Last reviewed: 2 Oct 2024
Last updated: 23 Sep 2021
Summary
Definition
History and exam
Key diagnostic factors
- spontaneous onset of neck pain
- cervical muscle pain and spasm
- headaches or occipital pain
- weakness or numbness
- presence of radiating arm pain
- reflex changes
- proximal arm weakness
- distal hand weakness
- gait ataxia
Full details
Other diagnostic factors
- cervical muscle spasm
- decreased cervical range of motion
- sensory changes
Full details
Risk factors
- age >40 years
- head or neck trauma
- previous cervical spine surgery
- previous cervical myofascial strain
- genetic predisposition
Full details
Diagnostic tests
1st tests to order
- cervical MRI
- cervical x-ray
Full details
Tests to consider
- cervical CT scan
- cervical CT myelogram
- cervical/upper extremity electromyography or nerve conduction velocity
- cervical nerve root block
Full details
Treatment algorithm
ACUTE
axial neck pain
cervical spondylotic radiculopathy (CSR)
degenerative cervical myelopathy (DCM)
Contributors
Authors
Dennis A. Turner, MA, MD
Professor
Neurosurgery and Neurobiology
Duke University Medical Center
Durham
NC
Disclosures
DAT is an author of a reference cited in this topic.
Peer reviewers
Ricardo Pietrobon, MD, PhD, MBA
Associate Professor of Surgery
Associate Professor in Anesthesiology
Associate Vice-Chair, Systems Integration
Department of Surgery
Duke University Medical Center
Durham
NC
Disclosures
RP is an author of a number of references cited in this topic.
Allan I. Binder, MD
Consultant Rheumatologist
Lister Hospital
East and North Hertfordshire NHS Trust
Stevenage
UK
Disclosures
AIB is an author of a number of references cited in this topic.
Differentials
- Whiplash injury (cervical myofascial strain)
- Acute disk herniation
- Metastatic malignancy
More DifferentialsGuidelines
- ACR appropriateness criteria: cervical neck pain or cervical radiculopathy
- A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression
More GuidelinesPatient information
Back pain (lower back)
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