Chronic neck pain syndrome

Vrat je jedan od najčešćih izvora muskuloskeletne boli. Iako je bol u vratu najčešće akutna i samolimitirajuća, u 30% slučajeva prelazi u kroničnu bol s umjerenim ili težim simptomima. Bol u vratu može biti povezana s degenerativnim promjenama te fizikalnim i psihosocijalnim čimbenicima, a važnu ulogu ima sjedilački način života te smanjena fizička aktivnost i stres. Ovisno o simptomatologiji razlikuju se cervikalni sindrom, cervikobrahijalni i cervikocefalni sindrom. Iako su simptomi u početku lokalizirani u području vratne kralježnice, s napredovanjem degenerativnih promjena dolazi do širenja boli u okolna područja. Dijagnoza kroničnog bolnog sindroma vrata temelji se na detaljno uzetoj anamnezi i kliničkom pregledu. Uz klinički pregled, često se u dijagnosticiranju boli koriste slikovna dijagnostika i elektrodijagnostika. Liječenje kroničnog bolnog sindroma vrata pretežno je neoperacijsko ili konzervativno te većina pacijenata dobro reagira na ovakav oblik liječenja. Cilj liječenja je smanjiti bol i omogućiti pacijentu obavljanje svakodnevnih životnih aktivnosti. U liječenju kroničnog bolnog sindroma vrata primjenjuju se lijekovi, metode fizikalne terapije, invazivno liječenje, alternativne i komplementarne metode te kognitivno-bihevioralna terapija. Fizikalna terapija je temelj liječenja i prevencije kronične boli u vratu. Najčešće korištene metode fizikalne terapije su kineziterapija, masaža, spinalna manipulacija, trakcija, krioterapija, termoterapija, ultrazvuk, elektroterapija i laser.The neck is one of the most common sources of musculoskeletal pain. Although neck pain is in most cases acute and self-limiting, in 30% of cases it can progress toward chronic pain with moderate to severe symptoms. The cause of neck pain may be associated with degenerative changes as well as physical and psychosocial factors. A sedentary lifestyle, reduced physical activity, and stress also play an important role. Depending on the symptomatology, it is possible to differentiate between the cervical, the cervicobrachial, and the cervicocephalic syndrome. Although symptoms are localized in the cervical spine in the beginning, the pain starts to spread to the surrounding areas as degenerative changes progress. The chronic cervical pain syndrome is diagnosed based on extensive history taking and a clinical examination. Apart from the clinical examination, diagnostic imaging and electrodiagnostics are often used to diagnose the pain. Treatment of the chronic neck pain syndrome is predominantly nonoperative or conservative, and most patients respond well to this type of treatment. The goal of treatment is to reduce pain and to enable the patient to perform everyday activities. Methods applied in the treatment of the chronic neck pain syndrome are medicines, methods of physical therapy, invasive treatment, alternative and complementary methods, and cognitive-behavioral therapy. Physical therapy is the basis of treatment and prevention of chronic neck pain. The most common methods of physical therapy are kinesitherapy, massage, spinal manipulation, traction, cryotherapy, thermotherapy, ultrasound, electrotherapy, and laser