Neck Pain – Causes, Symptoms, Diagnosis, Treatment

Neck pain is one of the most common degenerative acute or chronic pain that is seen in every person in life and most complicated complaint. It is usually caused by the degenerative chance in cervical vertebrae, intervertebral joints, muscle-tendon, ligament injury, bad sleeping posture, muscle strain sprain, traumatic injury, osteoarthritis, and rheumatoid arthritis in the neck. There are some common professions also responsible for right and left side neck pain.

Causes of Neck pain

There are many or multifactorial causes of right and left side neck pain that is following

• Osteoarthritis – It is one of the basic and complicated problems and causes of right and left side neck pain. It usually found the elder men and post-menopausal women in the late stage of life. The adjacent vertebrae have become thick which causes erosion in the margin of vertebrae.  It is also called the bony spurs or bony lesions
• Trauma – Direct and sudden trauma is responsible for the left and right side back pain. Blunt force trauma, rotating the neck, road traffic accident are also responsible for right and left side neck pain.
• Bad Sleeping position – It is another common problem that is happening in every person in life. Bad sleeping position or over high pillow causes chronic right and left side neck pain.
• Bad posture – Bad posture and spine alignment also lead to displacing the vertebrae and causes chronic neck pain in right and left side pain. Bad posture also causes muscle and tendon injury and causes the right and left side neck pain.
• Muscle Spasm – MUscular degeneration, spasm, muscle fatigue causes the blood supply problem to the neck muscle that leads to the right and left side neck pain.
• Nerve Injury – Injury to brachial plexus or nerve root compression causes pain, paresthesia, tingling sensation up to hand and nail. For that reason, the neck pain may increase in the movement of the right and left side neck pain.
• Tumor – In some cases, the bony overgrowth, neoplasm, tumors are causes the abnormal neck anatomical structure may cause the right and left side neck pain.
• Fracture – It is basically happening in the patients of post-surgical complication, abnormal vertebrae position, muscle wasting may lead to the right and left side neck pain.
• Pinch Nerve – The neck is a complicated structure with tendon, cartilage, ligaments, bone, vertebrae, and spinal cord. So muscle spasm spinal stenosis, cervical spondylosis is caused acute or chronic right and left side neck pain
• Over Uses or strain – Muscle strain and sprain meaning the overuses of specific muscle that is basically found in the computer operator, service holder, a smartphone user, reading in bed, or brushing in bed for a long time that may cause the right and left side back pain.

Symptoms of Neck Pain

The symptoms of neck pain are described bellow

• Pain – Pain is the first complaint of any patient. Pain may be sudden, throbbing, creeping pain in the neck region.
• Radiating pain – It is basically found in severe pain in the neck left and right sides. The pain may feel one side or both sides in right and left neck. Pain may be a burning tingling sensation, paresthesia, itching, numbness from neck to the hang.
• Throbbing pain – It is a kind of pain that may feel for some time and a few times later pain may go away. The pain may be increase during working, driving, traveling time and pain also decrease during rest.
• Periodic pain –  The patients may feel the pain that is worsened by holding their head in one place for a long period of time, such as traveling, driving a motorbike or other vehicles, typing time the pain may increase in the right and left side neck pain.
• Spasmodic pain – It may increase during stretching muscle and movement of the head. The decrease in the range of motion of the neck
• Headache – Due to lack of proper blood circulation in the right and left side neck pain, vertigo, delirium, and intension of vomiting may increase.
• Loss of movement – THe normal movement of the neck may hamper due to neck pain. It can also lead to an inability to touch the chin to the patient’s chest.
• Sharp pain – It is a kind of pain that is felt in a localized area to one spot and it may feel like it stabbing or stanging pain and it may be causes typically in the lower neck.

