Neck pain

Diagnosis

 Your healthcare provider will conduct a thorough medical history and perform a physical examination. This examination will include checking for tenderness, numbness, and muscle weakness, as well as assessing the range of motion of your head in forward, backward, and side-to-side movements.

Imaging tests are also valuable in identifying the cause of neck pain. Examples of these tests include:

• X-rays: X-rays can reveal areas in the neck where nerves or the spinal cord might be pinched by bone spurs or other structural changes.
• Computed tomography (CT) scan: CT scans combine X-ray images captured from various perspectives to create comprehensive cross-sectional images of the internal structures of the neck.
• Magnetic resonance imaging(MRI): Utilizes radio waves and a strong magnetic field to create detailed images of both bones and soft tissues, including the disks, the spinal cord, and the nerves emanating from the spinal cord.

It is important to note that X-ray or Magnetic Resonance Imaging can show structural issues in the neck even in the absence of symptoms. Therefore, imaging studies should be used in conjunction with a careful history and physical examination to pinpoint the cause of pain.

Other diagnostic tests include:

• Electromyography (EMG): EMG is a test that can help determine if neck pain is related to a pinched nerve. This involves inserting fine needles through the skin into a muscle to measure the speed of nerve conduction and assess nerve function.
• Blood tests: Blood tests can sometimes detect signs of inflammation or infections that may be causing or contributing to neck pain.

Treatment

Typically, mild to moderate neck pain, the most common types, typically improves with self-care within two or three weeks. Pain relievers and the application of heat may be sufficient for relief. 

Medications

Pain relievers may consist of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen or naproxen sodium, as well as acetaminophen. It’s crucial to take these medications only as directed, as overuse can lead to serious side effects. 

If over-the-counter pain relievers prove ineffective, your doctor might recommend prescription NSAIDs or muscle relaxers as an alternative. 

Therapy

• Physical therapy: A physical therapist can instruct on proper posture, alignment, and neck-strengthening exercises. Physical therapy may also incorporate the use of heat, ice, and other measures to alleviate pain. 
• Transcutaneous Electrical Nerve stimulation (TENS): Electrodes placed on the skin near painful areas deliver small electrical impulses that may offer pain relief. However, there is limited evidence supporting the effectiveness of TENS for neck pain. 
• Soft neck collar: Using a soft collar that supports the neck may help alleviate pain by reducing pressure on the neck. However, prolonged use for more than three hours at a time or beyond 1 to 2 weeks might have adverse effects rather than benefits. 

Surgical and other procedures

• Steroid injections: A doctor may administer steroid medications near the nerve roots, into the spinal joints, or into the muscles in the neck. Numbing medications, like lidocaine, can also be injected to alleviate neck pain.
• Surgery: While rarely necessary for neck pain, surgery might be considered as an option to address nerve root or spinal cord compression.