Cervicocranial syndrome patients are common case in clinics of family medicine. Problems on which patients are often complaining on are: neck pain, headaches, dizziness, vertigo disorders, pain in the shoulders and upper extremities, ringing in the ears, blurred vision and others.
Cervical syndrome includes the disorders which can cause changes in the cervical part of the spine. It most often represents a clinical syndrome degenerative changes which is manifested by pain, hypertonus muscles of the neck and shoulder area, limited movements and vegetative disorders in the head and upper extremities.
The patients are complaining on the pain in the neck and shoulders that occur gradually or suddenly after making rapid or uncontrolled movements.
Poor posture, injuries, prolonged sitting, working on the computer, physical inactivity, exposure to stress (vibration stress, lifting the burden and repetitive stress), injuries, smoking, inadequate nutrition, occupational exposure, genetic predisposition.
Neck pain which can be sharp or dull, neck tension, painful and limited mobility, the inability to perform daily activities because of stiffness in the neck, pain in the shoulders and arms associated with the pain in the neck, unconsciousness, dizziness, tinnitus, blurred vision, headache, diplopia, weakness, heavy feeling, sensitivity and paresthesias in the upper extremities, impaired concentration and memory.
The diagnostic process involves a precise history of physical examination, radiological processing and other additional diagnostic examinations as necessary (CT, NMR, EMNG, TCCD, EEG).
Indications for referral to the X – ray on cervical spine:
- History of previous trauma
- neumotor deficit
- Unexplained weight loss
- Substance abuse or alcohol (there is an increased risk of osteomyelitis, osteoporosis or trauma)
- History of existing malignancy
- Use of corticosteroids (increased risk on infections and osteoporosis)
- Temperature (potentially a sign of the osteomyelitis or epidural abscess)
- Poor response for conservative therapy
- Patients involved in the litigation
Analgesia, removing other symptoms, maintain mobility, preventing disability, improving the quality of life.
Treatment without medication
Massage hot / cold, rest, light stretching exercises (gently stretch the neck on one side, than to other side and hold up to 30 seconds), exercises for neck recommended by physiologists, transcutaneous electrical stimulation, short – term immobilization, surgical treatment, acupuncture, traction (intervertebral space extension).
Education about maintaining and achieving the correct posture, regular physical activity, proper diet, maintaining a normal body weight, avoid vibration stress when driving, prolonged flexion door, in the context of the secondary prevention, patients’ needs to be encouraged in conducting home therapeutic exercise program.
Recommendations for patients to maintain their health
In most of the patients with a neck pain is the cause of the bad posture. Small changes in daily activities can be useful to avoid or relieve pain and / or tension in the neck.
Make more breaks when driving on long runs or hours or if you are working on a PC.
Keep your head slightly tilted back above the spine to reduce strain in the neck muscles, avoid gripping your teeth. Adjust your desk, chair and computer so the monitor is at the same level as your eyes are. Knees should be slightly above the hips. Avoid holding the phone between ear and shoulder when talking. Stretch as often as possible if you work at a table. Raise and lower your shoulders, also stretch them. Do your exercises to strengthen the muscles of the chest. Avoid sleeping on your stomach, this position is bad for your throat. Choose a pillow that supports a natural curvature of the neck.