Neck Pain: Getting a Diagnosis

Neck Pain: Getting a Diagnosis

If you do seek help for neck pain from a physician, your evaluation will include a medical history, a physical examination, and, if needed, imaging tests. During the physical exam, the doctor will likely measure your reflexes, range of motion, sensation, strength, and muscle and nerve function in your neck, arms, and legs.

If pain is the only symptom, and it does not radiate beyond your neck, imaging studies are usually not necessary. In this case, the pain is likely temporary and requires no invasive treatment. However, for people with a traumatic injury, rheumatoid arthritis, or a physical exam that does not pin down the cause of the pain, imaging studies may be needed. Imaging tests include x-rays, MRI scans, and CT scans. Further options may include electromyography and nerve conduction tests to assess the combined function of the muscles and nerves. People with intense pain that lasts for months may need further evaluation to rule out cancer.

Neck Strength Training Improves Quality of Life:

Strength training may help improve the quality of life in women with chronic neck pain, a recent study suggests.

Researchers randomly assigned 180 women with chronic neck pain to take part in either a strength­training program three times a week for one year, an endurance­training program three times a week for one year, or a single session on neck stretching exercises. Women in the strength­training group performed high­intensity isometric neck strengthening exercises with an elastic band. The endurance­training group performed lighter dynamic neck muscle training.

At one year, women in both exercise groups reported significantly better quality of life compared with baseline. Women in the strength­-training group had the greatest improvement. Women in the neck-­stretching group had slightly lower scores at the end of the study.

These findings suggest that regularly performing neck exercises may help improve quality of life for chronic neck pain sufferers. If no treatable cause of your neck pain has been identified, ask your doctor to refer you to a physical therapist, who can design an appropriate program.

Range-of-motion exercises and massage also can be helpful for neck pain. A physical therapist can teach you appropriate neck stretches and exercises for the shoulders and upper back to help ease neck pain and prevent future episodes. Your doctor or physical therapist may also instruct you on how to correct detrimental aspects of your posture or the setup of your office.

If two weeks of conservative treatment do not alleviate the pain, muscle relaxants, ongoing physical therapy, or spinal manipulation (chiropractic) may be recommended. Another treatment option is a cervical traction device, which uses a system of weights and pulleys to help relieve pressure on the neck. The device is available at surgical supply stores.

For individuals whose neck pain appears to be caused by stress or depression, stress-management techniques, antidepressant medication, or both are often useful. In addition, your doctor may prescribe corticosteroid medications (either oral or injected), which can help reduce inflammation.

Even people with disk herniation or mild spinal stenosis should be treated first with conservative measures if the pain does not radiate beyond the neck. If no treatment has relieved the neck pain after eight weeks or if imaging studies indicate serious structural problems, you may need to consult with a spinal surgeon.

Surgery involves relieving pressure on the spinal cord or the pinched nerve. Up to 90% of people who undergo surgery for neck pain experience significant pain relief.