The term “cervicalgia†comes from the Latin term for “neck,†which is “cervic†and the Greek word for pain, which is “algos.â€
Therefore, “cervicalgia†literally means “neck pain.†However, this pain does not radiate outward, as most neck pain does.
Therefore, it is different than radiculopathy and other types of neck pain and is most likely a result of other things besides nerve compression.
You may not realize it, but your neck muscles are under constant pressure to maintain your posture and to hold up your skull and brain, which is around 10 pounds on average.
Every time your head projects forward an inch, the forces on it double- so, an inch of the forward projection means that your neck is having to sustain 20 pounds of weight.
Therefore, it’s pretty easy to see and understand how the strain on your cervical spinal muscles takes a toll over time.
You may begin to experience muscle fatigue, cramps, spasms, stiffness, and even cervicalgia.
Your neck muscles are likely to become tight and even inflexible. This can eventually lead to tearing and neck pain.
How Does Cervicalgia Develop?
There are several ways that cervicalgia may develop:
- Chronic wear and tear
- Inflammatory joint disorder (example: RA)
- Persistent stress and tension
- Acute sports injuries
- Whiplash
Another cause of cervicalgia is fibromyalgia, as many individuals with this condition have tender points between their shoulders and in their neck which cause them to experience constant pain.
For most people, cervicalgia is a temporary condition, as it can be caused by sleeping at an awkward angle, standing/sitting for a long period of time, or even slouched over a desk.
For some individuals, there may be a physical abnormality that is causing them to experience neck pain. These abnormalities include:
- Ligament calcification
- Spinal curvature
- Cervical arthritis
- Torticollis
What are the Symptoms of Cervicalgia?
Symptoms of cervicalgia include chronic pain, as well as sharp pains, in the neck, accompanied by aching, tension, tenderness, stiffness, headaches, and pain upon head rotation.
In some cases, the pain associated with this condition will be short-lived and you may be able to get some improvement by simply getting some rest.
However, in some cases, cervicalgia could be constant or could even lead to cervical spine degeneration, and even other symptoms such as myelopathy or radiculopathy.
Chronic neck muscle problems could also lead to an increased risk of other conditions such as osteoarthritis, because the cervical spine will try to compensate for the instability caused by osteophytes, and could lead to cervical spinal stenosis.
How is Cervicalgia Treated?
In most cases, the treatment for cervicalgia is fairly conservative and involved relieving obvious inflammation.
One of the best ways to relieve pain and swelling is to apply ice packs to the area. This is often recommended if a muscle tear is suspected.
Heat is discouraged if there is inflammation present, as it could actually make the problem worse.
Heat increases the flow of blood to the area, which can increase swelling and therefore lead to more pain.
However, on the other hand, if the cervicalgia is due to muscle tension, thermotherapy- or heat therapy- can be very effective for relaxing the muscle and relieving the pain.
Also helpful in some cases is getting sufficient rest and using a supportive neck collar.
Don’t use the neck collar for a long period of time, as this can actually cause the muscles in the neck to become weak.
Many individuals with cervicalgia also use OTC and/or prescription anti-inflammatory medications as well as natural supplements to decrease pain and inflammation.
For individuals who suffer from chronic neck pain, physical therapy such as strengthening exercises and neck stretches could be useful.
Finally, if the cervicalgia can’t be resolved with these treatments, surgical intervention may be necessary.
Causes of Cervicalgia
Did you know that around one-third of individuals suffer from some form of neck pain at least once a year and more than ten percent of the population suffers from neck pain that lasts longer than six months?
As mentioned, there are a number of things that can lead to cervicalgia, including poor posture.
This includes working at a desk with a poor ergonomic setup for long periods of time.
Ideally, you should have your computer set up so that you do not have to tilt your head or neck and you don’t have to strain to comfortably view it.
