Comment traiter les douleurs cervicales provoquées par les mouvements de la tête ?

Twist and shout

Patient 1 posted that they felt a 'pop' in their neck in the middle of the night. The following morning they felt they had 'slept wrong' and experienced a sharp burning pain all along the right side of their neck.

Patient 1 couldn't stand, turn their head to the left or right, or look up or down without getting an intense pain. They also got the pain when they moved their right arm, but were OK moving their left arm. The pain seemed to start at the bottom of the right side of the neck and extend to the base of the skull and the shoulder.

Neck pain can have many causes. Patient 2 posted that Patient 1's story sounded very much like torticollis, and I agree with them. The name comes from the Latin tortus which means twisted and collum which refers to the neck. The other name for it is wry neck.

Although it's unusual to feel a 'pop' in the neck, the symptoms otherwise are pretty much as Patient 1 described them. The symptoms come on very quickly, often overnight, so you wake up with pain and stiffness down one side of your neck. Movement of the neck may be difficult or almost impossible. The pain may spread to the back of the neck or the shoulder.

Patient 1 tried to massage their neck and it made the pain worse. They discovered another feature of torticollis - pressure on certain areas may aggravate the symptoms.

Sélection de patients pour Le dos et la colonne vertébrale

Os, articulations et muscles

Vidéo : Exercices contre les douleurs cervicales

Les douleurs cervicales sont très fréquentes mais, dans la plupart des cas, elles ne sont pas dues à un problème grave. La douleur est plutôt d'origine musculaire et les exercices décrits ici sont recommandés pour soulager les symptômes.

par Lilly Sabri, MHPC

Os, articulations et muscles

Spondylose cervicale

Ce dépliant s'adresse aux personnes qui ont appris que leurs symptômes cervicaux étaient dus à une spondylose cervicale. La spondylose cervicale est une "usure" des vertèbres et des disques du cou. Elle fait partie du processus normal de vieillissement et ne provoque pas de symptômes chez de nombreuses personnes. Cependant, elle est parfois à l'origine de douleurs cervicales. Les symptômes ont tendance à apparaître et à disparaître. Les traitements consistent à maintenir le cou en mouvement, à faire des exercices pour le cou et à prendre des analgésiques. Dans les cas graves, la dégénérescence peut provoquer une irritation ou une pression sur les racines nerveuses de la colonne vertébrale ou sur la moelle épinière. Cela peut entraîner des symptômes au niveau du bras ou de la jambe (voir ci-dessous). Dans ces cas graves, une intervention chirurgicale peut être envisagée.

par le Dr Doug McKechnie, MRCGP

Getting it in the neck

In most cases, torticollis comes out of the blue and the cause isn't known. Patient 3 mentioned that Patient 1 might have slept awkwardly or pulled something. Patient 1 certainly described waking up feeling that they had 'slept wrong'. This is often the story people with torticollis describe, although there's no particular evidence that any damage occurs while sleeping.

Occasionally, torticollis can be attributed to a particular cause, such as infection of the throat or upper airways (by virtue of swelling of the glands of the neck). It can also be caused by a neck injury, such as whiplash or as a side-effect of medicines such as phenothiazines. However, Patient 1 doesn't mention anything about infection, injury or medication.

Features which suggest neck pain may be due to something other than torticollis include progressively worsening pain, weakness or clumsiness of the hand or arm, or persistent numbness. If you already have an illness such as AIDs, cancer or rheumatoid arthritis, neck pain may suggest the condition has started to involve the structures in the neck. Other worrying signs include feeling generally unwell, weight loss or fever. Tenderness in the neck bones can indicate a bone problem. Difficulty with walking or passing urine suggests pressure on the spinal cord.

Patient 1 didn't report any of these worrying features, so it was worth trying some self-help treatments. But if any of these features developed, it would have been appropriate to seek urgent medical advice.

Pillow talk

The good news is that simple torticollis often improves in 24-48 hours. There's lots that Patient 1 can do to relieve the symptoms in the meantime. Patient 3 recommended wrapping a hot water bottle in a towel and applying it to the neck. He also advised paracetamol. Patient 3 and Patient 4 also suggested ibuprofen which can be taken as well as the paracetamol. All of these solutions have medical backing.

Patient 4 and Patient 5 recommended ice, which I must say is a new one on me. Ice is OK if there is an area of inflammation or injury but I would have thought heat would be better at relieving muscle spasm. But hey, if it works, it works. My advice to patients about all treatments I am unfamiliar with is that provided they don't do any harm, it's worth giving them a try. Just make sure you don't apply ice directly on to the skin - the last thing you want is skin damage to add to your woes!

Patient 6 mentioned pillows and I agree this is very important. The received wisdom is that people with neck pain should sleep with only one pillow. Any more than that and their head ends up at an abnormal angle. There are some weird and wonderful pillows designed for people with neck pain out there on the internet. Some you can fill with hot water. Some have extensions to support the sides of your neck. And some have weird shapes, like the Napping Pillow which makes you look like a squid (Google it). My own 'special pillow' is very old and falling to pieces and my wife has threatened to throw it away on several occasions. But I can't sleep without it. It's wonderfully soft and supports my neck in just the right places. It's been with me to Spain, Turkey and all points north of Tampa Bay and I'm never going to get rid of it.

Necks patient, please

There are many causes of neck pain, and it's worth being aware of these if the symptoms don't settle. Patient 4 had to have an MRI scan and was found to have several discs out of place. Patient 7's neck pain was due to a fracture of the first and second cervical vertebrae, but that was after a really serious accident in the gym.

So even if the condition seems to be uncomplicated torticollis, if the symptoms haven't settled down after a week's worth of anti-inflammatory tablets and/or painkillers, you should consider seeing a doctor.