Thyroid-stimulating hormone (also known as thyrotropin, thyrotropic hormone, or abbreviated TSH) is a pituitary hormone that stimulates the thyroid gland to produce thyroxine (T4), and then triiodothyronine (T3) which stimulates the metabolism of almost every tissue in the body. It is a glycoprotein hormone produced by thyrotrope cells in the anterior pituitary gland, which regulates the endocrine function of the thyroid. Physiology
Hormone levels
TSH (with a half-life of about an hour) stimulates the thyroid gland to secrete the hormone thyroxine (T4), which has only a slight effect on metabolism. T4 is converted to triiodothyronine (T3), which is the active hormone that stimulates metabolism. About 80% of this conversion is in the liver and other organs, and 20% in the thyroid itself.TSH is secreted throughout life but particularly reaches high levels during the periods of rapid growth and development, as well as in response to stress. The hypothalamus, in the base of the brain, produces thyrotropin-releasing hormone (TRH). TRH stimulates the anterior pituitary gland to produce TSH. Somatostatin is also produced by the hypothalamus, and has an opposite effect on the pituitary production of TSH, decreasing or inhibiting its release. The concentration of thyroid hormones (T3 and T4) in the blood regulates the pituitary release of TSH; when  T3 and T4 concentrations are low, the production of TSH is increased, and, conversely, when T3 and T4 concentrations are high,  TSH production is decreased. This is an example of a negative feedback loop.
Other common treatments could include medication, body mechanics training, ergonomic reform, and physical therapy. Treatments may also include patient education, but existing evidence shows a lack of effectiveness. Medication
Analgesics such as acetaminophen or NSAIDs are generally recommended for pain. A 2017 review, however found that paracetamol was not efficacious and that NSAIDs are minimally effective.Muscle relaxants may also be recommended. However, one study showed that one muscle relaxant called cyclobenzaprine was not effective for treatment of acute cervical strain (as opposed to neck pain from other etiologies or chronic neck pain). Surgery
Surgery is usually not indicated for mechanical causes of neck pain. If neck pain is the result of instability, cancer, or other disease process surgery may be necessary. Surgery is usually not indicated for "pinched nerves" or herniated discs unless there is spinal cord compression or pain and disability have been protracted for many months and refractory to conservative treatment such as physical therapy. Alternative medicine
Exercise plus joint manipulation has been found to be beneficial in both acute and chronic mechanical neck disorders. In particular, specific strengthening exercise may improve function and pain. Motor control using cranio-cervical flexion exercises has been shown to be effective for non-specific chronic neck pain. Both cervical manipulation and cervical mobilization produce similar immediate-, and short-term changes. Multiple cervical manipulation sessions may provide better pain relief and functional improvement than certain medications at immediate to long-term follow-up. Thoracic manipulation may also improve pain and function.