Things such as a chair that is not supportive, with an elevated keyboard or writing surface can also cause strains in the lower back, as well as the arms and wrists, which can lead to imbalances further up in your neck and shoulders.
Cervicalgia is most often caused by multiple factors, including a combination of poor posture- which increases muscle strain and tension and therefore makes a person more likely to become injured during recreational or sporting activities.
On the other hand, an injury can cause some posture problems, and if not treated, can actually cause an individual to develop chronic cervicalgia.
Additionally, physical symptoms of pain can be associated with depression and anxiety.
There are many individuals who carry their tension on their shoulders and neck. It’s like they are carrying the weight of the world on their shoulders.
In the case of stress and tension is the underlying cause of cervicalgia, a combination of thermotherapy and relaxation techniques can be used to effectively treat both the symptoms that are present as well as the underlying problems.
Individuals who experience frequent bouts of depression are also increasingly sensitive to pain, and even the small aches and pains in the neck seem so much worse than they are.
If there are no obvious reasons for neck pain and there are other symptoms present such as listlessness, fatigue, prolonged periods of extreme sadness, it could be that depression is what is causing the cervicalgia.
However, you should also know that prolonged periods of neck pain, especially if there is no clear reason, can cause stress, depression, and tension- which can make the symptoms of cervicalgia much worse.
Therefore, it is very important that a timeline for the symptoms be established so that a cause and effect can be determined.
Cervicalgia and Musculoskeletal Problems
In some cases, cervicalgia is part of generalized musculoskeletal issues such as RA, osteoporosis, osteoarthritis, ankylosing spondylitis, or fibromyalgia.
In some cases, herniated discs or spinal stenosis could be the root of cervicalgia.
However, most of the time, these actually lead to radiating pain in the arms, hands, and shoulders.
Very rarely, neck pain could be due to an infection in the spine, such as in the case of osteomyelitis which can occur after back surgery, or possibly due to a trauma.
Another rare cause of cervicalgia is tumor growth on the spine.
Cervicalgia and Cardiovascular Problems
In some cases, cervicalgia isn’t due to the spine at all and instead is due to cardiovascular, gastrointestinal, or respiratory problems.
Individuals may experience acid reflux in their neck instead of in their lower chest. If acid reflux is chronic, the acid can result in damage to the esophagus, leading to precancerous changes.
Additionally, compression of blood vessels or abnormalities in the vasculature of the neck can cause problems in the cervical spinal muscles, which leads to neck pain.
Finally, swelling, congestion, and other problems due to upper respiratory infections can cause neck pain.
A constant cough due to respiratory problems strains the muscles in the neck and causes pressure on the cervical spine, which can result in neck pain.
Symptoms of Cervicalgia
The symptoms of cervicalgia cover the non-specific neck pain and can be chronic or acute and vary according to the activities that the suffering has taken part in.
These activities include things such as sleeping in an awkward position, maintaining poor posture at work or recreationally, exercise/recreational activities, and more.
Also, there are certain movements that could cause the symptoms of cervicalgia to be worse, such as turning the head from one side to the other, extending the neck, or even raising the arm.
On the other hand, individuals suffering from cervicalgia find that specific movements actually result in a reduction of their symptoms.
In many cases, exercise offers many benefits for those with cervicalgia, especially if it is due to fibromyalgia. However, rest is also very helpful in other cases.
Symptoms Coexisting with Cervicalgia
While it is true that neck pain is the primary symptom of cervicalgia, other symptoms could coexist with this pain. These symptoms include:
- Dizziness
- Visual disturbances
- Neck stiffness
- Headaches
- Neck spasms
However, radiating pain is not a symptom of cervicalgia and is indicative of a neurological problem that creates pain outside of the neck, even though it originated in the cervical spine.
Loss of sensation and muscle weakness is also not a symptom of cervicalgia, and typically will be diagnosed with cervical radiculopathy or myelopathy.
