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Chronic neck pain

 

Chronic Neck Pain: A Primary Care Approach

Neck pain bahut hi common hai, aur ise hum teen main types mein divide karte hain:


Chronic Neck Pain



1. Mechanical Neck Pain

Ye sabse zyada commonly dekhi jaane wali neck pain hai jo primary care centre mein aati hai. Patients ko generally localized neck pain hota hai jo kisi aur jagah radiate nahi karta. Zyada tar ye pain neck ke center mein hota hai.

Symptoms: Localized pain jo neurological deficits ke bina hota hai, jaise weakness ya numbness nahi hoti. Agar aap us jagah ko press karte ho jaha "ouch" feel hota hai, toh wohi area problematic hota hai.

Etiology: Exact cause clear nahi hota, lekin myofascial ya musculoskeletal strain se related hota hai.

Management: Ye pain time ke sath apne aap theek ho jaata hai, chahe aap koi intervention karein ya na karein. Common treatments mein NSAIDs (painkillers), physical therapy, aur massage include hain. Physical therapy helpful ho sakti hai taaki patient apni posture aur movement ko sudhaar sake aur pain repeat na ho.

 

2. Cervical Radiculopathy

Is type ka neck pain ek haath mein radiate karta hai, jise hum "pinched nerve" kehte hain. Ye condition cervical spine mein ek taraf ka nerve compression hota hai. Pain ke sath mild sensory changes bhi ho sakte hain, lekin zyada tar motor weakness absent hota hai.

Symptoms: Neck pain jo ek haath tak radiate karta hai, kabhi kabhi mild sensory changes ke sath.

Management: Cervical radiculopathy usually time ke sath apne aap theek ho jaata hai. Initial management mein NSAIDs, physical therapy, aur muscle relaxants use kiye ja sakte hain. Surgery ki zarurat kabhi-kabhi padti hai agar functional deficits severe ho jaye. Gabapentin kabhi-kabhi diya jata hai, lekin ye first-line choice nahi hoti.

 

3. Cervical Myelopathy

Ye sabse serious type ka neck pain hota hai, jo bony compression ke wajah se spinal cord par pressure dalta hai, aur yeh zyada tar older patients mein dekha jata hai. Is condition mein prompt evaluation aur surgery kaafi zaroori ho sakti hai.

 

Symptoms: Neurological deficits jaise fine motor skills mein dikkat (jaise kapde ke buttons band karna), radicular symptoms, hyperreflexia, abnormal gait, ya upper motor neuron signs jaise Hoffmann’s test positive hona. Patients urinary symptoms ya gait unsteadiness bhi report kar sakte hain.

Management: Agar cervical myelopathy ka suspicion hai, toh jaldi se MRI karwana zaroori hota hai. Agar condition persist kare ya worsen ho jaye, toh neurosurgery referral ki zarurat padti hai. Surgery ka main goal yeh hota hai ki condition aur zyada serious na ho, lekin agar patient already severely disabled hai, toh complete recovery possible nahi hoti.

 

Summary of Approach:

Mechanical Neck Pain: Supportive care, NSAIDs, physical therapy, aur patient ko reassure karna zaroori hai.

Cervical Radiculopathy: Conservative treatment (NSAIDs, physical therapy) ke saath patient ko reassure karna ki yeh pain time ke sath apne aap theek ho jayega.

Cervical Myelopathy: Jaldi MRI karwana aur neurosurgical referral dena zaroori hai taaki neurological decline ko roka ja sake.

 

Early identification of cervical myelopathy bahut zaroori hai taaki further disability ko prevent kiya ja sake, aur mechanical neck pain aur radiculopathy ka proper management patients ko invasive procedures ke bina relief provide kar sakta hai.

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