Pains in the cervical region can be caused by disk degeneration, herniation, or osteophyte formation. The changes affect nerve roots, which can produce waves of pain. Even a temporary strain or trapping of a nerve can produce similar symptoms. It is usual to distinguish between pain confined to the nape of the neck and back of the head, and pain radiating into the arms with either a widespread (cervical brachialgia) or clearly defined (cervical rhizopathy) distribution.
Symptoms and diagnosis
– Pain radiates from the nape of the neck into the shoulder, arm, and/or fingers. The pain is usually deep and widespread (brachialgia), but it can have clearly defined limits with intense, sharp pain following the distribution of the affected nerves (rhizopathy). The pain is felt more acutely during neck movements than during shoulder movements.
– Pain radiating up the neck and into the back of the head can cause headaches, insomnia, and sometimes dizziness.
– Numbness and weakness are felt in the arm and fingers. There may be areas of complete anesthesia.
– An X-ray examination should be carried out, especially if pain is caused by movement. The examination should elicit those positions that provoke the pain in order to detect any abnormal mobility.
– Magnetic resonance imaging (MRI) may show the effects on soft tissues, e.g. by pressure of osteophytes on herniated disks.
Treatment consists of:
– neck collar and a heat retainer;
– analgesic and anti-inflammatory medication;
– physiotherapy with or without traction.