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Diagnosis

Your health care provider will take a medical history and do an exam. The exam will include checking for tenderness, numbness and muscle weakness. And it will test how far you can move your head forward, backward and side to side.

Imaging tests

Imaging tests might help find the cause of the neck pain. Examples include:

  • X-rays. X-rays can reveal areas in the neck where the nerves or spinal cord might be pinched by bone spurs or other changes.

  • CT scan. CT scans combine X-ray images taken from many different directions to produce detailed cross-sectional views of structures inside the neck.

  • MRI. MRI uses radio waves and a strong magnetic field to create detailed images of bones and soft tissues. The soft tissues include the disks, the spinal cord and the nerves coming from the spinal cord.

It's possible to have X-ray or MRI evidence of structural problems in the neck without having symptoms. Imaging studies are best used with a careful history and physical exam to determine the cause of pain.

Other tests

  • Electromyography (EMG). An EMG can determine whether neck pain might be related to a pinched nerve. It involves inserting fine needles through the skin into a muscle. The test measures the speed of nerve conduction to determine whether nerves are working properly.

  • Blood tests. Blood tests can sometimes provide evidence of inflammation or infections that might be causing or contributing to neck pain.

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Treatment

The most common types of mild to moderate neck pain usually respond within two or three weeks to self-care. Pain relievers and the use of heat might be all that's needed.

Medications

Pain relievers might include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), or acetaminophen (Tylenol, others). Take these medications only as directed. Overuse can cause serious side effects.

If pain relievers you can buy without a prescription don't help, your health care provider might suggest prescription NSAIDs or muscle relaxers.

Therapy

  • Physical therapy. A physical therapist can teach correct posture, alignment and neck-strengthening exercises. Physical therapy might also involve the use of heat, ice and other measures to help ease pain.

  • Transcutaneous electrical nerve stimulation (TENS). Electrodes placed on the skin near the painful areas deliver tiny electrical impulses that may relieve pain. However, there's little evidence that TENS works for neck pain.

  • Soft neck collar. A soft collar that supports the neck may help relieve pain by taking pressure off the neck. However, if used for more than three hours at a time or for more than 1 to 2 weeks, a collar might do more harm than good.

Surgical and other procedures

  • Steroid injections. A health care provider might inject steroid medications near the nerve roots, into the spinal joints or into the muscles in the neck. Numbing medications, such as lidocaine, also can be injected to relieve neck pain.

  • Surgery. Rarely needed for neck pain, surgery might be an option for relieving nerve root or spinal cord compression.

 

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