Neck pain radiates to back of head

Female 22 years old. Complaints of neck pain radiating to the back of head after work, which has become more frequent recently. Noticed deterioration of posture, which is also starting to bother her. Work has been sedentary before, in recent months as a seamstress.

A quick test showed only one positive answer - "pain of constant intensity in the form of cramps or waves", but this is more about another complaint - pain during menses. The detailed questionnaire provided a wealth of information useful in understanding the nature and causes of the symptoms. Localization of pains symmetrically in the occiput and back of the neck, sometimes it goes to the shoulders, spine area between the shoulder blades.
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Movement tests showed restricted neck mobility, "like strings being pulled," according to the patient. Which already tells us it's important to check the muscles. Nerve restriction tests were positive, more on the right side. The video call clarified the details and confirmed the assumptions resulting from the analysis of the questionnaire data.

Verification tests: in this case, the most important task was to verify the condition of the muscles that could hurt in the way described by the patient. Namely, radiating pain from the neck to the head, shoulders and limited range of motion. At self palpation of muscles according to the given instructions (including illustrations) - strong localized soreness and quick provocation of remote reflected pain.

Structural verification and diagnosis was made possible by analyzing all available information of the history and behavior of symptoms. The resulting assumptions were confirmed palpatorily and the structures responsible for the symptoms were found - specific muscles and myofascial trigger points arising in them.

Treatment Plan. The first step is to make recommendations for eliminating or minimizing long-term harmful factors. This is advice on the ergonomics of the workplace, how to improve posture, control of stress and related tension, taking vitamins and trace elements.
The next step is to work independently with the triggers found in the muscles. What cannot be done, what can be done and how, methods of self-treatment are explained in detail. Exercises to improve the mobility of the nerves of the brachial plexus are shown.

Results: gradual reduction in strength and frequency of neck and head pain over three weeks. Patient complies with recommendations, although she admits that she does not exercise every day. Continuation and re-consultation if necessary is recommended.

Pain radiating from neck to back of head. What to do?

Conclusions: an example of a fairly common dysfunction especially in young people. Yes, they do not die from it, but the pain can be very severe, in this case the maximum was 7-8 points out of 10. Pains that do not go away and cannot be treated with medication. Let me remind you that myofascial dysfunction is neither spasm nor inflammation, so pills and ointments can only temporarily reduce the intensity of symptoms.
On the other, positive side, if you understand the problem, know how to solve it and have practical experience - it is a very good find. Why? Because this dysfunction is completely reversible in nature and can be treated, which is very encouraging.

P.S. An attentive reader of my blog will have noticed that it was myofascial pain and dysfunction that was my first and deepest interest and entry point into the vast sea of musculo-skeletal medicine, biomechanics and osteopathy.

Grigori Tafi
Osteopath, sports medicine doctor
15 years of experience in osteopathy and manual therapy. Read more...

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