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Neck pain


Neck pain is a collective term for painful tension in the neck and shoulder muscles. Sometimes it is accompanied by headaches, dizziness, ringing in the ears, nausea and visual disturbances. Particularly disturbing are tingling paresthesias that radiate from the arm to the fingers. Rarely there are also symptoms of paralysis. The predominant cause of neck pain is wear and tear of the cervical spine.


Very rare causes of neck pain must be excluded, for example:

  • Meningitis (in combination with fever and extreme neck stiffness).
  • Brain hemorrhage/stroke (! sudden headache with change of consciousness or paralysis).
  • Whiplash after a car accident or sport should be clarified immediately in the hospital.

Usually the main cause of neck pain is wear and tear caused by incorrect posture at work, e.g. at a desk or overhead work. Because the neck and back muscles are too weak, the intervertebral discs and small vertebral joints are overloaded.

Therefore, over 90% of patients with neck pain improve with more exercise and anti-inflammatory medications. Physiotherapy, massage and infiltrations are supportive measures.

If there is no improvement or if there are tingling paresthesias or even paralysis, then an imaging procedure such as MRI (magnetic resonance tomography) of the cervical spine is necessary.

The cause is more likely to be a herniated disc in youth and often a spinal stenosis/vertebral canal stenosis in old age.


20-40% of patients with a narrowing of the spinal canal in the lumbar spine also have a narrowing of the cervical spine at an advanced age. The pressure on the spinal cord, which no longer has room in the canal of the cervical spine, causes pain in the hands - combined with tingling paresthesia and sometimes paralysis. It is very important to recognize this problem of spinal canal narrowing in the cervical spine. This is because a minor fall can result in injury to the spinal cord - paraplegia!

In short, in older people it is important not to ignore chronic neck pain that is associated with symptoms (tingling paresthesia, loss of dexterity in the hands, unsteady gait).

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