bone, joint, and muscle disorders
Neck Pain
Evaluation of Neck Pain
The following information can help people with neck pain decide whether a doctor's evaluation is needed and help them know what to expect during the evaluation. In the evaluation, doctors first try to identify serious disorders. In people with neck pain, certain signs are cause for concern. They include Loss of strength or sensation in the arms and legs—possibly a symptom of nerve damage Fever Night sweats Headache Lethargy or confusion Chest discomfort Sudden sweating or difficulty breathing Pain that is triggered by exertion or worsens during exertion People with warning signs or difficulty or pain when swallowing should see a doctor immediately. or a Nonsteroidal Anti-Inflammatory Drugs [NSAID]), they should see a doctor within a day or so. Other people can wait a few days or call their doctor to discuss how soon they need to be seen. Doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What they find during the history and examination often suggests a cause of the neck pain and the tests that need to be done (see table). The physical examination focuses on the spine and nervous system ( Neurologic Examination ) to look for signs of nerve root or With information about the pain, the person’s medical history, and results of a physical examination, doctors may be able to determine the most likely causes: Loss of strength or sensation may indicate damage to the spinal cord or nerves exiting from the cervical spine. Pain on the front or on one side of the neck usually is not caused by a problem with the spinal cord. Neck pain that radiates down an arm is usually caused by cervical disk herniation, cervical spinal stenosis, or spondylosis with compression of the spinal nerve root. Pain in the chest that travels up into the neck or into the arm may be caused by a heart disorder such as Angina or a Pain that is constant, severe, progressively worse, and unrelieved by rest, particularly if it keeps the person awake at night and is accompanied by sweating, may indicate cancer or an infection. Often, testing is not necessary because most neck pain is caused by muscle spasm and strains, which doctors can typically diagnose based on the examination. Testing is usually done if doctors suspect certain other disorders (see table). If people have symptoms of nervous system malfunction (neurologic symptoms), such as weakness or numbness, Magnetic Resonance Imaging (MRI) (MRI) or Occasionally, Electromyography and Nerve Conduction Studies are done to evaluate possible nerve root compression or to determine an alternative explanation for weakness or tingling and numbness. 