When I got up this morning, my neck hurt when I moved my right back, but I couldn't feel it when I touched it with my hands. It hurts when I move my neck. Now my back hurts when I twist my neck to the

When I got up this morning, my neck hurt when I moved my right back, but I couldn't feel it when I touched it with my hands. It hurts when I move my neck. Now my back hurts when I twist my neck to the right, that is, my right back. The cause of disease

Stiff neck is also called "training short neck" in Guangdong. There are two main reasons: one is muscle sprain, such as poor sleeping posture at night, and the head and neck are in an excessive deflection position for a long time; Or because the pillow is not suitable, too high, too low or too hard during sleep, the head and neck are overstretched or overstretched, which can cause muscle tension on one side of the neck, make the cervical facet joint twist, and static injury may occur over time, which will make the injured muscles and tendons hard and uncoordinated, the blood flow is not smooth, local pain and discomfort, and the activity is obviously limited. Second, I feel cold, such as cold during sleep and cold in midsummer, which makes my neck and back stagnate in qi and blood, and my muscles and veins are blocked, resulting in stiff pain and unfavorable movements. Third, some neck injuries can also lead to muscle protective contraction and joint sprain, and then poor neck posture, stagnation of qi and blood, and muscle contracture during sleep can also lead to this disease. Fourth, neck and shoulder injuries such as cervical spondylosis. If you feel a little cold or sleep badly, it may cause this disease, or even "stiff neck" repeatedly.

clinical picture

Generally speaking, after getting up, I feel pain and discomfort in the back of my neck and upper back, with more pain on one side, or pain on both sides, or heavy and light. Because my body has changed from lying flat to standing upright, the strength of the neck muscles has changed, which can cause progressive aggravation and even involve the shoulders and chest and back. Most patients can recall the poor sleeping posture last night, and the neck muscles were tender during the examination. Because of the pain, the neck movement is unfavorable and it can't rotate freely. In severe cases, it is difficult to pitch, and even the head is stiff in an abnormal position, which makes the head lean to the affected side. During the examination, the neck muscles are tender, the superficial muscles are cramped and stiff, and there is a "rope feeling" when touched.

diagnose

1. Due to poor sleeping posture or feeling cold.

2. Acute onset, pain and soreness in one side of the neck after sleep, which can radiate to the upper limbs or back. The activity is unfavorable, and the pain on the affected side increases during the activity. In severe cases, the head inclines to the affected side, and some cases get worse gradually, even involving the shoulders and chest and back.

3. Cervical muscle spasm often occurs on the affected side, and the sternocleidomastoid muscle, trapezius muscle, rhomboid muscle and levator scapulae muscle are tender. Masses and cord-like changes can be touched when muscles are tense.

treat cordially

1. TCM therapy

There are many methods of treating stiff neck in Chinese medicine, such as manipulation, acupuncture, medicine, hot compress, etc., and the effect is very good, especially massage.

(1) Massage and tendon management can be relieved by general stiff neck 1~2 treatments, and mild cases can be cured. However, some patients actually develop the disease on the basis of long-term cervical lesions, such as long-term strain of neck muscles or cervical degenerative diseases. Under certain conditions, diseases are induced. Even if the disordered joints are reset through treatment, inflammatory changes such as congestion, edema and thickening of the soft tissues in the neck will continue to cause neck discomfort, which will take 2 weeks or even 1 month of treatment and rest to recover. There are several ways to massage the tendons and veins: ① The masseur stands behind the neck of a stiff neck, gently presses the neck with one finger to find out the most painful point, and then massages the most painful point from the top of the neck to the shoulder and back in turn with his thumb until he feels obvious pain, indicating that his strength is enough. Repeat this massage for 2 ~ 3 times, and then tap the massage part with a hollow fist for 2 ~ 3 times. Repeating the above massage and slapping can quickly relax the spasmodic neck muscles and relieve pain; ② Put the middle finger, middle finger and ring finger of the left hand or right hand together, find the tender point in the neck pain (mostly in sternocleidomastoid muscle and trapezius muscle), and press from light to heavy for about 5 minutes. It can be done alternately with left and right hands; Hit the thenar lightly and quickly from top to bottom for about two minutes; Press left and right Fengchi points and Jianjing points with thumb and forefinger 1-2 minutes; Press the stiff neck point with your thumb or forefinger (between the second and third metacarpals of the back of your hand and 5 points behind the metacarpal joint) for 2-3 minutes when you feel sore; Finally, the head and neck should bend forward, lean back, turn left and right. This action should be done slowly, and it must not be too hard. ③ Massage Chengshu and Fengfu points with both hands at the same time for about 65,438+0 minutes, with gentle manipulations, then massage Hegu points and Houxi points on the opposite side of the affected part with both hands, with strong stimulation (depending on the patient's tolerance), and at the same time, make the patient twist his neck gently from left to right, as far as possible, for about 65,438+0 minutes, and then lower his head, raise his head and move his neck. This technique can be effective if the symptoms of stiff neck are mild. If the headache is serious and the neck can't rotate, you can first press the affected shoulder well point for 2~3 minutes and ask the patient to rotate the neck slowly. When the pain is slightly relieved, the treatment effect will be better. ④ Self-massage: Massage hard on the pillow with two palms until local fever occurs.

