Neck pain and rheumatic disease. Illustration: FotoFyl / E. Tsavari. CC BY 2.0

Definition

Pain in the neck is common and most often caused by harmless, though troublesome muscles. The symptoms can come acute or during periods of stress or a lot of work in front of the computer screen. However, there are many other and sometimes serious illnesses that can also cause neck pain. Below is a selection and a list of "Red Flags" / danger signals listed alphabetically.

Rheumatic disease with neck pain

• Arthritis
  • Juvenile Arthritis (Childhood Arthritis)
  • Rheumatoid Arthritis (Arthritis)
• Osteoarthritis, Spondylosis
  • Between discs in the neck
  • Side joint (facet joint)
• Bekhterevs / ankylosing spondylitis
  • Ankylosis (confusion of vertebra)
  • Syndesmophytes
• Muscle pain (myalgia)
  • Bad posture (Scheuermann's disease, Ankylosing spondylitis, osteoporosis. with fractures or work on PC screen)
  • Fibromyalgia
  • Muscular tension (stress, load like work on screen, occupation as hairdresser)
• Polymyalgia rheumatica (PMR)
  • Never before 50's age
  • Quick start (within hours)
  • High CRP and lowering reaction (SR)
  • At the same time in both shoulders, pelvic or thighs
• Systemic lupus erythematosus (SLE) with spinal cord manifestation / myelitis (rare)
• Takayasu arteritis
  • High CRP and lowering reaction (SR)
  • Pain on the side of the throat (over arteries, carotidynia)
  • Young women

Other causes of neck pain

• Arterio-venous fistula (vein change) in the neck (rare)
  • Varying symptoms including paralysis
• Fracture
  • Sports Injury
  • Assault
  • Diving Accident
• Eagles syndrome (calcification in the jaw ligament) (reference: More C, 2017)
  • Cramp-like pain in the left part of the neck, face and head
  • Exacerbation of the side bend and rotation to the right
  • Rare
• Infection
  • Discitis (Intermediate Disc Infection)
    • Often other signs of infection (night sweats, some fever, pain)
  • Osteomyelitis (vertebra infection) in the neck
  • Spinal cord infection (Myelitis)
  • Herpes zoster («Shingles»: always on one side of the throat, painful blisters and skin sores)
  • Meningitis (meningitis)
    • Headache, nausea, neck stiffness
• Cancer (rare)
  • Different types and locations (skeleton, spinal cord)
    • Spinal tumors
  • Bone pain
  • Nerve compression (with nerve symptoms)
  • May be metastases from another tumor
• «Crick in the neck» (Torticollis)
  • Muscle pain triggered by unusual movement or muscle stretch during sleep
  • Congenital (congenital) malformation of muscle or neck vertebrae. Kippel-Feil syndrome with more
  • Muscular fibrosis in newborn or small children
• Intervertebral discs
  • Prolapse with nerve compression
    • Most often between C5 / C6 or C6 / C7
  • Discitis (intervertebral infection)
• Myelitis (inflammation of the spinal cord)
  • See also SLE above
• Whiplash
  • Various types of neck injury after sudden overextension (extension)
  • Most often associated with a car accident with collision from rear
  • The mechanism behind chronic pain is often unclear

6 Red Flags (Danger Signals)

1. Troublesome symptoms for more than 6 weeks
2. No improvement or gradual deterioration over time
3. Pain radiate to arm or leg
4. Pain by knocking against the vertebra of the neck
5. Numbness or loss of muscle strength
6. Other new symptoms (unexplained new night sweats, fever, weight loss, headache, nausea)

Investigation of neck pain

• Clinical examination (GP, neurologist, rheumatologist)
• Laboratory tests (CRP, Sedimentation rate / ESR, number of blood cells, liver and renal function tests with more)
• Image Diagnostics (X-ray, MRI examination, CT images)

Headache and rheumatic disease are described here (Vaskulitt.no)

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