Last reviewed:September 2019
Last updated:June  2018

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

Other diagnostic factors

  • cervical muscle spasm
  • decreased cervical range of motion
  • sensory changes

Risk factors

  • age >40 years
  • head or neck trauma
  • previous cervical spine surgery
  • previous cervical myofascial strain
  • genetic predisposition

Diagnostic investigations

1st investigations to order

  • cervical MRI
  • cervical x-ray
Full details

Investigations to consider

  • cervical CT scan
  • cervical CT myelogram
  • cervical/upper extremity EMG or nerve conduction velocity
  • cervical nerve root block
Full details

Treatment algorithm

Contributors

Dennis A. Turner

Professor

Neurosurgery and Neurobiology

Duke University Medical Center

Durham

NC

Disclosures

DAT is an author of a reference cited in this topic.

Peer reviewersVIEW ALL

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.

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.

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