颈部疼痛 诊断与治疗 妙佑医疗国际

颈部疼痛 诊断与治疗 妙佑医疗国际

颈部疼痛 - 诊断与治疗 - 妙佑医疗国际

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颈部疼痛

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诊断

医生会了解病史并做检查。医生会检查是否有压痛、麻木和肌无力,以及您的头能向前、向后和左右移动多远。

影像学检查

医生可能会要求做影像学检查,以便更好地了解您颈部疼痛的原因。示例包括: X 线。X 线检查可以显示您颈部的神经或脊髓可能因骨刺或其他退行性改变被挤压的区域。 CT 扫描。CT 扫描结合许多不同方向的 X 线图像来创建您颈部的内部结构的横断面视图。 磁共振成像 (MRI)。MRI 采用无线电波和强磁场来生成骨骼和软组织(包括脊髓和来自脊髓的神经)的详细图像。 有可能在无症状的情况下,X 线检查或磁共振成像 (MRI) 检查证据表明您的颈部结构有问题。影像学检查最好作为病史详审和体检的辅助手段来确定疼痛的原因。

其他检查

肌电图 (EMG)。如果您的医生怀疑您的颈部疼痛可能与神经挤压有关,可能建议做肌电图。它包括将细针穿过皮肤插入肌肉,并进行测试,测量神经传导速度,以确定特定神经是否正常运作。 血液检测。血液检查有时可以提供可能导致或促成您颈部疼痛的炎症或感染性疾病的证据。

Imaging tests

Imaging tests might help find the cause of the neck pain. Examples include: X-rays. X-rays can reveal areas in the neck where the nerves or spinal cord might be pinched by bone spurs or other changes. CT scan. CT scans combine X-ray images taken from many different directions to produce detailed cross-sectional views of structures inside the neck. MRI. MRI uses radio waves and a strong magnetic field to create detailed images of bones and soft tissues. The soft tissues include the disks, the spinal cord and the nerves coming from the spinal cord. It's possible to have X-ray or MRI evidence of structural problems in the neck without having symptoms. Imaging studies are best used with a careful history and physical exam to determine the cause of pain.

Other tests

Electromyography (EMG). An EMG can determine whether neck pain might be related to a pinched nerve. It involves inserting fine needles through the skin into a muscle. The test measures the speed of nerve conduction to determine whether nerves are working properly. Blood tests. Blood tests can sometimes provide evidence of inflammation or infections that might be causing or contributing to neck pain.

更多信息

CT 扫描X 线磁共振成像肌电图 (EMG)腰椎穿刺(脊椎穿剌)显示更多相关信息

治疗

对于最常见的轻度至中度颈部疼痛,通常在 2 到 3 周内对自我护理有良好反应。如果颈部疼痛持续存在,您的医生可能会建议其他治疗。

药物治疗

您的医生可能开出比非处方药更强的止痛药、肌肉松弛剂和三环类抗抑郁药来缓解疼痛。

治疗

物理疗法。物理治疗师可以传授您正确的姿势、矫正和颈部增力训练,并可以使用热、冰、电刺激等措施来帮助您缓解疼痛,防止复发。 经皮电刺激神经疗法(TENS)。放置在疼痛部位附近皮肤上的电极可传递微小的电脉冲,从而缓解疼痛。 牵引疗法。牵引疗法会使用砝码、滑轮或气囊来轻轻拉伸您的颈部。在医疗专业人员和物理治疗师的监督下,该疗法可缓解一些颈部疼痛,尤其是与神经根刺激相关的疼痛。 短期制动疗法。支撑颈部的软颈托可能有助于减轻颈部结构压力带来的疼痛。但是,如果每次使用超过 3 个小时或总使用时间超过 1 到 2 个星期,颈托可能弊大于利。

外科手术及其他手术

类固醇注射。您的医生可能会在神经根附近、颈椎骨骼的小关节或颈部肌肉注射皮质类固醇药物,以缓解疼痛。也可以注射麻醉药物,如利多卡因,以缓解颈部疼痛。 外科手术。外科手术很少用于治疗颈部疼痛,而是缓解神经根或脊髓压迫的一种可能选择。

Medications

Pain relievers might include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), or acetaminophen (Tylenol, others). Take these medications only as directed. Overuse can cause serious side effects. If pain relievers you can buy without a prescription don't help, your health care provider might suggest prescription NSAIDs or muscle relaxers.

Therapy

Physical therapy. A physical therapist can teach correct posture, alignment and neck-strengthening exercises. Physical therapy might also involve the use of heat, ice and other measures to help ease pain. Transcutaneous electrical nerve stimulation (TENS). Electrodes placed on the skin near the painful areas deliver tiny electrical impulses that may relieve pain. However, there's little evidence that TENS works for neck pain. Soft neck collar. A soft collar that supports the neck may help relieve pain by taking pressure off the neck. However, if used for more than three hours at a time or for more than 1 to 2 weeks, a collar might do more harm than good.