Very rarely, individuals will also experience chest pain, syncope, dysphagia, or a migraine in conjunction with cervicalgia.
Signs and symptoms of cervicalgia that are observable during a physical examination include torticollis or wry neck.
This is a result of asymmetry in the muscles of the neck. Additionally, individuals with cervicalgia may also develop restricted movement in their neck as well as an asymmetric range of motion.
This is very common in the elderly or those who have significant wear and tear due to their choices of recreational activities and/or profession.
Finally, tender points in the neck or between the shoulders could possibly indicate cervicalgia, though these most often indicate fibromyalgia or an acute muscle injury.
Cervicalgia and Herniated Discs
In cases where the individual also complains of difficulty swallowing or a sore throat in addition to tiredness and a slight fever, tonsillitis or retropharyngeal abscess is indicated.
Neck and jaw pain could be indicative of a tooth infection or crowding of teeth, which requires dental work to correct instead of suggesting a neck problem alone.
Also, cervicalgia could be present in cases such as a herniated disc, spinal fracture, osteomyelitis, cervical lymphadenopathy, or even stroke.
Other things such as adverse drug reactions, tumors on the spine, or encephalitis could seem like cervicalgia.
However, upon further examination and testing, the physician will change the diagnosis.
Diagnosing Cervicalgia
If an individual is suffering from cervicalgia, the physician will typically put them through a full examination of the spine as well as a neurological examination of their upper limbs.
Additionally, the physician will take a neurological history to look for any signs of nerve issues.
If the spinal cord is compressed in the neck, this could lead to the lower limbs being affected.
The physician will also note whether or not the gait is affected, as well as take into consideration any bowel or bladder issues.
Tender points located in the neck muscles, between the shoulders, and in the intervertebral joints could possibly be observed during a physical exam, as well as localized nodules or tight muscles.
If there are signs of heat present in the joints or muscles, inflammation is indicated, which could be due to an acute injury or condition such as RA.
If the individual complains of excruciating pain upon a light touch of these tender points, the physician is more likely to lean towards a diagnosis of fibromyalgia- especially if other symptoms such as constant pain across the entire body and fatigue are present.
When performing a physical examination to diagnose neck pain, the physician will also check for Lhermitte’s Sign.
This will indicate a neurological issue. If Lhermitte’s Sign is present, the individual will experience an electric-shock type sensation upon flexing their neck.
This sensation will radiate down their spine and into their limbs. Compression of the upper spinal cord will be checked as well as an altered function of the motor neurons in the lower limbs.
Other signs that will be checked for is Babinski’s Sign, which is an up-going plantar reflex, and Hoffman’s Reflex, which is located in the thumb.
Any changes in sensation of vibrations or issues with coordination, joint position, and other reflexes can reveal the cause or reason of development of cervicalgia.
Diagnostic Testing for Cervicalgia
In cases where the physician finds evidence of a neurological problem during the initial examination, the individual will be referred to a neurologist to receive further testing.
In many cases, this additional testing includes an electromyogram. Other imaging tests are also used to observe any degenerative problems, the presence of tumors, blood vessel/nerve compression, and other issues in the cervical spine that are not obvious. These imaging tests include:
- MRI
- CT
- X-rays
- Ultrasound
However, if there are a clear cause and effect, these imaging tests will not be required. These obvious cause and effects are things such as sleeping awkwardly, poor posture, tension, and/or lack of exercise in an individual’s daily routine.
In some cases, especially if the individual is also suffering from migraines, dizziness, and visual disturbances in conjunction with cervicalgia, the physician will monitor circulation in the neck.
Symptoms such as malaise, fever, or unexplained weight loss are not symptoms of cervicalgia and should be examined further.
These could indicate infection, cancer, or the presence of an inflammatory disease/disorder such as RA.
There are some specific “red flags†that exist for those who suffer from cervicalgia.
These include new/worsening symptoms before twenty or after fifty-five- which could indicate a more serious problem.