In addition, for patients with cervical spinous process deviation, pulling method can also be applied, which is usually more effective for traumatic stiff neck. When operating, the force should be steady, and it is better to hear the sound of bullets suddenly, but the sound of bullets must not be forced, enough is enough, and the force should not be rough. Make a clear diagnosis before pulling, and rule out diseases such as fracture, dislocation and tumor, so as not to cause unnecessary harm.

(2) There are many methods to treat this disease by acupuncture therapy, such as acupuncture, pointer, electroacupuncture, ear point pressing pills, etc. ① Acupuncture Points: Hanging Bell, Supporting the Aged and Houxi. Matching points: Neiguan, Waiguan, Zhongzhu and Yanglingquan. Treatment: Take the main point as the main point, only point one at a time. When the effect is not good, add or change points. Hangzhong point, pricking 1, 5 ~ 1, 8 inches deep, with strong or moderate stimulation, leaving the needle 15 ~ 20 minutes after getting angry; At the senile point, the needle tip pricks obliquely upwards 1. 5 inch, so that the needle sensation is transmitted to the shoulder; In Houxi, stab 0, 5 ~ 0, 8 inches straight, twist the needle 1 ~ 3 minutes after getting angry, or add electroacupuncture stimulation, frequency 40 ~ 50 times/minute, continuous wave. Match points with routine acupuncture and deep needling to obtain a strong sense of qi. When acupuncture any of the above points, the patient must be required to actively move his neck, and the range will gradually increase from small to large. Leave the needle 15 minutes, one day 1 time. Still use the main point: Dazhui. Matching points: good shoulders. Treatment: Let the patient sit in a chair and lean forward. After selecting the right acupoints, the needle tip deviates to the affected side by about 0,5 ~1inch, so that the needle sensation is transmitted to the affected neck and shoulder. After getting angry, the operator presses the affected shoulder well point with one hand, so that the patient can move his neck to the maximum extent, while twisting the needle with the other hand for 3 ~ 4 minutes. If the effect is not obvious, take a 5cm long moxa stick and light it on the needle handle. After moxibustion, take out the needle and add cupping 10 ~ 15 minutes in the acupoint area. Every day 1 time; ② Main acupoints of the pointer: Waiguan, Neiguan and Ashi. Matching points: Fengchi, Shoujing, Shouzhen, Pension, Tianzhu, Fengfu, Dazhui and Ideal. Ideal acupoint position: from Fengchi to the midpoint of Jianjing point. Treatment: focus on the main points, and add more points when the effect is not good. First tap or press the tender point with your finger, Ashi point, 1 min. The operator squeezes the patient's Neiguan point with his thumb, and touches Waiguan point with his middle finger or forefinger for 2-3 minutes at a time, so that the pressure permeates from Neiguan to Waiguan point, and the patient may feel sour, numb, bloated, hot, or get angry. When pinching the neck, the patient should be instructed to turn the neck left and right. Matching points: hold Fengchi point 20 times with one hand and Shoulder well point 20 times with both hands. The resting acupoints can be acupressure, or pushing up, down, left and right for 1 ~ 2 minutes. The above method is/kloc-0 times a day, and 3 times is a course of treatment; ③ electroacupuncture at main points: divided into two groups. The first group is the elderly, newly established, foreign customs, comfortable; The second group is wind pool, shoulder well, paravertebral 1 inch, and handwritten books. Select all points on the processing method. A DC induction electrotherapy machine was used and operated with a circular handle electrode with a diameter of 3 cm. Anode takes 1 group of holes and cathode takes the second group of holes. Massage the acupoints for a while before electrifying, and then electrify with induction electricity, and the power will gradually increase to 2 ~ 10V, which is limited to the patient's tolerance, and each electrify will last for about 3 ~ 5 seconds. When the muscle contraction of the affected side is seen, it is changed to direct current therapy, the current is 20 ~ 40 mA, and the electricity is also applied for 3 ~ 5 seconds each time, so that the patient can do neck activities during the treatment. The total treatment time is about 5 ~ 10 minute. 65438+ 0 times a day, 3 times as a course of treatment; ④ Ear point pill pressing essentials: neck and Shenmen. Treatment: Use both points. Take 1 ~ 2 mung beans, put them into the square of/kloc-0 /×1cm ~ 2 cut with commercially available Huoxue Zhitong ointment or Shangshi Zhitong capsule, and stick them on the selected ear points, pressing and tightening them. After that, the auricular point was pressed for 0,5 ~1min, and the manipulation was from light to heavy until the patient felt fever and pain, and asked the patient to move his neck for 2 ~ 3 minutes. Patients are required to press themselves three times a day until they are cured.

