Physical Examination

The cause of common neck pain is not usually determined on physical examination. Range of motion of the neck and areas of tenderness in the neck and shoulder girdle muscles are noted. In patients with neurologic symptoms, a neurological examination including motor, sensory, and reflex testing in upper and lower extremities may help narrow findings to specific nerve roots (Table 26.7). The presence of hyperreflexia, clonus, Babinski's sign, and abnormal gait may indicate myelopathy.

Table 26.7 Physical findings with cervical nerve root compression.

Disk

Nerve root

Pain

Motor weakness

Decreased sensation

Decreased reflex

C4-5

C5

Medial scapula, lateral arm to

Deltoid, supraspinatus,

Lateral upper arm

Supinator

elbow

infraspinatus

C5-6

C6

Lateral forearm, thumb, index

Biceps, brachioradialis, wrist

Thumb and index

Biceps

finger

extensors

finger

C6-7

C7

Medial scapula, posterior arm,

Triceps, wrist flexors, finger

Posterior arm,

Triceps

dorsum forearm, third finger

extensors

third finger

C7-T1

CS

Medial forearm, fifth finger

Thumb flexors, abductors,

Fifth finger

intrinsic hand muscles

Modified from Carette (2005)-with permission.

Modified from Carette (2005)-with permission.

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