Neck Pain

There are seven vertebrae that are the bony building blocks of the spine in the neck (the cervical vertebrae) that surround the spinal cord and canal. Between these vertebrae are discs, and nearby pass the nerves of the neck. Within the neck, structures include the skin, neck muscles, arteries, veins, lymph nodes, thyroid gland, parathyroid glands, esophagus, larynx, and trachea. Diseases or conditions that affect any of these tissues of the neck can lead to neck pain.

Doctors who treat neck pain can include general medicine physicians, including family medicine doctors and internists, as well as orthopedists, rheumatologists, neurosurgeons, neurologists, ENT specialists, emergency physicians, physiatrists, and chiropractors. Other ancillary health professionals who treat neck pain include physical therapists, massage therapists, and acupuncturists.

In diagnosing the cause of neck pain, it is important to review the history of the symptoms. In reviewing the history, the doctor will note the location, intensity, duration, and radiation of the pain. Is the pain worsened or improved with turning or repositioning of the head? Any past injury to the neck and past treatments are noted. Aggravating and/or relieving positions or motions are also recorded. The neck is examined at rest and in motion. Tenderness is detected during palpation of the neck. An examination of the nervous system is performed to determine whether or not nerve involvement is present.

Further testing of undiagnosed neck pain can include X-ray evaluation, CT scan, bone scan, MRI scan, myelogram, and electrical tests such as electromyography (EMG) and nerve conduction velocity test(NCV).