In this case, the patient experiences pain in the neck, shoulder, upper back.

In the area of \u200b\u200bthe neck and arms, there is often a “running”, like an electric current, acute pain or numbness, movement increases pain.

On examination, rigidity (numbness) of the neck muscles, limitation of mobility are revealed; spot examination necessarily reveals places with acute pain sensations.

Decreased sensitivity and muscle atrophy are also observed.. With acupressure, a symptom of infringement of the spinal nerves in the cervical region is pain that occurs at the site of the infringement of the nerve, as well as along its course, on the outer side of the shoulder, the inner upper corner of the scapula and in the lateral parts of the neck. The most pronounced point pain when exposed to the feng ni (VB20) and jian jing (VB21) points.

To diagnose the infringement of the spinal nerves in the cervical spine, special tests are used:.

Brachial plexus nerve stretch test.

The patient sits down and tilts his head slightly forward.. The doctor with one hand rests on his head, and the other grabs the brush. Then, with a short movement, he pushes the patient in one direction, and the brush pulls him to the other.. If during the test there is acute pain or numbness, such as " 28).

Test for narrowing of the intervertebral foramen (pressure).

The patient sits down, slightly tilts his head to the painful side. The doctor puts his left hand on the top of the patient, presses lightly and performs a slight blow on his left hand. You can replace the blow with a short pressing movement with both hands. If at the moment of pressure the patient feels " 29).

In the direction of the spread of pain during testing, the localization of the infringement of the spinal nerve in the interval between:.

• 3rd and 4th cervical vertebrae - there is local pain on palpation of the neck, occiput and along the occipital nerve;

• 4th and 5th cervical vertebrae - pain spreads along the outer side of the shoulder, forearm and radiates to the hand;

• 5th and 6th cervical vertebrae - pain in the form of " In this case, pain is also felt on palpation between the spinous processes of the 5th and 6th cervical vertebrae.;

• 6th and 7th cervical vertebrae - pain spreads to the index and middle fingers, with point pressure - to the middle of the inner edge of the scapula;

• 7th cervical and 1st thoracic vertebrae - pain is given in the little finger and ring finger, with acupressure it concentrates in the lower inner corner of the scapula.

It should be borne in mind that the above tests indicate only single pathological changes, which is rare in practice, therefore, the patient's reaction to the tests is characterized by their combination..

An important diagnostic method is the analysis of X-ray images in the lateral and oblique images.. On the lateral x-ray, various pathological abnormalities can be detected: straightening of the spine or bending in the opposite direction, narrowing of the intervertebral distances, bone growth, calcification of the ligament.

An oblique x-ray shows bone spikes in the region of the uncinate processes protruding into the cavity of the intervertebral foramina, and slight changes in the intervertebral foramina themselves..

Symptoms of spinal cord injury.

When the spinal cord is infringed, numbness of the limbs and torso, impotence and lethargy of the muscles that raise the arms appear, which indicates the defeat of the motor neurons innervating these muscles and their pathways.

At the same time, these symptoms appear and disappear, but with each new attack they appear brighter and more acute.. This development of the disease indicates a greater likelihood of damage to the spinal cord and is a symptom of this disease..

If signs of pinching of the spinal nerves first appear, and then the above symptoms, this also indicates the likelihood of developing a pinched spinal cord.

There are differences in the symptoms of infringement of the spinal cord and roots of the spinal nerves.. First, neck pain and restriction of its mobility are only mild, and sometimes absent altogether..

Secondly, the manifestations of the disease do not indicate a clear localization of the disorder, as was the case in the case of nerve infringement, and, thirdly, there is also no clear picture of pathology on x-ray images..

There are cases when bone spurs seen on an x-ray are not confirmed by radiography, and vice versa, bone formations determined by radiography are not confirmed by x-ray.

This once again indicates the complexity of diagnosis and selection of treatment methods for spinal cord infringement.. It should be borne in mind that in the initial stage of the disease, the symptoms have a smoothed character of paresis and paralysis.. With the aggravation of the processes of infringement or, even worse, injury to the spinal cord, along with the symptoms of infringement of the spinal cord, symptoms of infringement of the roots of the spinal nerves may appear..

