REVIEW – February 2010

Principles of the treatment of neck pain


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Neck pain is a common disorder with two thirds of the population having this complaint at some point of their lives. Acute neck pain usually has a good prognosis and often recovers spontaneously. In clinical practice, neck pain can be classified into localised neck pain, cervical radiculopathy, whiplash injuryrelated neck pain, myelopathy, neck pain associated with systemic illness, tremors, trauma etc. Patient with neck pain should pass careful clinical examination: history, neurological status, local clinical findings. Diagnostic tests are needed to obtain detailed information about the vertebrae, the intervertebral  discs, the facet joints, the cervical channel, and the cervical spine cord. MRT is the diagnostic test of choice. Routine X ray investigation is recommended in case systemic serious illness or trauma is suspected. Treatment options depend on the form of pathology. In most cases neck pain is a myofascial type of pain and should be treated conservatively, i.e. with medications (NSAIDs) physical therapy, excersise. In cases of cervical radiculopathy and cervical myelopathy surgery may be performed with appropiate indications. These patients should be referred to the neurosurgeon.