Radical pain in cervical joints

Introduction Cervical facet joint synovitis, fluid accumulation in the joint capsule, swelling, can cause adjacent nerve roots to stimulate root pain. If the neck 5 to the chest 1 anterior branch is provoked, the patient may have the upper limb brachial plexus neurosis; when the joint is inflamed, the joint capsule is distributed with sensitive nerve endings, which can reflexively cause the related muscles to contract or Hey, there is radiation pain on one side of the upper limb, neck and shoulder pain, and neck function is limited. The root artery is the nutritional artery of the cervical nerve root, and the anterior root artery in front of the nerve root in the intervertebral foramen is compressed, causing the corresponding nerve root ischemic lesion and root symptoms.

Cause

The anterior scalene injury or the displacement of the vertebra causes the nerve roots that innervate the muscle to cause tendon. When the anterior scalene muscle contracts, the brachial plexus and the subclavian artery between the anterior and middle angled muscles can be compressed, causing radiation pain from the shoulder to the upper limb, numbness in the ulnar nerve innervation, and lower skin temperature in the upper limb. The nerve endings distributed in the muscles and tendons are susceptible to the stimulating effects caused by passive activities and can cause painful reactions.

an examination

Related inspection

Neck MRI examination neck test

Clinical manifestation

The clinical symptoms of cervical spondylotic radiculopathy are painful, mainly neck and shoulder pain, radiating to one or both upper limbs. Pain is colic, dull or burning, affecting work or sleep. Pain increases when the neck is stretched or coughing, sneezing, or forced stool. Some patients have dizziness, headache, and tinnitus. The upper limbs are dull, sore and weak, and the grip strength is reduced or the object is easy to fall. There are many numbness and pain in the fingers and forearms. It has been reported that because the nerve roots are twisted in the neural tube, the anterior branch is dominated by dyskinesia when the iliac crest is inside, and the post-impression is the main sensory dysfunction.

Signs: The neck is obviously restricted in activity and stiff. The cervical spine of the lesion, the upper scapula of the affected side, and the pectoralis major area often have tenderness. The feeling of the upper limbs and fingers is reduced, and muscle atrophy may occur. The main nerve that governs the biceps is the neck 6 nerve, and the triceps muscle is the neck 7 nerve. In early lesions, if these nerve roots are stimulated, sputum reflexes may be active, and sinus reflexes may be reduced or disappeared.

Differential diagnosis

(a) rheumatic or chronic strain

Fibrous tissue inflammation, shoulder periarthritis can have neck and shoulder pain, hand numbness and other performance, but no nerve root radiation pain, tendon reflex normal.

(B) thoracic outlet syndrome

Such as cervical rib (or anterior scalene muscle) syndrome, this is the 7th cervical vertebrae transverse process is too long, the shoulder is drooping, the anterior scalene muscle compression of the brachial plexus and the subclavian artery caused by symptoms. Identification points: There are vascular symptoms, such as cold, purple hair, weak or disappeared radial artery, extensive sensory disturbance of the cervical 8 segment or hand, X-ray anterior segment, neck 7 transversely long or short rib .

(three) cervical myositis (arthritis, fasciitis)

Multiple sites, no radiation pain, numb area is not distributed according to the nerve segment, no vertebrae changes, anti-inflammatory drug treatment (such as indomethacin, anti-inflammatory pine) is effective.

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