In this regard, it must be borne in mind that the spinal cord, like the brain, consists of gray and white matter.. The gray layer consists of nerve cells and partially processes, the white one consists mainly of processes (axons).

The spinal cord is surrounded by three membranes: dura, arachnoid and vascular, adjacent to the spinal cord. The space between the arachnoid and choroid is filled with cerebrospinal fluid. The gray matter is the anterior and posterior horns of the spinal cord: two motor roots emerge from the anterior, two sensory roots enter the posterior.

Sensory and motor roots, merging into the spinal ganglion, form the spinal nerve. Therefore, when the spinal cord is infringed, motor, sensory and vegetative functions are disturbed, which manifests itself in the form of paresis (partial absence of motor function), paralysis (complete absence of muscle contraction), convulsions, trembling, involuntary movements accompanying active.

There may be a lack of coordination. The patient is not able to maintain balance in a standing position, inaccuracy of movements appears, gait is disturbed, the patient walks staggering, legs wide apart. Sensitivity is often disturbed, there is a feeling of "

Pain is a peculiar, painful and oppressive sensation, often causing severe suffering.. Pain occurs when the sensory nerve endings located in the tissues are irritated, as well as when the conductive sensory fibers that make up one or another peripheral nerve are damaged.. When sensitive spinal roots are damaged, pain and disorders of all types of sensitivity occur in the zone of innervation of this root..

The following types of disorders are common: skin and its appendages (dryness or high humidity, keratinization, deformation or brittle nails, hair loss or increased hair growth, the formation of trophic ulcers or bedsores); muscles (atrophy or tendency to be replaced by adipose or connective tissue); bones (atrophy, osteoporosis - pathological fragility); joints (deformation or formation of exostoses) and vessels (tendency to spasms or congestion).

Symptoms of infringement of the vertebral artery.

When the vertebral artery is infringed, in addition to pain in the cervicobrachial and occipital regions, as in the case of pinching of the spinal nerves, there are: dizziness, especially when standing up abruptly, nausea, vomiting, impaired coordination of movements, balance, deterioration in the ability to tightly hold objects in hands,.

All these signs indicate a deterioration in the blood supply to the brain and spinal cord by the vertebral artery.. Very often, these symptoms appear or increase when turning or tilting the head in one direction or another..

When the vertebral artery is infringed by an osteophyte, a bone spur can usually be seen on a direct x-ray image to the side of the joint of the uncinate processes, and an overgrowth of bone tissue and a decrease in the intervertebral foramen are also visible on an oblique image.

Symptoms of infringement of the sympathetic nervous system.

With damage to the sympathetic nervous system, the symptoms are very diverse: headaches, vestibular and vegetative-vascular disorders, eye, pharyngeal, cardiac.

Frequent migraines and burning pains in the occipital region. Typical impotence and lethargy of the eyelids, dilated pupils, vagueness of the visual image, tearing. There are also pains in the region of the heart, tachycardia or bradycardia.

Vegetative-vascular disorders are manifested by a decrease in the temperature of the extremities and local skin temperature, skin itching due to a deterioration in the blood supply to the extremities.. In addition, sweating decreases or increases.

Vestibular disorders are manifested by: dizziness, feeling of falling down, staggering, loss of balance, tinnitus, hearing loss. Often the symptoms of damage to the sympathetic nervous system are manifested in combination with symptoms of infringement of the spinal nerves..

Symptoms of chronic fatigue.

Manifested in the form of aching pain in the neck and upper back, a feeling of discomfort, which becomes unbearable during attacks. The pain appears in the shoulder area, but this is a local pain, and not "

With chronic overwork, the tone of the muscle that lifts the scapula, trapezius, sternocleidomastoid increases, and on palpation, point pain occurs in the places of their attachment. Most often, signs of chronic overwork appear after a long stay in static poses with a low head tilt or after deep sleep in an uncomfortable position..

These symptoms are aggravated by colds and rheumatic diseases.. In the case of chronic overwork, unlike other types of disorders, neck mobility is not limited, and X-ray examination does not reveal any pathological changes..

The listed symptoms of chronic overwork or overexertion are also called cervical syndrome, and in the system of Chinese traditional medicine, “cervico-shoulder pain of wind and dampness”. In China, it was found that today cervical syndrome worries 80% of the country's population.

Danilov, V. Naboychenko medbe. en.