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Musculoskeletal disorders of the neck (cervical sprain, torticollis)

The neck pain or neck pain can have many causes. They may be due to a whiplash , torticollis or osteoarthritis, for example. Often, they come with a stiffness that limits the movement of the neck.

Pain is sometimes felt throughout the upper body, especially the upper back and shoulders . Symptoms vary depending on the location: vertebrae, tendons, ligaments, muscles or nerves.

Most of the time, neck pain is relieved within a few days to a few weeks (eight to twelve weeks at most). However, they may last longer if the vertebrae of the neck are affected by osteoarthritis or other chronic diseases, such as rheumatoid arthritis.

The neck consists of seven vertebrae , whose name goes from C1 to C7 (see diagram above). Between the vertebrae are the intervertebral discs. These discs contain a gel that gives the neck mobility and allows it to better absorb shocks. Without the intervertebral discs, one would feel the vertebrae rub against each other. The whole is surrounded by muscles, tendons and ligaments, whose role is to ensure the stability, support and mobility of the delicate joints of the spine.

 

Prevalence of Musculoskeletal disorders of the neck

Although it is less common than back pain, neck pain still affects 10% to 20% of the adult population.

The musculoskeletal disorders of the neck causing pain affecting a growing number of people. This phenomenon is explained mainly by the aging of the population and the fact that more and more workers spend long hours in front of the computer. The link between computer use and sore neck is likely, but there is no certainty scientifically .

Types of Musculoskeletal disorders of the neck

Here are the most common causes of acute neck pain (pain that has not lasted long, regardless of the intensity of the pain).

  • The tension and muscle stiffness . Maintaining a posture for several hours or repetitive gestures while having poor posture leads to prolonged muscle contractions in the shoulders and neck, which may become painful.
  • The cervical sprain . It is commonly called whiplash or whiplash . It can occur at the time of a car accident (if the head is moving forwards and backwards) or a strong impact while playing a sport. Recovery is usually done in four to six weeks. Pain that does not fade is most often caused by lack of movement. Indeed, people who have neck pain are apt to keep the neck still, which increases the tension on the muscles.
  • The torticollis . Torticollis results from an involuntary muscle contraction, a spasm, that occurs on the side or back of the neck. The head remains stuck in a certain position. Any movement of the neck becomes almost impossible. Most often, torticollis occurs suddenly, sometimes in a period of high stress. More rarely, it can result from a sprain or herniated disc.

Important. Meningitis sometimes causes stiff necks that can be mistaken for torticollis. In case of fever, vomiting, severe headache and hypersensitivity to light, consult a doctor without delay.

Here are the most common causes of chronic neck pain , that is, lasting for weeks or months (be careful, the word “chronic” does not mean that these pains cannot be cured).

  • The osteoarthritis of the neck vertebrae . Cervical spondylosis is more common in women. They usually suffer after the age of 35. In men, osteoarthritis occurs later, around fifty. Small bumps form on the vertebrae. These sometimes impede the transmission of nerve impulses. All kinds of troubles can result: headaches, dizziness when changing head position, tinnitus , minor vision problems, etc.
    From the age of 50, signs of cervical spondylosis are detectedlight in just about everyone. But, most of the time, neck osteoarthritis caused by aging does not cause pain.
  • chronic systemic disease . About 10% of neck pain cases are caused by some form of arthritis .

SYMPTOMS of Musculoskeletal disorders of the neck

Any of the following symptoms may be present.

  • pain and a stiff neck.
  • Limited neck movements , sometimes on one side more than the other.
  • Pain on the back of the neck , upper back , shoulders and arms .
  • Of dizziness and headaches.
  • When the root of a nerve is squeezed or inflamed: feeling numb , tingling or weakness in an arm or hand.

People at risk for Musculoskeletal disorders of the neck

  • The  women  are somewhat more prone to neck pain than men.
  • People who practice  contact sports  (football, boxing, hockey, etc.) and soccer players who throw the ball away using their heads. The accumulation of small incidents increases, over time, the risk of osteoarthritis of the vertebrae of the neck.
  • Certain types of workers, more specifically those who have to hold the neck  flexed or stretched  for extended periods of time (for example, painters, joint shooters and people working under the microscope). The  computer work  also increases the risk of neck pain and upper body, especially when sitting for several hours and we have bad posture.
  • People who had several small  incidents  neck are more likely, over time, that osteoarthritis appears in the vertebrae of the neck.

Risk factors

The risk factors are very similar to those of back pain  .

  • Obesity.
  • Smoking. It increases the risk of osteoporosis and fractures; it reduces  bone mineral density ; it causes degeneration of the spine.
  • A high degree of dissatisfaction or stress at  work .
  • Intense practice of  certain physical activities  in inadequate postures.
  • A problem in the  spine  (scoliosis, lordosis, etc.).
  •  The use of an   inadequate pillow (too flat, too thick or not supporting the head).

