Guidelines for Neck Pain Treatment and Evaluation
Briefly into this subject, if there are no red flags no imaging or intervention is recommended unless the symptoms progress or go beyond 4-6 weeks. If mild radicular symptoms present but not progressive over 3-4 weeks, then observe with short course of pain management. If no improvement beyond 4-6 weeks, then consider an MRI.
Red flags that warrant urgent evaluation for neck pain include:
- Infection signs or symptoms
- Vascular emergencies feature like diplopia or syncope
- Malignancy features
- Myelopathy features like bowel/bladder incontinence or retention, tremors
- Rheumatologic signs or symptoms
- Thoracic outlet syndrome
- Trauma or mild trauma in RA/Trisomy 21 due to fear of atlanto-occipital instability
Interesting read on neck pian with Dr Bydon's book.