How is it Diagnosed?
Neck pain is a common complaint that can stem from musculoskeletal, neurological, or
systemic causes. Diagnosis begins with a detailed medical history that explores pain
characteristics (location, duration, severity), associated symptoms (radiation to arms,
numbness, weakness), recent trauma, posture, occupational habits, and systemic signs
such as fever or weight loss.
Physical examination includes inspection, palpation for tenderness or muscle spasm,
assessment of range of motion, and neurological testing (reflexes, muscle strength,
sensation) to evaluate for cervical radiculopathy or myelopathy. Specific tests like
Spurling’s test may help identify nerve root compression.
Imaging studies are chosen based on clinical suspicion. X-rays of the cervical spine can
detect alignment issues, fractures, or degenerative changes. MRI is the preferred
modality for assessing soft tissues, intervertebral discs, spinal cord, and nerve roots,
especially when neurological symptoms are present. CT scans provide detailed
information on bony structures and are useful in trauma settings.
Electrodiagnostic tests such as electromyography (EMG) and nerve conduction studies
(NCS) can help localize nerve compression or muscle dysfunction. Blood tests may be
ordered if an infection (e.g., meningitis), autoimmune condition (e.g., rheumatoid
arthritis), or malignancy is suspected. In rare cases, lumbar puncture or bone scans may
be necessary. Identifying the root cause is crucial for appropriate management, which
may include physical therapy, medication, or surgical intervention.