Neck Pain

Examinations and Tests

Initial testing

Neck pain is usually evaluated with a medical history and physical examination. Your health professional will ask about your symptoms, injuries or illnesses, any previous treatment, and habits and activities that may be causing your neck pain. During the physical examination, your health professional will check your neck's range of motion and check for pain caused by movement. He or she will look for areas of tenderness and any nerve-related changes, such as numbness, tingling, or weakness in the arm or hand.

Blood tests may be done to check for an illness or infection.

If you have no signs of a serious condition or recent injury, imaging tests, such as X-rays, may not initially be needed.

Imaging, electromyogram, and nerve conduction tests

If, after a period of treatment, your neck pain does not improve, you may need imaging tests, particularly when:

• You have signs of nerve damage.
• Another serious problem is suspected.
• Neck pain is chronic (lasting more than a few weeks) and has not improved with treatment.
• The cause of your condition cannot be clearly identified.
• Your health professional is asked to provide documentation of your condition, such as when legal or compensation issues arise from a neck injury.

In some cases, imaging test results do not correspond to symptoms or the findings of a physical examination. For example, test results may be normal, yet you may have severe symptoms. However, imaging tests provide useful information and are commonly used. Imaging tests that may be used to evaluate neck pain include:

• X-rays, which help to evaluate the bones and joints of the neck.
• Magnetic resonance imaging (MRI), which helps to evaluate the spinal cord and nerve roots. MRI is helpful in identifying a herniated disc and nerve root impingement (pinched nerve).
• Computed tomography (CT) scan, which helps to evaluate the bone and spinal canal.
• Myelogram, which can provide further detail of the spinal canal and nerve roots.

Access to MRI and CT scanners is not available in all areas. If you need an MRI or CT scan, you may need to travel to a regional centre.

Tests that are done to check the spinal cord and nerves in the neck include electromyogram and nerve conduction studies. These tests can help identify the location and nature of a nerve problem that is causing pain, numbness, or weakness in the arm or hand.

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Author:	Carrie Henley Monica Rhodes	Last Updated: October 16, 2006
Medical Review:	William M. Green, MD - Emergency Medicine Tom Bailey, MD - Family Medicine Robert B. Keller, MD - Orthopedics
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