Neck pain is an extremely common symptom. Its origin is usually an inflammation of the pharynx (pharyngitis) or the tonsils (tonsillitis). In over 50% of cases the sore throat is viral or allergic origin, and there is therefore a specific treatment to improve inflammation, since antibiotics are indicated only in cases of pharyngitis or tonsillitisbacterial origin.
In fact, viral sore throats are self-limiting and spontaneously improve after a few days. This means that treatment must be only symptomatic, i.e. facing the symptoms, not necessarily the case.
The distinction between pharyngitis (or tonsillitis) viral and bacterial is very important as the drugs given to treat neck pain will differ according to the cause.
In this article we will only address the symptomatic treatment of sore throat, or delete antibiotics, which is the form of treatment directly targeted against bacterial infections.
Regardless of the source of neck pain, the physician should always be open to treat her, because even in benign and self-limited forms, the symptoms are often very uncomfortable. The fact of pharyngitis have viral or allergic origin, and therefore do not need antibiotics, does not mean that other medicines aimed at relieving the symptoms can not be used. If the patient expresses desire to treat the symptoms, there are a range of options to achieve this goal.
Also in bacterial tonsillitis, prescribing symptomatic drugs is important and indicated, because antibiotics take 24-48 hours to take effect. The patient does not need to be suffering all this time with a sore throat waiting for a result.
What follows is a review of the symptomatic drugs most commonly used for neck pain.
There are currently on the market dozens of different types of inserts to neck pain, which can be easily purchased at any pharmacy without a prescription. The main substances present in these pills are menthol, ambroxol, benzydamine, lidocaine, benzocaine and some anti-inflammatories.
The inserts have better effect than sprays, but should not be used in children under 4 to 5 years at risk of choking.
We have selected some of the most studied substances to do a quick review of its effectiveness and side effects. All the tablets described below are indicated only for symptomatic treatment, not having any significant antibacterial effect.
Menthol
Menthol is an often substance present in lozenges for sore throat, either alone or in combination with other active substances.
Menthol has proven anesthetic properties, though it has not been specifically studied for the symptomatic treatment of sore throat. It is a valid option and with very low rate of side effects for those seeking relief from the burning sensation in the throat in mild to moderate cases.
Ambroxol
Ambroxol is a local anesthetic relatively well studied for the treatment of sore throats, particularly viral and allergic origin. The tablets containing ambroxol are proven effective in relieving moderate to severe neck pain. The effect usually has its peak after 30 minutes and lasts for up to 3 hours.
This treatment is usually well tolerated, although some patients complain it is numbness of the tongue or in the oral cavity and temporary changes in taste perception.
Lidocaine
Lidocaine is a local anesthetic stronger and longer action Ambroxol. Its use in tablets pharyngitis is very common and its effectiveness in controlling pain is scientifically proven. However, as with the ambroxol lozenges, most studies have been done only with patients who had viral or allergic pharyngitis. In bacterial pharyngitis, the lidocaine tablets were few studied, but it is assumed that its symptomatic efficacy is similar.
Lidocaine is associated with a very rare but potentially fatal complication called methemoglobinemia.
Benzocaine
Benzocaine is also a local anesthetic, with action similar to lidocaine. Benzocaine is also rarely associated with the occurrence of methemoglobinemia.
Benzidamine
Benzidamine is an anti-inflammatory and anesthetic substance widely used in tablets against sore throat. Clinical studies have proven its effectiveness in controlling pain. The most common side effect is a temporary numbness in the mouth.
Diphenhydramine
Diphenhydramine is an antihistamine, that is, an antiallergic drug. Its main indication is in pharyngitis allergic origin, being somewhat less effective than the tablets mentioned above for sore throats of infectious origin.
Sprays for neck pain
Most existing drugs into tablets can also be found spray. In general, the effectiveness of the tablet is superior, the spray being the best option when the patient's risk of choking with tablets, as in the case of small children.
Analgesics and anti-inflammatory for sore throat
A variety of analgesics and anti-inflammatory tablet that can be used for pain relief in cases of sore throat. Analgesics and anti-inflammatory also have antipyretic action, serving not only to control pain, fever but also, if it is present.
It is always important to remember that are not anti-inflammatory antibiotics, and therefore do not act directly on the bacteria in cases of tonsillitis or pharyngitis bacterial.
Among the most commonly used analgesics, highlight the Paracetamol and dipyrone. Among the anti-inflammatory, options are very numerous, including ibuprofen, diclofenac, nimesulide, piroxicam, celecoxib and others. Among all the anti-inflammatory drugs, the most studied for the sore throat is Ibuprofen.
In general, anti-inflammatory drugs that are more effective analgesics but have side effects rates somewhat higher.
Aspirin (acetylsalicylic acid) is also a good option, but its use is not recommended for children or adolescents at risk of a rare complication called Reye's syndrome, which causes cerebral edema and liver failure.
Some simple measures that may be imposed at home, help to improve the symptoms of sore throat. The most popular is gargling with warm salt water. No studies have proven their real efficacy, but because it is a cheap measure and risk of adverse effects, it is very suitable. Half teaspoon salt diluted in 300 ml of warm water and make various gargles throughout the day. Be careful only not to swallow the water so that you are not ingesting unnecessary amounts of salt.
If you have pain and sensation of dry throat, moisturise well. Drink plenty of water during the day. The same goes if you have fever.
Contrary to popular belief, most people can consume cold water for a sore throat crisis. Some of them even prefer because the cold relieves symptoms. Sucking on ice or ice cream can also help. One must remember, however, that some people report having neck pain when taking liquid ice cream. Only these, the cold food intake should be avoided.
Warm drinks are allowed, but if they are too warm can be harmful because they increase inflammation of the throat.
Sucking candies or chewing gum help increase salivation, keeping the oral cavity better hydrated, which in many cases relieves sore throat. This is why many remedies for pharyngitis come in the form of pellets. Choose one that contains menthol or eucalyptus, because they have a "cooling" effect that helps in controlling pain.
warm soups help, because besides the fact that the consumption of liquid to be better tolerated than the solids, the soup has water and salt, which can bring relief from symptoms.
Rest is essential in the treatment of any infection. If your throat is inflamed, avoid making efforts and try to sleep enough. It is also important to avoid environments with smoke or very cold and dry places to not perpetuate the irritation of the throat. Smoking during crisis often aggravate inflammation.
Treatments with little or no effectiveness for sore throat
There are many substances with great popular appeal for the treatment of sore throat that apparently have little or no effectiveness. The best known is the honey. There is no scientific work that has been able to show a real benefit of honey as a treatment for pharyngitis or tonsillitis. All studies show that the effect is similar to placebo.
Propolis is another very famous and substance often associated with honey. Propolis even has some anti-inflammatory effect, but it is too small. It works much less than any common anti-inflammatory or lozenges for sore throat.
Papain, and does not improve inflammation in the throat, in large amounts can aggravate neck pain.
The marshmallow plant has been used for centuries as a treatment for the relief of sore throat. It is believed that the modern marshmallow, industrially produced in the form of sweets, can keep some of these properties. This, however, has never been properly studied.
The consumption of vitamin C or any other vitamin does not improve or accelerate the healing of throat infections, whether of viral or bacterial origin. Fruits are always a healthy choice of food, to treat sore throats they have no effect.
There are studies that prove the efficacy of homeopathy or herbal medicine in the treatment of tonsillitis or pharyngitis. Studies show that the duration of disease and the incidence of complications with these treatments are equal to placebo.