Diagnosis of Neck Pain

Right and left side neck pain test and diagnosis is following

• History – The most common complain of neck pain is tenderness, movement problems. The character of pain may differ for men and women due to osteoarthritis and arthritis in right and left side neck pain It may be worse with joints movent and is relieved by rest inpatient history. Your doctor may feel pain and often associated with stiffness, tenderness, and worse in the morning, and gets better as the day goes on. Symmetric involvement or the same types of neck joints pain is also the most common in right and left side neck pain.
• Observation– Most of the time the neck may feel warm during tests or keep tenderness with a muscle spasm in a non-traumatic case also suggest inflammation or inflammatory neck pain. Patients may also complain of the presence of limitations in range of motion and can even feel weakness and worm, tenderness when moving.
• Inspection – Redness or color change, muscle spasm, spasticity, and deformities are the most important findings associated with neck right and left side pain. Swelling and tenderness are important to identify between a joint swelling from tenosynovitis, sprain, strain, or a localized abnormal mass formation that may be found in the neck region. Ankle osteoarthritis and rheumatoid arthritis usually produce diffuse circumferential swelling.
• Palpation – Palpation is the manual test that helps in identifying the specific affected area by the underlying pathological condition. In neck pain is best palpated in slight flexion and extension feeling with the support of hand with wrist and fingers of both the hands. The instability can be also tested by looking for transmission of pressure from one hand placed at one side of the joint to the second hand placed on the opposite side in right and left side neck pain.
• Range of Motion – The doctor or clinicians must test the active range of motion first for right and left side neck pain with arthritis. They should be seen if there is any limitation to look for any important improvement. The range of motion tested in maintaining the posture of the spine.
• Range of motion test –  It is the test or diagnosis to see how the neck moves side to side, up and down, and rotates compared to what would be considered normal. If your doctor found any abnormality if the neck has a full range of motion, will note whether that is felt with ease or if certain neck movements cause pain or struggles.
• Reflexes – It is the manual test are performed by your doctor or physiotherapist. It is tested with a rubber hammer to examine reflexes in the biceps muscle, triceps muscle, and forearm muscle, which can indicate whether nerves in the right and left neck are sending signals as intended.
• Muscle power – It is an important test to identify the endurance of muscles, tone, fatigue in the shoulder, arms, or hands for any signs of weakness.

Lab Tests

• Laboratory tests – Leukocytosis is one of the most important tests for neck osteoarthritis and rheumatoid arthritis that supports the possibility of infection and bone-related disease. Blood cultures, urine examination, or other possible primary sites of bone infection that obligatory, when a septic infectious joint in the neck is being considered for examination. The CRP and ESR are elevated inflammatory condition markers like ESR or CRP include suggesting an infectious or inflammatory disease condition, tuberculosis of the spine.
• Rheumatoid factor and anti-CCP – cyclic citrullinated peptide antibodies test should be increased if there is clinical abnormality for ankle osteoarthritis and rheumatoid arthritis in right and left side neck pain are found.
• A serum uric acid level – It is often considered by clinicians and doctors when gout, pseudogout is suspected, but it is not a reliable and dangerous condition as it may be spuriously elevated or high in acute inflammatory conditions or acutely during a true gout attack or not.
• Synovial fluid analysis – A joint arthrocentesis or the system of aspiration of synovial fluid with blood and synovial fluid analysis that are mandatory if an infection is suspected or dangerous. Such as the patients should also be started properly treatment by using empiric antibiotic therapy as soon as possible if the synovial fluid sample is obtained from the cervical joint. The fluid analysis or any kinds of abnormalities is also helpful in diagnosing crystal formation with osteophyte and steroid-induced arthritis. The degree of the high elevation of synovial fluid are founded by WBC count can be useful in differentiating inflammatory abnormality or from non-inflammatory causes of right and left side neck pain.

