Diagnosing Neck Pain

Acute neck pain is not always serious, especially if it’s caused by just a minor muscle strain or sprain. However, if you are experiencing chronic neck pain, it could be a symptom of a much larger condition and it should be treated as such. If you have chronic neck pain, make an appointment with your doctor as soon as possible, especially if the pain radiates to your extremities or it is accompanied by other neurological symptoms like numbness, weakness, or a tingling sensation in your extremities. You should also seek medical attention immediately if you have pain lingering in the days or weeks after an accident or fall. 

Given the wide range of factors that can precipitate neck pain, diagnosing the specific cause of a patient’s discomfort is a multi-step process. At your first appointment, your physician will take a detailed family and medical history, including your experience to date with the neck pain and what factors you think might have caused it. They will also put you through a thorough physical examination, including a variety of neurological tests, to gather some objective data about your condition and the extent of any weakness or disability that your neck pain has caused. They will also likely perform x-rays at your first appointment, which allows them to visualize the bones of the cervical spine and judge their orientation to one another, the presence of any fractures in the vertebrae, and the spacing between them. Compressed space between the vertebrae could be a sign of degradation or damage to the intervertebral discs which cushion the cervical spine.

The information gleaned from this first appointment will inform the next steps in the process of diagnosing your condition. Based on the findings of the history and physical examination, your physician may order follow up diagnostic tests, which will help them better understand what is going on with the underlying anatomy of your neck. 

Some of the tests they can order include:

  • Computed tomography (CT) – this study allows your physician to better visualize the bones of the neck. The test provides them with “slices” of the bone, which can be used to judge the extent of a fracture or to determine how well the interior of the bones have held up over time.
  • Magnetic resonance imaging (MRI) – this examination uses a strong magnetic field to allow your physician to better visualize the soft tissue structures of the neck. It can be used to diagnose issues with the vertebral disc, including bulges or herniations that could be pressing into a nerve, as well as other soft tissue deformities like muscle strains and nerve impingement.
  • Diagnostic injections – once your physician has identified a potential issue that they believe might be driving your neck pain, they could suggest a diagnostic injection. This procedure allows them to inject a small amount of anesthetic medication in or near the anatomy in question to see if you experience any relief. If you do, then they know they’ve targeted the right part of your neck and they can evaluate more comprehensive treatment options for that specific issue. If you do not experience relief, then they know to keep looking!

If you experience neck pain that lasts more than a few days or as a result of an accident or fall, you should seek medical treatment as soon as possible. Neck pain could be isolated and not severe, or it could be a symptom of a much more serious condition. Furthermore, if you have any accompanying neurological symptoms, you should seek treatment immediately!