When the neck hurts

Neck-shoulder-arm syndrome, cervical syndrome, cervicobrachial syndrome, cervicocephalic syndrome - all these terms are from the environment of neck pain. What to do for neck pain? We inform about causes, symptoms, course and treatment of neck pain.


Pain in the neck region of various causes, which can also radiate in the shoulder, arms or head. Feeling dizzy and headache often does not stay away from neck pain.

Neck pain: causes

Neck pain can be a symptom of very many and very different disorders mainly in the cervical spine but also the shoulder and chest. Most common are overload problems of the local musculature and the soft tissue by static malpositions (for example screen work). Furthermore, the cervical spine is subject to a chronic wear process with increasing age. This can, similar to the lumbar spine, infect intervertebral discs and vertebral joints and lead to herniated discs or vertebral blockages.

Other, but much rarer causes are inflammation (spondylitis, spondylodiscitis) or tumors in the spine, rheumatic diseases (rheumatoid arthritis, ankylosing spondylitis and others), neurological diseases (nerve paralysis, spinal cord lesions) and post-injury conditions (eg whiplash, Vertebral body fractures, spinal instabilities).

In addition to these diseases of the cervical spine, shoulder joint diseases can also lead to neck pain. Mainly these are shoulder joint arthrosis, inflammation of the biceps surrounding the shoulder joint, tears of the tendons stabilizing the shoulder joint or other shoulder injuries.

Also, internal diseases such as the coronary arteries (angina pectoris, myocardial infarction) can cause shoulder or neck pain. Not infrequently, especially chronic recurring neck pain is the expression of mental stress or stress situations without orthopedic cause.

Neck pain: symptoms

Neck pain can occur in any age group, but it does increase in older age. An accumulation in the female sex is described. Cervical syndrome is characterized by sheer neck pain, often with radiations in the shoulder, and no neurological symptoms. Not infrequently, the painfully tensed muscles leads to a neck stiffness with complete blockage of the mobility of the cervical spine (torticollis).

If, in addition to the neck pain, there is pain on the arms or hands, paralysis or sensory disturbance, this is called cervico-brachial syndrome or neck-shoulder-arm syndrome. This is mainly caused by nerve irritation (herniated discs, inflammation, bone, tumors) in the lower cervical spine.

The cervicocephalic syndrome, however, describes the occurrence of headaches (dizziness, tinnitus, blurred vision) with or without additional neck pain. These are often caused by mental stress situations, less often by injuries or circulatory disorders of the cervical spine.

Neck pain: diagnosis and course

Due to the variety of causes, the possible diagnosis in this area is very diverse. The clinical examination of the cervical spine with regard to local pain points and muscle hardening and their mobility is a matter of course. The standard is also the radiograph of the cervical spine in four levels.

Depending on the course (acute / chronic), history and degree of complications, additional imaging techniques or neurological examination techniques should follow. The course of the neck pain due to muscular tension is usually benign and temporary. Neck pain due to signs of wear, conditions following cervical spine injury, neurological or rheumatic disease generally takes a chronic course with periods of acute pain and periods of relative discomfort. This, of course, depends on the underlying underlying disease.


Due to the variety of possible causes as well as different complications in the course are possible. No complications are known for the purely muscular, tension-related neck pain. If symptoms of paralysis on both the arms and / or legs appear, further diagnostic measures should be taken.

Treatment and therapy

In the foreground of the treatment of neck pain are physiotherapeutic and physical-therapeutic measures as described under low back pain. In the acute stage is usually symptomatic therapy, ie the administration of pain medication, as well as temporary relief of the cervical spine sufficient.

This relief is achieved, for example, by a Schanz necktie (neck cuff) made of foam, in severe cases by a more stable neck collar made of plastic. A neck roll or a suitably ergonomically shaped neck pillow can also relieve the cervical spine. Physiotherapeutic and physical-therapeutic measures should be the basis of the treatment for longer courses as well as in the chronic stage.

Alternative treatment of neck pain

In addition, the methods of complementary medicine such as acupuncture or naturopathic procedures can be applied here. In addition, a variety of injection treatments and special catheter methods for pain relief can be used.

Depending on the actual cause of the pain in the neck, surgical interventions are of course possible after a clear diagnosis and after exhaustion of all conservative treatment options. The development in modern spine surgery towards more microsurgical and less burdensome surgical techniques offers a wide range of therapeutic options.

Preventive measures

Essential in the prevention of neck pain is the avoidance of monotonous stress and poor posture, for example, in the workplace. Ergonomically shaped neck cushions or neck rolls prevent position-dependent tension during sleep. Exercises to strengthen the neck muscles can also help prevent neck pain.

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