Imaging

• Radiographs of the joint – Conventional x-ray and radiography is the most widely used imaging modality and allows for the detection of bone fractures, osteoporosis, and abnormal pathologies condition like fracture, osteoporosis, erosions, osteonecrosis, osteoarthritis, or a juxta-articular bone tumor, neoplasm. Characteristic features of neck rheumatoid arthritis, osteoarthritis include marginal osteophytes formation, joint space gradually narrowing, subchondral sclerosis formation, and cysts.
• CT Scan – High contrast CT scan is more effective to diagnose the spinal cord, surrounding muscle, rheumatoid arthritis. Abnormal tendon, ligament, cartilage, muscle and osteophyte, synovial fluid are also found in this test. It also helps to identify the bone tumor, necrosis, spinal stenosis,  abnormal vertebrae condition, etc.
• MRI – It is called magnetic radical imaging is also helpful to find the bone conditions, abnormal tendon, ligament, cartilage, muscle and osteophyte, synovial fluid. It also helps to identify the bone tumor, necrosis, abnormal joint condition, soft tissue, etc. It is the final stage test to confirm that all joint abnormality.
• Bone scintigraphy – It is the most important test to diagnose bone cancer, neoplasm, fractures, necrosis of bone, and joints. It also helps to identify the tendon, sprained ligament, cartilage, muscle spasm.

Treatment of Neck Pain

Non-pharmacologic treatments of the right side and left side neck pain

• Cervical collar – In neck osteoarthritis or rheumatoid arthritis and acute or chronic injury with neck pain the cervical collar are very helpful for maintaining the right posture, position to erase the right and left side neck pain. Proper protection means the save the neck joint from further injury and dislocation, sprain, strain.
• Rest – After an injury from osteoarthritis, sprain, strain, muscle spasm of the neck is very helpful to keep in rest your neck for sometimes to days to prevent injury and accelerate the healing, relieving pain. It is an excellent manual process to protect your neck after trauma or injury.
• Ice  Compression – The application after acute injury is helpful for the healing process of neck pain. It basically constricted the peripheral blood vessel that helps to prevent edema, swelling, or accumulated water. It can be used alternatively by ice and heat therapy at the same time in your home or therapy center.
• Manipulation – It is the most important manual techniques to protect the acute injury, sprain, strain in right and left side neck, and keep the tendon, ligament, cartilage intake, and regenerate the joint cartilage.
• Mobilization – It is one of the surprising treatment that works instantly in neck pain, neck strain, sprain. It is very helpful to reduce muscle tone, muscle spasticity.
• Cervical traction – It is a very helpful manual treatment procedure in the treatment of nerve root compression, radiating pain, paresthesia. It is basically two types of traction manual and electric traction. Both are very helpful in the treatment of cervical spondylosis, spondylolisthesis, slipped disc, radiating pain, and nerve root compression.
• Physiotherapy – It is one of the most common and effective non-pharmacological treatments in the world. It has a variety of treatment module to erase acute and chronic pain. It is especially helpful in muscle spasticity, spasms related to hand and shoulder or backs pain. Inflammatory and noninflammatory pain is treated by ultrasound, MRI, Shortwave, microwave, wax therapy, IRR, laser therapy, interferential current therapy.
• Exercise – Different types of exercise may be done under the supervision of a physiotherapist or healthcare provider. It falls into the active range of motion, tapping, isometric movement, active range of movement, or passive range of motion.
• Stretching – It is one of the most helpful treatments to reduce muscle pain, spasm, spasticity that is gradually increasing due to old age and not perform daily workouts or activities.
• Bracing – It is one of the most important self-help devices that is used in hand rheumatoid arthritis, osteoarthritis and, maintaining proper joint position, reducing swelling, improve posture and maintain the range of motion exercise.
• Acupuncture – It is the China-oriented acute and chronic treatment system where are needle is used to stimulate the pain receptor to reduce pain. It is also helpful in some spasticity formation in neck pain, stroke, hemiplegia, and chronic rheumatoid arthritis pain.
• Diet – Diet may be normal or according to the doctor mentions food you can take for you, such as papaya, banana, potato, nut cereal, seasonal fruits, and drink of water. In your daily routine meal must have magnesium, calcium, cholecalciferol, iron, zinc, folate, vitamin B complex, Vitamin A, Vitamin C riched food. In some cases, cord liver oil, spirulina, and omega -3 are very helpful.

