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Cervical spine pain

Many people have problems in the upper (cervical) part of the spine. Some feel tension, pain, and muscle burning around shoulder blades and even tingling in the arms. Modern lifestyle, sitting down jobs, and not enough physical activity can lead to certain damaging of intervertebral discs and reduced elasticity of pulpous core, fissures, and ruptures of certain parts of fibrous ring, as well as reducing the intervertebral space.

Mentioned changes occur with older but also younger people which proves that intervertebral disc degeneration is caused by factors other than just aging. First symptoms surface in the beginning of degenerative changes, and first clinical signs surface when the pulpous core stimulates neural endings in the peripheral layer of fibrous ring and longitudinal ligament.

Patients experience pain in the affected part of the spine due to pressure on the nerve root, followed by instability of vertebral dynamic segment due to fibrous ring rupture, and that part shows enhanced mobility as a result of greater muscle activity which then leads to tiredness, pain, and imbalance because of constantly enlarged muscle tone.

Clinical image manifestation can occur in the area of degenerative changes (vertebral syndrome) but symptoms can transfer to parts further away from the spine due to irritation of compression of spinal roots or blood vessels (vertebrogenous syndrome). Pressure on neural structures can also appear (compression syndrome).

Vertebral syndrome is clinically manifested through local symptoms of pain, tense paravertebral muscles, damaged function and change in shape of vertebral dynamic segment (scoliosis, kyphosis).
Vertebrogenous syndrome is manifested through pain transferred to head, upper extremities (cervical spine) or lower extremities (lumbar spine), motoric breakdowns, sensation breakdowns, and circulatory symptoms.  
Disc damage in upper part of cervical spine (C2-C3,C3-C4) creates pain in shoulder blade or shoulder area, while damage in the cervical spine creates hand pain. Pressure on the disc in sixth and seventh spinal root causes pain in frontal part of the chest. Due to compression in fifth and sixth spinal root raw motoric strength is reduced and trophic changes in certain muscle groups occur.  

In disc protrusion (C4-C5,C6-C7) motoric breakdowns happen in one or both arms, along with feeling weak and tense, with tingling in one or both hands.
Patients with such symptoms should go through certain diagnostic procedures (EMNG,MR) in order to set a proper diagnosis because that is the only way to know what is wrong with the patient and how to help him or her.

Treatment:

Patients with sub acute and chronic pain due to spinal roots compression treatment is conducted via resting and relieving pressure using Schanz collar. It would be good to go through well performed and focused physical therapy. Electro analgesia, ultrasound, and medical massage are indicated. Kinesitherapy should be conducted very carefully. Exercises help strengthen weakened muscles, enhance mobility, and correct body posture. Patients with this diagnosis should go through physical therapy twice a year, continually go to massages, and do required exercises.
In case of acute intervertebral disc protrusion patient should rest in a suitable position and take pain medication. Skull traction is conducted only if rest and pain medication failed to provide an effective result, and if traction doesn't prove to be successful, operative treatment is indicated (after consulting with the neural surgeon).

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