What is Spinal Nerve Neuralgia?
The vertebral nerve is in close anatomical connection with the vertebral artery, which vascularizes the nerve roots of the V-VII cervical vertebrae involved in its formation. Osteophyte compression of the vertebral artery causes headaches in the occipital region and mastoid processes, as well as vestibular disorders (vertebral artery syndrome). This symptom complex is difficult to distinguish from the pain of paroxysmal in neuralgia of the vertebral nerve itself, which can also last for several hours.
Causes of Spinal Nerve Neuralgia
The provoking factors can be sudden movements of the head, overloading the cervical spine with fixed postures.
Symptoms of Spinal Nerve Neuralgia
There are two forms of cervicular neuralgia:
- acute form without prodromal period;
- chronic form with prodromal period and repeated exacerbations.
The acute form occurs under the influence of trauma, sudden movement of the head, infection. Patients complain of severe pain localized in the innervation zone of the affected root of the sensory nerve, usually in the neck, or radiating from the neck to the fingers along the lateral or inner surface of the arm. In some patients, the vegetative component may be observed – cyanosis, increased sweating in the zone of innervation, edema. In such cases, the intensity of the pain is especially great. Such phenomena depend on the irritation of one of the vegetative ganglia of the cervical region – the middle or lower.
In a patient in the acute period of the disease, torticollis can be detected – a fixed inclination of the head and neck toward the lesion. All movements, both in a healthy and in a painful direction, are sharply painful and limited. Arm movements in the shoulder girdle are also somewhat limited. Violations of sensitivity in the zone of innervation of the affected root in the acute phase of the disease, as a rule, does not happen. Lassega test is positive – head tilted forward with its rotation to the side increases pain.
The chronic form of cervical neuralgia with exacerbations is characterized by a prodromal period lasting several months, during which the patient may notice slight pain, “muscle fatigue” in the back of the neck or shoulder area.
Under the influence of provoking factors, for example, with long-term fixed posture, a typical attack of the above-described clinic develops cervical-neuralgia.
Diagnosis of Spinal Nerve Neuralgia
The disease is differentiated from the periarthritis of the shoulder joint, which is characterized by significant limitations of active and passive arm movements. shoulder girdle, a symptom of compression of the supraspinatus tendon, painful points in the places of attachment of the tendons of the muscles surrounding the shoulder joint. It is also necessary to differentiate from the “shoulder – hand” syndrome, in which changes in the hand with initial edema and subsequent development of finger contractures are observed.
The clinic is very similar to cervicofacial neuralgia with cervical osteochondrosis and spondylosis with neuralgia caused by an additional cervical rib. In the differential diagnosis of these two diseases, the identification of an additional cervical rib during X-ray examination is crucial.
Treatment of Spinal Nerve Neuralgia
The basic principles of treatment and prevention are the same as for neuralgia of the occipital nerves. Neuralgia Pathological changes are found in the Cv-Cviii region. The provoking factors can be a head injury (hit from top to bottom, carrying a load on the head), forced head movements, fixing it in the extreme position of flexion, extension, twists and turns during sleep; forced posture when working, for example, with a bent head in persons of clerical work, draftsmen, etc.