The Evaluation of Patients With Neck Pain

Donald R. Gore, MD


Medscape Orthopaedics & Sports Medicine eJourn. 2001;5(4) 

In This Article

Abstract and Introduction


The prevalence of nontraumatic neck pain in the United States is 10%. The anatomic source may be myofascial, ligamentous, osseous, neurologic, cutaneous, or visceral. Possible causes include compression of neural structures; inflammatory, neoplastic, infectious, or degenerative processes; or the disruption of tissue secondary to trauma. The exact location should be determined and specific characteristics of the pain described, including severity, whether it is constant or intermittent, how it is currently affected by activities and body position, and a subjective description by the patient. Physical exam includes inspection and palpation, a sensory exam, range of motion, strength evaluation, and testing of reflexes.


Although low back pain is the most common spinal malady, neck pain is frequently seen by primary care physicians and other healthcare professionals who treat musculoskeletal problems. The cervical nerve roots C5, C6, and C7 are most commonly affected and involvement results in characteristic signs and symptoms in the upper extremities. The prevalence of nontraumatic neck pain in the United States is 10%.[1]

The focus of this article is on the clinical evaluation and diagnosis of neck pain in the adult patient. Neck pain in children in the absence of trauma is uncommon and when it occurs, the diagnostic considerations are different from those in adults. Therefore, they will not be discussed here.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.