Stiff neck

Introduction The neck, shoulder and occipital pain are accompanied by corresponding tender points and the neck is stiff, which is the clinical feature of cervical cervical spondylosis. Cervical cervical spondylosis is very common in clinical practice, and it is the earliest cervical spondylosis, and it is also a common early manifestation of other types of cervical spondylosis. It is mainly called local type. Because the symptoms are mild, often paying insufficient attention, resulting in repeated attacks and aggravating the disease, many patients with repeated stiffening are mostly of this type. Due to the inappropriate height of the pillow or the improper sleeping position, the cervical vertebra rotates beyond its own movable limit, or because the cervical vertebra bends for a long time, part of the intervertebral disc tissue gradually moves to the extension side, stimulating the nerve root and causing pain.

Cause

(1) Causes of the disease

Due to degeneration of the cervical vertebrae, the nucleus pulposus and the annulus fibrosus dehydrated and denatured, directly stimulating the sinus nerve endings and causing disease

(two) pathogenesis

In the initial stage of cervical degeneration, the main manifestations are dehydration, degeneration of the nucleus pulposus and annulus fibrosus, and local tension of the vertebral ganglia, which in turn causes loosening and instability of the intervertebral space. The symptoms of the patient are often in the morning, overwork, and posture. And suddenly increased after the cold stimulation. The instability of the vertebral ganglion not only causes local imbalance of the internal and external balance of the cervical vertebrae and defensive tendon of the cervical muscle, but also directly stimulates the sinus nerve endings distributed in the posterior longitudinal ligament and the lateral root sleeves, causing cervical symptoms.

an examination

Related inspection

Neck test

1. Clinical features: Mainly complained of sensory abnormalities such as neck, shoulder and occipital pain, accompanied by corresponding tender points and neck stiffness.

2. Imaging changes: X-ray film shows changes in cervical curvature, cervical lateral dynamics can show intervertebral joint instability, loosening and trapezoidal changes (earlier than magnetic resonance imaging), MRI shows disc degeneration Or after the sudden levy.

3. Except for other diseases: mainly except for neck sprains, periarthritis of the shoulders, rheumatoid muscle fibrosis, neurasthenia and other neck and shoulder pains caused by cervical disc degeneration.

Differential diagnosis

A differential diagnosis of a stiff neck:

1, head and neck activity is limited: one of the symptoms of cervical spondylosis, head, neck, shoulders, back, arms sore, neck and neck stiffness, limited mobility.

2, neck stiffness: neck stiffness refers to neck muscle tension, bloating, hard, sputum (cramp) and other phenomena, neck movement is not flexible. Common in fatigue, cervical spondylosis. Neck stiffness is a persistent over-contraction of the muscles, which not only reduces the blood supply to the neck muscles, but also causes the accumulation of metabolites such as lactic acid, which causes muscle ischemic pain. Back pain and head pain may be tension headaches caused by head or cervical lesions.

3, can not turn the neck: can not turn the neck is the clinical manifestations of the atresia syndrome. The atresia syndrome, also known as the atresia syndrome, is the efferent state, which is caused by the basal lesion of the pons. Mainly seen in the cerebral vasculopathy, mostly bilateral occlusion of the basilar artery pons, resulting in bilateral infarction at the base of the pons.

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