Pain in the neck and shoulder is one of the most common symptoms in clinical practice. Pain in the neck, giving in the shoulders and hands, are noted in 50% of the adult population (20% of men, 30% of women) - this is explained by the mobility of the cervical spine, which predetermines its vulnerability to degenerative changes and mechanical effects. Acute or chronic (constantly renewing) pain in the shoulder requires scrupulous differential diagnosis, as it may indicate a tumor process, somatic diseases or serious pathologies of the spinal column.
Anatomical structure
The neck is an important part of the body, connecting the trunk and head, performing a number of vital functions. The spinal cord is located in the vertebral canal, the cervical region of which is formed by seven vertebrae, between the five of them intervertebral disks are placed, alongside the roots of nerves. The anatomical structure of the neck consists of veins, muscles, arteries, larynx, lymph nodes, esophagus and trachea.
Why there is pain in the neck and shoulder?
Pain in the shoulder can cause: sleep in an uncomfortable position, incorrect posture, prolonged stress - these are the most innocuous reasons. Leading positions in the etiological "rating" of pain in the cervical region and muscles of the shoulder girdle are defective cervical and thoracic spine and shoulder-blade periarthritis, which account for up to 85% of all clinical cases. The remaining 15% include somatic diseases, oncology, arthrosis and arthritis.
Vertebrogenic (provoked by the pathology of the spine) pain in the neck and shoulder:
- arthrosis of the shoulder joint. Degenerative disease, most commonly diagnosed in middle-aged people. Osteoarthritis progresses slowly, but in the latter stages it gives a lot of pain, causing limitation of joint mobility and aching pain in the shoulder, which increase with weather fluctuations and physical exertion. As the pathological process develops, edema, hyperemia of the skin, an increase in body temperature;
- arthritis. It arises because of inflammation of articular cartilage, degeneration / deterioration of cartilaginous joints. It is manifested by intense pain in the shoulder, dizziness, a feeling of tingling and numbness in the upper limbs;
- osteochondrosis. Cervical osteochondrosis affects the cartilaginous tissue of the intervertebral discs, which gives a characteristic symptom complex: severe pain in the neck, giving in the arm, pressing headache, deterioration of vision, pain in the heart;
- intervertebral hernia. Depending on the severity of the lesion, the pain radiates to the interlapar area, arm, shoulder (right / left), medial scapula. Typical manifestations: acute "start" after trauma / intensive physical exertion, increased pain in the neck and shoulder when sneezing, coughing, tilting the head, flexing the neck, reducing pain - with a raising of the hand behind the head, traction of the head;
- plexitis. Inflammation of the nerve plexuses, which are formed by the anterior branches of the cerebrospinal recipes. Cervical plexitis provokes paroxysmal pain in the neck, weakness of the neck muscles, less often - prolonged hiccough due to involvement of the diaphragm in the inflammation of the nerve, respiratory failure;
- humeroparous periarthritis. Inflammation of the capsule of the shoulder joint and shoulder tendons causes a sharp growing pain in the shoulder, giving into the arm;
- cervical spondylosis. A set of degenerative deformations, including the formation of osteophytes, hypertrophy of the intervertebral joints and ligamentous apparatus, the defeat of inflammatory tissues, are the cause of unilateral / bilateral acute pain in the neck and shoulder, regressing (disappearing) for 7-8 days. Chronic spondylosis can lead to the development of torticollis, compression of the spinal cord;
- myalgia. Characterized by prolonged pain and spasms in the muscles. Objective treatment of myalgia with the definition of classification of the disease is a complex task, since many systemic rheumatic, endocrine, neurological, and infectious diseases have a similar clinic. Causes of muscle pain: excessive physical stress of untrained muscles, vascular deviations, metabolic disorders, the effect of toxic substances. Patients complain of severe pain in the neck, shoulder, arm, lower back, limitation of movement, temperature jumps, sweating, vomiting, nausea;
- stenosis of the spinal canal. A dangerous disease that can cause compression of the spinal cord and cervical myelopathy (damage to the segment of the spinal cord in the neck area). Stenosis occurs against the background of squeezing the roots of the spinal nerve with a deformed disc / osteophytes, resulting in a disruption of the nerve, a partial loss of motor sensitivity;
- curvature of the spine (kyphosis, lordosis, scoliosis);
- shoulder injury (left / right). It manifests itself as a "twisting" pain, radiating to the neck;
- dislocation of the cervical disc / neck trauma. There is a spontaneous pain with a concentration in the neck and shoulder, gaining intensity during the turn of the head;
- inflammation / rupture of tendons. Characterized by pronounced blunt pain in the problematic area of the shoulder / neck, is strengthened when the arm is raised;
- dysfunction of the vertebral-motor segment. Degeneration of the disc provokes its moderate uniform protrusion, a decrease in height, a change in the relative location of the main components of the spinal-motor segment - this results in a persistent pain in the neck and shoulder.
