MANUAL MINORS
Non-traumatic neck pain is a common condition that can arise from multiple factors, such as poor posture, muscle overuse, stress, degenerative diseases (osteoarthritis), muscle contractures, disc herniation, infections, or inflammatory disorders. Often, the pain is chronic or subacute and may be linked to sedentary work, excessive use of electronic devices, or poor sleeping positions.
Diagnosis
Diagnosis is based on the clinical history, including the duration of the pain, aggravating factors (such as prolonged work at a computer), and whether the pain is localised or radiates to other areas, like the shoulders or arms. The physical examination includes assessing the neck’s range of motion, checking for muscle spasms or stiffness, and palpating painful points.
If the pain persists or is associated with neurological symptoms, such as weakness or tingling in the arms, imaging studies (X-rays, MRI) may be performed to rule out conditions like disc herniation or cervical osteoarthritis.
Differential Diagnosis
Pathology | Characteristics |
|---|---|
Cervical osteoarthritis | Chronic pain, stiffness, and limited movement, worsening with age |
Cervical disc herniation | Pain radiating to the arm, with possible weakness or numbness |
Acute torticollis | Severe muscle spasm, with pain and movement limitation |
Myositis | Muscle pain associated with inflammation or viral infections |
Fibromyalgia | Generalised pain, tenderness in multiple points, fatigue |
Emergency Management
In the emergency setting, the management of non-traumatic neck pain focuses on symptom relief. Analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) are administered, along with muscle relaxants if muscle spasm is present. Local heat application may help to relax tense muscles.
In some cases, gentle stretching exercises and early mobilisation of the neck are recommended, avoiding prolonged immobilisation. If there are signs of nerve compression or neurological symptoms, further evaluation with imaging studies is necessary.
Definitive Treatment
Long-term treatment involves correcting posture and ergonomics, especially in patients with sedentary jobs or poor posture. Physiotherapy is essential for improving flexibility and neck muscle strength, and for teaching stretching techniques.
For stress-related or muscle tension, relaxation therapies such as massages and breathing exercises may be helpful. If the pain is related to a disc herniation or osteoarthritis, specific medical treatment may be required, and in severe cases, surgical intervention might be necessary. Prevention is key, with recommendations to avoid poor posture and take regular breaks from work for active movements.
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