Other things that indicate a more serious problem include sensation changes, or developing weakness.
Treatment of Cervicalgia
Initially, the treatment of cervicalgia involves rest, application of heat and/or ice- depending on the cause of the cervicalgia, and using a neck collar or other supportive device for a short period of time.
Additionally, stretching and strengthening exercises for the neck are commonly used to treat cervicalgia, because these could help to relieve muscle tension and improve posture so that the risk for future occurrences is reduced.
Physicians may refer individuals suffering from cervicalgia to a physical therapist to create a routine.
Additionally, the physical therapist will most likely offer some tips on preventing neck pain in the future, such as establishing proper posture, carrying heavy things properly, and evenly distributing lighter things. For example, it is better to use a backpack instead of a shoulder bag.
Treating Cervicalgia with Massage Therapy
In some individuals, massage and mobilization therapy is recommended. This is most effective if the cervicalgia appears to be caused by tightness or tension in the muscles of the shoulders and neck.
However, if the neck pain appears to be part of a larger pain profile, some alternative pain management strategies may be necessary.
These alternatives include analgesics, antidepressants, antispasmodics, anxiolytics, or possibly psychosocial therapy, including cognitive behavioral therapy.
Cervicalgia with No Cause
In the cases where cervicalgia seems to have no obvious causes, the pain will resolve within three to four weeks on its own.
When this is the case, the individuals are typically reassured that it is a very common condition and that there is rarely a more serious underlying problem that requires invasive treatment such as surgery.
They are encouraged to take part in normal activities and to avoid what they think could have caused or contributed to their pain.
This may require participation with a practitioner of Alexander Technique or even consult with an ergonomic specialist for the work/office environment.
In some cases, it may be recommended that the individual uses a supportive device to help with posture, but these must only be used for a short period of time.
Typically, though, this is discouraged because it can lead to a weakening of the muscles and also cause problems with hypermobility of the neck in the future.
Cervical collars can be used, but not for more than two to four days, unless advised by your physician.
Special neck pain pillows could be effective at addressing symptoms of cervicalgia that are related to the sleeping position of the individual.
In some cases, the individual may be discouraged from driving, especially if they have limited mobility of their neck. Driving with limited neck mobility could lead to accidents and possible whiplash, which would further cause problems with the neck as well as more serious consequences for the driver as well as others on the road. Pain medications, such as NSAIDs, can be used to treat cervicalgia, but are not advised for long-term use.
If the symptoms of cervicalgia persist beyond four weeks, you may need to visit a physiotherapist, who will help with specific exercises to treat neck pain, as well as manual therapy.
Additionally, many individuals find that acupuncture is effective at relieving neck pain as well as promoting relaxation, and relief of tension that could be causing or contributing to cervicalgia.
How to Find the Appropriate Cervicalgia Treatment
If the cervicalgia seems to be linked to anxiety, fears, or avoidance, then it may be necessary to seek treatment through a psychologist or therapist.
If there an underlying, unrelated chronic medical condition, it may be necessary to manage this condition effectively, and therefore obtain relief of neck pain.
If the pain lasts for more than twelve weeks, it is considered to be chronic and the individual will most likely be referred to a pain clinic in order to develop coping strategies for their specific condition.
Unless it is proven to be beneficial, physiotherapy will most likely be discontinued.
Additionally, therapies such as massage and other passive treatments should be avoided because they typically do not prove to be beneficial for chronic suffers from cervicalgia.
Physicians may prescribe a low-dose antidepressant to a cervicalgia patient, as well as those with other chronic pain, especially when it is indicated that worsening pain will result in further testing for spinal stenosis or other mechanical problems.
If no other treatments are effective for treating cervicalgia, your physician will suggest surgery to correct any underlying problems.
This is most effective when there is an obstruction in the spine that cause blood vessel or nerve compression in the cervical spine, causing cervicalgia.