Nonvertebrogenic pain in the neck and shoulder:
- diseases of internal organs / systems: pneumonia, meningitis, retropharyngeal abscess of left-sided / right-sided localization, subarachnoid hemorrhage, enlargement of the thyroid gland. Typical manifestations: limitation of head movements, intense / moderate pain in neck and shoulder;
- infectious lesions: tuberculosis, poliomyelitis;
- malignant / benign neoplasm of the neck. Isolate tumors of the neck (thyroid, esophagus, pharynx, larynx, salivary glands), extraorganic tumors developing from soft tissues, and tumor lesions of cervical lymph nodes (in hemoblastoses - primary, with metastases - secondary). Precursors of oncology - the growing persistent pain in the neck and shoulder, not "leaving" at rest, increased fatigue, a significant decrease in body weight, febrile state. More than 75% of malignant tumors of the cervical spine are metastases of the prostate or mammary gland, lung cancer.
Myofascial syndrome.
It is characterized by muscular dysfunction and the formation of muscular local seals in the affected muscles. Myofascial pains are grouped in the muscles of the shoulder girdle (a muscle that lifts a scapula, a trapezoidal, multi-parted muscle, a straightener muscle), masticatory, suboccipital and facial muscles. Reflex pain is fixed in the eye, head, shoulder, neck.
Why does the shoulder and neck ache on the right side?
Pain affecting the right shoulder joint and neck may indicate gall bladder, lung or liver disease. When raising / withdrawing the hand to the pain in the neck and shoulder, tingling on the inspiration in the sternum, abdominal pain, cough, not associated with the common cold, are added.
Why does the neck and shoulder hurt on the left side?
The cause of pain can damage the spleen or lung. If the sharp pain in the left shoulder and neck is accompanied by heaviness or chest tightness, which arise literally "on a flat spot" (there was no dislocation, fall, abrupt movement), you need to call an ambulance - these symptoms indicate a myocardial infarction.
Pain in the neck and shoulder - diagnosis and treatment
If there is severe discomfort in the cervical spine, you need to see a doctor and undergo a complete examination, which will help to eliminate serious diseases requiring immediate intervention: epidural abscess, swelling, fracture, meningitis, subarachnoid bleeding or thrombosis. In the absence of a dangerous pathology, therapy is aimed at accelerating the regression of symptoms, preventing chronic pain and further exacerbations.
Methods of treatment:
- medicamentous. To relieve pain in the shoulder, ointments with a warming effect are used, which help improve blood circulation, neutralize the pain syndrome, accelerate the regeneration of tissues. Inflammation is stopped by intramuscular anti-inflammatory injections;
- physiotherapy: magnetotherapy, acupuncture, ultrasound / current exposure;
- physiotherapy. Special exercises help to remove tension and pain, return the shoulder mobility, strengthen the muscular corset, give flexibility to the ligaments;
- manual therapy. Therapeutic massage includes stretching of the spine and manipulation for relaxation of the neck muscles.
Pain in the neck and shoulder should be an occasion to visit the specialized specialists - neurologist, orthopedist, traumatologist, rheumatologist. Only a doctor can identify the cause of painful sensations and, depending on the diagnosis, choose the optimal treatment regimen.