increase the discomfort and lead to damage to the cervical spine.
Complications
If the tension persists for a long time and does not disappear on its own, other complaints are often added. There may be numbness in the neck and shoulders, as well as in the fingers and hands, due to the impairment of the nerves. Even a feeling of weakness in the legs can be caused by neck tension.
When should you go to the doctor?
If symptoms that cannot be immediately attributed to tension join them, caution is called for. Significant weight loss, for example, may indicate a more serious cause. An immediate visit to the doctor is also indicated in the case of a radical deterioration of the condition. Neck tension may also occur in the case of coronary artery disease such as myocardial infarction (heart attack) or angina pectoris. Severe mental strain and prolonged stress can lead to a stiff neck even without orthopedic findings. If paralysis symptoms occur in the arms or hands, a doctor should be consulted.
Diagnosis
Physical examination by a physician clarifies whether there are dysfunctions of the musculoskeletal system, joints, tendons, or ligaments. An overload of the musculature is checked as well as a strain or a possible herniated disc. It is determined how mobile the cervical spine is or whether nerves are pinched. The extent of poor posture, the quality of the musculature and possible external causes such as accidents or jerky movements are included in the diagnosis. Other diagnostic options may also be used to gain clarity on the cause of the condition. A blood count will rule out infectious diseases and Lyme disease, and imaging techniques such as an X-ray, computed tomography (CT) scan or magnetic resonance imaging (MRI) will provide reliable information about orthopedic causes. A herniated disc would show up here, as would a pathological change in bones or intervertebral discs. Once the reasons for the disease have been clarified, treatment of the symptoms can begin. In consultation with the patient, the doctor will point out the appropriate methods to alleviate discomfort and permanently eradicate the cause of the impairment.
Treatment and therapy
Heat usually relieves the discomfort of tight neck muscles. Also blood circulation-promoting ointments with camphor or peppermint oil are proven first aid measures. If the condition persists, self-treatment is not advisable. At the latest after a few days with the pain in the neck or if the symptoms worsen, a doctor should be consulted. In the case of a very severe manifestation of the disease, for example paralysis of the arms, or in the presence of a known previous disease (for example osteoporosis or rheumatism) a medical doctor should be consulted. He or she will take a specific medical history to define the scope of the examination and initiate treatment. The question about the duration of the existing pain is just as much a part of the initial anamnesis as the reconstruction of the course of the disease, the determination of the severity of the pain and the question about other existing diseases. The measures the physician suggests depend on the severity of the impairment and the patient’s perceived pain. In cases of severe discomfort, relief of the cervical spine with the help of a special foam collar or an ergonomically shaped neck pillow may be recommended. Complementary measures such as acupuncture or naturopathic procedures must be weighed in individual cases. Only in rare cases and after all other measures have been exhausted may surgical intervention be necessary. First, the acute symptoms are treated. Tension usually responds well to therapeutic measures: Massages, heat applications such as mud packs or red light are often used. In most cases, the treating physician combines manual treatment with physiotherapeutic sessions. This is intended to loosen the muscles, release agglutinated fasciae and reduce stress.The tape technique with special kinesiological adhesive tapes applied to the skin can also provide relief. The tapes act like a permanent massage and gently stretch. Depending on how the patient feels, the doctor prescribes painkillers (e.g. paracetamol) as well as non-steroidal rheumatic drugs (e.g. ibuprofen, diclofenac) to quickly relieve the pain. Targeted injections of numbing medications such as lidocaine into the myofascial trigger points where the tight muscle bundles converge may be used. Injections have been shown to be very effective, especially when combined with stretching exercises. Light exercise such as walks, gentle gymnastics, targeted stretching exercises or relaxed swimming support loosening and, when used correctly, provide relief even for acute symptoms. The additional use of heat pads, sauna sessions and hot baths is often recommended by the doctor. Manipulation of the cervical spine with chiropractic grips should be considered with caution: This type of treatment should always be done very gently, and rough jerking or tearing should be avoided at all costs. This type of treatment should only be performed by certified physicians.
Outlook and prognosis
The prognosis of neck strain is favorable. In most of the affected people, it is a matter of disturbances in everyday movements. The load on the organism is not optimal and therefore triggers tension in the neck. Provided that the muscular system is supported by balancing or therapeutic movements, relief of the complaints sets in within a short time in most cases. In addition, the affected person can independently contribute to improving his or her health by regularly performing sports activities. If one-sided physical stress or incorrect posture is avoided, the symptoms can also be alleviated. In the case of long-lasting or deep-seated tension, heat baths or massages can also help. These lead to a loosening of the muscle fibers and accordingly relieve the existing tension. For a lasting freedom from symptoms, a change in the movement patterns is absolutely necessary. Otherwise, the relapse rate of neck tension is very high. If the tension is caused by disorders of the skeletal system, physiotherapeutic exercises are necessary for a long-term improvement in general health. These should be applied by the patient on his or her own responsibility, even outside of therapy sessions, in order to take preventive measures. If it is not possible for the affected person to perform compensatory movement exercises due to an existing serious underlying disease, relief of the symptoms will only be achieved once the underlying disease has subsided or been cured.
Prevention
For lasting improvement of the condition, the physician will emphasize relaxation of muscle tissue and loosening of agglutinated muscle fascia to lower the basal tone of the muscles. Regular exercise and a good mental state are equally important in order not to cause new complaints. One-sided stress and monotonous movement patterns should be avoided. Stress hormones such as cortisol, adrenaline and noradrenaline promote the complaints: Stress reduction, flexibility and suppleness are therefore preventive priorities. Loose running, swimming or other endurance sports improve blood circulation and supply the muscles with blood and oxygen. This strengthens the immune system and prevents infectious diseases, which can also trigger neck tension. Physiotherapy is recommended for very severe symptoms and is often prescribed by the doctor in conjunction with passive heat applications.
Aftercare
Aftercare following neck strain is very important. It is equal to prevention, as the aim is to prevent the unpleasant discomfort from flaring up again. For this purpose, it is ideal if the affected person is aware of how the neck tension occurred. If the cause is an unhealthy posture, for example at work, ergonomic design is an important part of aftercare. Taking breaks during work is also important to help the neck relax again. This is especially true for anyone who sits at a desk or PC in a bent posture.Anyone who makes a lot of phone calls and has the habit of holding the phone between their head and shoulder would do well to configure a suitable headset during aftercare. If the neck tension is the cause of an unfavorable positioning of the cervical spine in bed, the mattress and pillow should be reconsidered. Orthopedists, physiotherapists and often also the appropriately qualified personnel in the bed store can help here. If the neck tension has been treated by physiotherapy, the patient has usually also learned exercises to be continued at home. This is also an integral part of follow-up care for this condition. If drafts were the cause of the neck tension, they should be consistently avoided. This is especially true if the hair is wet after showering.
This is what you can do yourself
Back exercises are used to work not only the neck, but the entire systemically connected musculature of the back, neck and front of the body, as well as the shoulders and arms: Strengthening, flexibility, mobilization and stretching are the top priorities here. Gentle yoga pulls tense muscles back into shape, but also provides stress reduction with meditative elements and promotes oxygen supply with breathing techniques. Relaxation techniques such as progressive muscle relaxation provide improved awareness of the body and one’s own stress level. Many of these courses are subsidized by health insurance companies.