Medication

Your doctor may consider prescribing the following drug to relieve right and left side neck pain

• NSAIDs – It is considered to be the fast-acting nonsteroidal anti-inflammatory drugs (NSAIDs) as the first-choice drugs are tapentadol, aceclofenac and including acetylsalicylate, naproxen, ibuprofen, indomethacin, and etodolac, ketorolac in pain is acute. Aspirin is also an effective anti-inflammatory for neck pain when used at high doses, due to the decrease or inhibition of prostaglandin synthesis. It is also called one of the oldest NSAIDs used for multiple joint pain. NSAIDs work by inhibiting cyclo-oxygenase to prevent the synthesis of prostaglandins, prostacyclin, and thromboxanes. It has also some side effects of aspirin at high doses when used are including tinnitus, hearing loss, and gastric intolerance.
• Muscle relaxant – It is important for patients with chronic muscle spasms, wasting, and muscle cramping releasing drugs. The drugs are tolperisone HCL, eperisone, baclofen, dantrolene, etc. The drug increases the blood supply with oxygen and nutrition to the affected joint.
• Nerve relaxant –  It is basically used to reduce neuropathic pain, inflammation, nerve root entraption, myalgia, neuralgia, and fibromyalgia. Your doctor may prescribe gabapentin, pregabalin, vitamin B1, B6, B12, etc. Major side effects are abdominal pain, nausea- vomiting.
• Calcium & vitamin D3 – to improve bone health and healing fractures and osteoporosis, osteonecrosis. Your doctor may prescribe to take calcium and vitamin D3 supplementation to prevent thinning of the bone and maintain bone health and muscle pain. In scientific study show that normal men and women needed calcium 1200milligram and vitamin D3 500 milligram.
• Glucosamine & Diacerein – It is one of the most important supplements that can help to tighten the loose tendon, cartilage, and regenerate cartilage or inhabit the further degeneration of cartilage. The dosage of glucosamine is 15oo mg per day in divided dosage and chondroitin sulfate approximately 500mg per day in different dosage may be taken.[rx] The major side effects are the yellow color of urine, abdominal pain, nausea- vomiting.
• Vitamin B1, B6, and B12 – It is essential for neuropathic pain management, pernicious anemia, with vitamin b complex deficiency pain, paresthesia, numbness, itching with diabetic neuropathy pain, myalgia, etc. A side effect may be nausea- vomiting, abdominal pain, cramping, bad smell
• Corticosteroid injections –  Corticosteroids to healing the nerve inflammation and clotted blood in the joints that are accumulated in the joint. The injections may provide temporary pain relief anywhere from days to several months. With repeated injections, several times the patient may experience a more permanent improvement in their symptoms.^[rx] The steroid injections are typically used in severe conditions when normal treatment can not respond.^[rx] Common side effects muscle cramping, increase metabolism, dry mouth, vertigo, blurred vision.
• Dietary supplement – Especially seasonal fruit vitamin B complex, vitamin b12, omega-3 fatty acid, antioxidant, spirulina, cord liver oil,  avocado soybean, unsaturated fatty acid, fish oil, etc to remove general weakness & improved health.
• Injections – For patients with severe pain, especially leg pain, steroid injections may be a reasonable treatment option to reduce chronic ankle pain. The injections are effective in helping to reduce pain and increase a patient’s functional mobility and increase the range of motion. If a steroid injection does work to relieve the patient’s pain, it can be done up to three times per year. Injections your doctor injects cortisone into the affected joint to give you temporary relief from the pain and inflammation.

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