What is Cervicalgia?
Cervicalgia is the medical term for neck and shoulder pain. Cervicalgia is difficult to diagnose and treat because it manifests itself in many different ways with several possible etiological symptoms and causes.
Neck pain with associated shoulder pain is one of the most common reasons that people seek medical attention and the fourth leading cause of disability.
Cervicalgia presents some unique diagnostic problems. Neck pain and shoulder pain are the presenting problems, however upon exam neurological causes are rarely found.
The lack of associated neurological issues makes accurate diagnosis very difficult.
This is very frustrating for the patient because their pain is absolutely legitimate and they want diagnostic validation as well as proper treatment, but physicians are left to their best guess which makes the pain patient feel unsettled and a bit like a guinea pig.
The Cervical Spine
The spinal canal starts at the base of the skull and runs down the torso to the tailbone. The spinal cord has three separate sections: cervical (neck), thoracic (upper back to lower back), and lumbar (low back to tailbone).
The cervical spine is connected directly to the brain and is responsible for holding up the head and transmitting electrical impulses throughout the body to organs, nerves, and muscles.
It is the most flexible part of the spine moving several hundred times per day. The mobility of the cervical canal is what makes it most susceptible to overuse, wear and tear, and injury.
The Most Common Symptoms of Cervicalgia
Cervicalgia patients most commonly see their doctor after an extended period of time in which they have tried home remedies like time, ice, heat, aspirin, and too much over the counter anti-inflammatory medicine like Tylenol, Aleve, and Ibuprofen.
Their neck and shoulder pain have become an aggravating, ongoing problem that impedes their daily activities and interferes with healthy sleep patterns because it is just about impossible to get comfortable for extended periods of time.
Refreshing sleep is imperative in the body’s ability to heal so this lack of sleep only adds to the pain, but it also makes people feel irritable, run down, and thus the psyche is less able to cope with everyday stresses.
Cervicalgia symptoms vary according to cause. Proper functioning of the cervical spine depends on musculature.
The International Archives of Otorhinolaryngology presents a study on adults with Otoneurological problems.
The study revealed that muscle spasms and other types of dysfunction can cause sensory symptoms such as dizziness/vertigo, ringing in the ears (tinnitus), neck cracking, pins, and needles or tingling sensations in the arms and legs, trouble walking, and hearing loss.
Cervical headache/migraine is a debilitating, painful symptom of neck pain that will undoubtedly cause people to seek medical attention.
A neurologist usually does a neurological exam, but Cervicalgia often fails to meet the severe scoring requirements for physicians to take neck pain seriously.
Neck migraines present special problems because they are often misdiagnosed as a typical migraine that is caused by a combination of eye strain, stress, insomnia, caffeine rebound, and dietary problems like gluten intolerance or food allergy.
The doctors often recommend a trial of triptan medication for migraine prevention and may do a battery of testing for food allergies/intolerance, but they fail to consider the spine as a primary cause because a migraine and Cervicalgia symptoms overlap.
There are many other symptoms a person may experience including heart palpitations, acid reflux, insomnia, anxiety, depression, tingling and numbness in the hands, cold fingers/hands/feet (due to blood vessel compression), neck pain, shoulder pain, forearm pain, hand pain, muscle spasm, blurred vision, muscle weakness, balance problems, lose bladder/bowel, genital numbness, irritability, mood swings, chronic widespread pain, fatigue, lethargy, and individual symptoms related to cause.
The Root Causes
Cervicalgia has a multitude of potential causes. Some people suffer for years before a doctor does a thorough medical history accounting for all symptoms and related conditions contributing to long-lasting, chronic neck pain.
The Mayo Clinic compiled a list of some of the most common causes of Cervicalgia.
Poor posture is a cause and symptom of Cervicalgia. Poor posture is a tricky condition because it causes neck pain, however neck pain also causes people to unconsciously hunch over or stoop after they have injured their neck.
This hunched/stooped posture is done automatically as the body is turning in to protect the very vulnerable cervical spine from further injury.
The subconscious protective act fails to recognize the long-term consequence of intensified, ongoing, and worsening neck pain.
Cervicalgia following an injury may be displaced/dislocated discs. The Mayo Clinic recommends checking for tumors, bone spurs, herniated discs, pinched nerve, facet joint irregularities, degenerative disc disease, spinal stenosis or cervical myelopathy.
Positional cervical cord compression (PC3) is responsible for mild to severe neck pain caused by spinal cord abutment or compression.
Cervical spinal canal narrowing causes rubbing and pinching of the spinal cord. This irritates the spinal cord and causes pain and autonomic arousal. Fibromyalgia and PC3 have many overlapping symptoms.
Diagnosis and Treatment of Cervicalgia
Cervicalgia is often caused by a structural problem of the cervical spine or cervical vertebrae.
There are so many moving parts that can cause overlapping symptoms that it is important to do blood work, nerve conduction tests as well as imaging (X-RAY, MRI, CT, Ultrasound, functional MRI, etc.) to rule out as many conditions as possible until finding an accurate diagnosis.
Treatment depends on the root cause. Some people respond well to physical therapy when it is targeted to a person with a spinal cord injury otherwise it can exacerbate the problem. Medication can help.
Short-term use of narcotic pain relievers and muscle relaxants work for people however if the problem continues it is important to re-evaluate the medication.
Surgical intervention is also a solution, but it should be followed up with an intense aftercare plan to ensure complete recovery.
Dr. John Bergman’s informational video on neck pain. Learn more about symptoms, causes, and treatment.