Patients can determine many cases of neck pain often without having to see a physician or to undergo testing. In most cases, the pain will resolve in a few days or a couple of weeks. If two weeks pass and pain levels have not improved, a physician should be consulted.

In diagnosing the source of neck pain, the physician will review the patient’s medical history and perform a physical examination. In some cases, a physician is able to diagnose the cause of neck pain and recommend treatment based on answers to a pain assessment or unstructured questions about the type, location and onset of pain. However, there are other instances in which additional testing may be necessary to make an accurate diagnosis.

Tests often include imaging tests. These techniques may reveal compression of nerve roots, narrowing of nerve root outlets and spinal cord and disc problems. Examples of imaging techniques used to diagnose neck pain include:

• X-rays. Reveal problems in the cervical vertebrae. Types of x-rays include:
  
• • Myelography. An x-ray image of the spinal cord after dye has been injected in the fluid around the spinal cord. This test can help reveal if a protruding spinal disc or some other factor is crowding the spinal nerves and causing pain.
    
    
  • Discography. A special dye is injected into a spinal disc that is thought to be injured or otherwise damaged. The dye highlights damaged areas that are revealed when x-rays are taken. This procedure is often used on patients who are considering lumbar surgery or whose pain has not responded to conventional treatments.
    
    
  • DEXA scan. This measurement of bone density is a routine screening test for osteoporosis.
    
    
• MRI (magnetic resonance imaging). Allows evaluation of the spinal cord and nerve roots.

• CAT scan (computed axial tomography). Allows evaluation of bone and the spinal canal.
  
  
• Bone scan or other radionuclide imaging. Tests using radioactive tracers to highlight internal structures.
  
  
• Electromyography (EMG). A test that evaluates the electrical activity in nerves and muscles, helping to reveal damage.

In some cases, the physician may refer the patient to a spine specialist, orthopedist or pain specialist if surgery is not an option or the patient has refused surgery.

Research has shown that MRI or CAT scan may miss facet joint arthropathy and that the most sensitive test to detect it is a diagnostic injection by a pain specialist.