Prevention of musculoskeletal disorders of the neck (cervical sprain, torticollis)

Basic preventive measures
To avoid musculoskeletal problems in your neck , you need to do a few small things every day  :

  • Practice of physical exercise during leisure. This can prevent most neck pain, the researchers 6. In fact, sedentary workers who have a low level of physical activity during their leisure time are more likely to have neck and shoulder problems.
  • Do not sit for too long without changing position. Set aside moments of relaxation every hour to stretch your back, neck, legs and arms.
  • Properly adapt your workstation to its size: adjust your chair, the height of the computer screen and keyboard, support your forearms, etc.
  • Perform safe movement when practicing a profession where physical strength is deployed. Ask a trained professional.
  • In the car, adjust the height of the head restraint properly . The eyes should be halfway up the head restraint.
  • Practice exercises to strengthen the muscles of the neck and trunk.
  • Become aware of your posture and correct it as needed.
  • When playing a sport , protect yourself with proper equipment and muscle training.
  • Avoid sleeping on your stomach.

Get personal advice from a specialist in sports medicine, physiotherapist or occupational therapist enables better prevention.

Medical treatment of musculoskeletal disorders of the neck (cervical sprain, torticollis)

If the neck pain does not go away after a few days of treatment suggested below, it is advisable to consult a doctor or physiotherapist.

Acute phase

Rest . For a few days, avoid large neck movements. Do light stretches in non-painful directions (turn your neck to look to the left and then to the right, flex your neck forward, back to the center, then flex your left shoulder, and the right, avoid rotational movements of the head). The cervical collar is to be avoided because it creates weakness of the muscles and helps to prolong the healing time. Prolonged rest also helps to stiffen the joint and contributes to the development of chronic pain.

Ice . Applying ice to the pain area three or four times a day for 10 to 12 minutes reduces the inflammation response . It is good to do so as long as the acute symptoms persist. It’s useless to use cold compresses or “magic bags”: they are not cold enough and they heat up in a few minutes.

Tips and warnings for applying cold

Ice cubes wrapped in a plastic bag or in a wet towel can be applied to the skin (choose a thin towel). There are also cold gel packets (Ice pak) sold in pharmacies. These products are sometimes practical, but they should not be placed directly on the skin: this could cause frostbite. A bag of green peas or frozen corn is another convenient and economical solution: it molds well to body shapes and can be applied directly to the skin.

Medications for pain relief (analgesics) . Acetaminophen (Tylenol, Atasol) is often enough to relieve mild or moderate pain. Anti-inflammatory drugs such as ibuprofen (Advil, Motrin, etc.), acetylsalicylic acid (Aspirin), naproxen (Anaprox, Naprosyn) and diclofenac (Voltaren) also have an effect analgesic. However, they cause more side effects and should therefore be used sparingly. Inflammation following trauma is part of the healing process (different from inflammation in case of arthritis, for example) and is not necessarily a fight. It is also possible to use an anti-inflammatory cream such as diclofenac (Voltaren emulgel), which makes it possible to avoid systemic side effects.

The muscle relaxants can also help, but they cause drowsiness (eg Robaxacet and Robaxisal). To mitigate this effect, it is recommended to take them at bedtime or at low doses during the day. They should not be used more than a few days. These medications contain an analgesic (acetaminophen for Robaxacet, and ibuprofen for Robaxisal). You should avoid taking them at the same time as another pain reliever.

A doctor is able to suggest the most appropriate category of pain medication, if needed. In case of stronger pain, he may prescribe opioid analgesics (derivatives of morphine). When there is neurological pain, anticonvulsant medications or other drugs that act on neurotransmitters may be prescribed.

During the acute phase, gentle massage can help relieve tension temporarily.

Readjustment

When neck pain decreases (after 24 to 48 hours), it is good to practice careful and progressive stretching exercises several times a day.

It may be helpful to apply heat to the muscles just before stretching (using a moist warm-up pad or warm bath). The heat relaxes the muscles. Once the exercises are over, you can apply ice .

If necessary, consult a physiotherapist. It seems that combining walking with a physiotherapy program and stretching exercises at home can help relieve neck pain.

Corticosteroids and injections

In some cases, this option may be considered if previous treatments have proven ineffective. The corticosteroids have anti-inflammatory action.

An injection of lidocaine, a local anesthetic, in painful areas (trigger areas) has shown some effectiveness. Doctors often combine lidocaine with a corticosteroid.

In case of chronic pain

Diary of symptoms. It is good to be aware of the situations that give rise to the pain, to record them and to discuss them with your doctor or a physiotherapist. Do they worsen in the morning or at the end of the day? Should the layout of the workstation be evaluated by an ergonomist? Would a state of permanent stress create tension in the trapezius and in the neck?

Surgery. In case of compression of a nerve root in the neck area that causes numbness or weakness in the arms, surgery may be indicated. A damaged intervertebral disc may also be removed by surgery. We then merge the vertebrae together.

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