Surgical and other procedures

Steroid injections. A health care provider might inject steroid medications near the nerve roots, into the spinal joints or into the muscles in the neck. Numbing medications, such as lidocaine, also can be injected to relieve neck pain. Surgery. Rarely needed for neck pain, surgery might be an option for relieving nerve root or spinal cord compression. 申请 Mayo Clinic 预约

生活方式与家庭疗法

缓解颈部疼痛的自我护理措施包括: 非处方止痛药。试试非处方止痛药,比如布洛芬(Advil、Motrin IB 等)、萘普生钠(Aleve)和对乙酰氨基酚(Tylenol 等)。 冷热交替。通过冷敷减轻炎症,如使用冰袋或把冰包在毛巾里进行冷敷,每天敷几次,每次 20 分钟。或者冷热交替处理。试着洗个热水澡,或者使用设为低热的加热垫。 居家运动。一旦最严重的疼痛消退,开始每天进行温和的伸展运动。医生或物理治疗师可以指导您如何正确运动。首先,用加热垫或者通过淋浴或坐浴温暖您的脖子和背部。然后轻轻倾斜、弯曲和转动您的脖子。

替代医学

如果您有兴趣尝试治疗颈部疼痛的替代方法,请咨询您的医生。您的医生可能与您讨论这些替代方法的益处和风险。替代治疗方法包括: 针刺疗法。针刺疗法是将细针插入身体的各个部位。研究发现,针刺疗法可能对多种类型的疼痛有帮助。但对颈部疼痛的研究结果不尽相同。要获得最佳疗效,您可能需要进行多次针刺疗法。当由执业医师使用无菌针头进行时,通常认为针刺疗法是安全的。 脊椎按摩疗法。脊柱推拿调整主要在脊柱上进行,对关节施加可控制的、突然的力。颈部的脊椎按摩疗法可以在短期内缓解疼痛,并且对许多人而言,风险最小。 按摩。在按摩过程中,经过训练的从业人员用双手揉捏您的颈部肌肉。几乎没有科学证据支持按摩对于颈部疼痛患者有效,但配合医生推荐的治疗方法时,按摩可能会缓解疼痛。

准备您的预约

您可能会先去联系您的家庭医生以了解您的颈部疼痛,而她/他可能会将您转诊给: 专门从事肌肉骨骼疾病非手术治疗(物理医学和康复治疗)的医生 专门研究关节炎和其他影响关节的疾病的医生(风湿科医生) 专门治疗神经相关疾病的医生(神经内科医生) 给骨头和关节做手术的医生(骨科外科医生)

您可以做什么

就诊前,您可能应该写出下列问题的答案: 您何时开始出现症状? 您的颈部之前受过伤吗?如果有,损伤发生于何时? 有什么特殊的颈部运动会改善或加重疼痛吗? 您定期服用哪些药物和补充剂?

医生可能做些什么

您的医生可能会询问下列问题: 具体哪里出现疼痛? 疼痛是钝痛、剧痛还是刺痛? 您是否出现过麻木感或感到虚弱? 疼痛是否辐射到您的手臂? 排便、咳嗽或打喷嚏是否会加重疼痛? 您是否有其他身体问题?

What you can do

Before your appointment, be prepared to answer the following questions: When did your symptoms begin? Have you ever injured your neck? If so, when? Do certain neck movements improve or worsen the pain? What medications and supplements do you take regularly?

What to expect from your doctor

Your provider might ask some of the following questions: Where exactly is your pain? Is the pain dull, sharp or shooting? Do you have numbness or weakness? Does the pain radiate into your arm? Is the pain made worse by straining, coughing or sneezing? Do you have other physical problems? 来自妙佑医疗国际员工 申请 Mayo Clinic 预约 症状与病因医生与科室 July 13, 2022 打印 Share on: FacebookTwitterWeChat

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CloseWeibo 显示参考文献 Neck pain. American College of Rheumatology. http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Neck_Pain/. Accessed June 11, 2015. Chronic neck pain tip sheet. American Osteopathic Association. tps://www.osteopathic.org/search/Pages/results.aspx?k=Chronic neck pain. Accessed June 11, 2015. Isaac Z. Evaluation of the patient with neck pain and cervical spine disorders. http://www.uptodate.com/home. Accessed June 11, 2015. Isaac Z. Treatment of neck pain. http://www.uptodate.com/home. Accessed June 11, 2015. Chiropractic and neck pain. American Chiropractic Association. https://www.acatoday.org/content_css.cfm?CID=2430. Accessed June 11, 2015. Neck pain. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00231. Accessed June 11, 2015.

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Associated Procedures

CT 扫描 X 线 磁共振成像 肌电图 (EMG) 腰椎穿刺(脊椎穿剌) Show more associated procedures

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书籍:《妙佑医疗国际疼痛缓解指南》 书籍:《背部和颈部健康》 Show more products and services from Mayo Clinic

颈部疼痛

症状与病因诊断与治疗医生与科室

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