(3) Ashi point, the main point of cupping therapy. Ashi point location: the most obvious place of neck tenderness.

Matching points: air door and shoulder well.

Treatment: rub Ashi point hard for a while, after routine disinfection, quickly prick it with a triangular needle for 3 ~ 5 times, or tap it moderately with a leather needle, which can be equivalent to the caliber of a jar. Then, choose a jar with suitable caliber to suck and pull. 1 ~ 2 points are optional. After acupuncture, keep the needle, and then cupping on the needle. The drawing time is 10 ~ 15 minutes. After cupping, moxa sticks can be used to rotate moxibustion at Ashi point for 5 ~ 7 minutes. 65438+ 0 times a day, excluding course of treatment.

2. Drug therapy

Most of this disease is treated with external drugs, such as plasters and ointments. Plaster is often put on neck pain and replaced once a day, which has an ideal analgesic effect. However, the patient's neck movement is limited to some extent after sticking plaster. It should be noted that some plasters contain pungent, bloody and slippery drugs, which should not be used by pregnant women. The ointment can be massage milk, Qingpeng ointment, etc. And rub it on the sore, 2 ~ 3 times a day, which has certain effect.

Step 3: physical therapy

(1) There are different opinions on whether traction therapy is used after stiff neck. Some people think that the mandibular pillow can be used for traction like cervical spondylosis, and the weight can be increased appropriately. The common weight is 4 kg-7 kg, and the traction time is 20-30 minutes. However, some people think that traction after stiff neck is not only ineffective, but also aggravates the pain. In the differential diagnosis with cervical spondylosis, if the patient's head and neck are pulled up slightly with both hands, the symptoms of cervical spondylosis can disappear or be alleviated, while the stiff neck pain is aggravated. It is generally believed that the weight of traction should be paid special attention to because the muscles are in a state of spasm after stiff neck. Too light is not effective, and too heavy is easy to aggravate the injury. Therefore, other methods can be used for treatment. Of course, whether to use traction therapy can also be discussed and studied in clinical work. Some hospitals have accumulated a lot of experience in treating stiff neck with traction therapy. According to practice, traction therapy can also be used.

(2) Hot compress therapy with hot water bottle, electric hand stove, hot towel and infrared lamp irradiation can play an analgesic role. Care must be taken to prevent burns. In addition, you can also apply vinegar: take 100g vinegar, heat it until it is not hot, and then dip gauze in hot vinegar and apply it to the neck and back pain. You can use two pieces of gauze alternately to keep the pain feeling of damp heat, and at the same time move your neck for 20 minutes each time, 2 ~ 3 times a day.

4. Exercise therapy

Sit in a chair with your head down, raise your head, hold your chest out, keep your head down until your chin is next to your chest, and then look up. Stop for 3 seconds and then lower your head. Repeat this for 20 times.

Sitting in a chair, your head swings left and right, and your arms naturally hang down. Swing your head to the left, then to the right, and repeat this action 20 times.

Sit in a chair and swing your jaw, with your arms hanging naturally, your chest standing up, and swing your jaw forcibly from side to side for 20 times in a row.

