Key Learning Points

• Neck pain and cervical radicular pain are different entities, and should not be confused.

• Patterns of cervical referred pain indicate the likely segmental location of the source of pain, but not its cause.

• The cardinal risk factors relate to the work environment.

• The natural history of neck pain is not always favorable.

• Tumors, infections, and aneurysms are serious causes of neck pain but are uncommon.

• Spondylosis and osteoarthrosis are not valid causes of neck pain.

• The natural history of neck pain after whiplash is generally favorable.

• Lesions of the disk and zygapophysial joints are the likely causes of the chronic neck pain after whiplash.

• History is the most important and most useful component of clinical assessment for neck pain.

• Imaging is indicated only if the history reveals indications of a possible serious disorder.

• Disk stimulation may be used to diagnose cervical discogenic pain.

• Cervical medial branch blocks can diagnose cervical zygapophysial joint pain.

• Evidence is lacking for most treatments of neck pain.

• For acute neck pain, the focus of management should be on explanation, reassurance, resuming activity, and simple exercises.

• For chronic neck pain, exercises may be palliative.

• Radiofrequency medial branch neurotomy is the only proven treatment for chronic neck pain.

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