Stretch your neck, sit in the chair and hold your chest out. First, stretch the neck upward as far as possible, then shrink the neck downward as much as possible, and stretch it continuously for 20 times.

Turn your neck and sit in the chair. Don't move, first turn your neck 90 degrees to the left, then 90 degrees to the right, and do it 20 times.

5. Mechanical therapy

Treatment can choose TDP magic lamp local irradiation, local gyromagnetic therapy, local cold therapy or wet hot compress. In addition, a slight stiff neck can also be treated with an electric massage stick. The powerful tapping massage function of massage stick penetrates into muscle tissue, which can effectively relieve muscle soreness. The weight of the massage stick is concentrated on the massage head, which greatly strengthens the massage strength and has a good effect.

prognosis

The stiff neck itself often heals itself. As long as the treatment measures are taken in time, the symptoms can disappear quickly. Although the onset is urgent, if treated systematically, the course of disease is very short, and it can be cured within 1 week. Timely treatment can shorten the course of disease, and those who don't can heal themselves, but there are more chances of recurrence. If the symptoms of stiff neck recur or do not heal for a long time, it is necessary to consider whether there is cervical spondylosis, and to find a specialist for examination, so as to achieve early detection and early treatment.

prevent

1. Maintenance

(1) One third of a person's life is spent in bed. The hardness of the pillow has a direct effect on the cervical spine. The best pillow should be able to support the physiological curve of the cervical spine and keep it straight. The pillow should be elastic and stable, and the pillow core should be thermally compressed with sponge pillow core. Like to lie on your back, the height of the pillow is about 8 cm; I like to lie on my side, and my height is about 10 cm. In supine position, it is best to pad the lower edge of the pillow on the upper edge of the scapula to avoid making the neck empty. In fact, the real name of the pillow should be "pillow neck". Improper pillow often causes stiff neck, and repeated stiff neck is often a precursor to cervical spondylosis, so it should be diagnosed and treated in time. Also pay attention to the pillow mat, which is made of straw. One bamboo mat is too cold and the other is too hard, so it's better not to use it.

(2) Keep the neck warm When the neck is stimulated by cold, muscles and blood vessels will spasm, which will aggravate the pain in the neck. In autumn and winter, it is best to wear high-necked clothes; The weather is a little hot, so you should pay attention to prevent your neck and shoulders from catching cold when you sleep at night; In hot season, the air conditioning temperature should not be too low.

(3) The main cause of cervical spondylosis with correct posture is incorrect posture in work and study. Good posture can reduce fatigue and avoid injury. Bowing your head for too long will cause muscle fatigue, cervical disc aging and chronic strain, which will lead to a series of symptoms. The best posture for desk work is to keep your neck upright and lean forward slightly, and don't twist or tilt; If the working hours exceed 1 hour, you should take a break for a few minutes and do some neck exercises or massage; It is not advisable to lean your head against the bedside or sofa armrest to read or watch TV.

(4) Avoiding neck injury can also induce this disease. Besides paying attention to posture, if you take a fast vehicle and suddenly stop, your head will be thrown forward, which will lead to "whiplash-like" injury. So pay attention to protect yourself, don't doze off in the car, and don't twist and lean forward when sitting in the seat; Cervical spine injury should be avoided in sports competitions; In the acute attack of cervical spondylosis, the activity of cervical vertebra should be reduced, especially to avoid turning around quickly, and neck brace should be used for protection if necessary.

2. Neck function exercise

Exercise of cervical vertebra should be cautious, and rapid rotation or swing without purpose should be avoided, especially in the acute stage of cervical spondylosis, vertebral artery type cervical spondylosis or cervical spondylotic myelopathy. The method we recommend is simple and easy, but to achieve the goal of preventing and treating diseases, we must persevere.

(1) The neutral position in the head bends forward to the limit and returns to the neutral position; Stretch back to the limit and return to the neutral position; Turn left to the limit and return to the neutral position; Turn right to the limit and return to the neutral position; The left side bends to the limit and returns to the neutral position; The right side bends to the limit and returns to the middle position. Slow down and push harder. During exercise, some patients can feel the murmur in the neck. If there is pain, they should reduce the number of exercises or stop exercising. If there is no pain, you can continue to exercise.

(2) Hold with both hands, with fingers crossed behind the neck, in a neutral position, and make a slow flexion and extension of the head. At the same time, both hands vigorously oppose the movement of the head to exercise the muscle strength at the back of the cervical spine.