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Neck pain is a common complaint. The prevalance is approximately 75% to 80% in the U. S. population. The neck is composed of many pain-sensitive tissues in a small area, including tendons, ligaments, muscle insertions, vertabrae, zygopophyseal joints, nerve roots, nerves, and plexi. The cervical spine is mobile and situated between an immobile thorax and a relatively weighty head; therefore, it is subject to varying degrees of trauma with body movement. Neck pain ranges from minor self-limited aches to severe pain associated with signs and symptoms of nerve root impingement. Patients with minor neck pain may not consult a physician. Those who see a primary care physician often can be helped by conservative management. A patient with severe chronic symptoms may be best served in a comprehensive pain management clinic. Treatment options can range from the conservative (transcutaneous electrical nerve stimulation [TENS] unit, physical therapy and stretching) to the interventional (facet joint injection and cervical nerve root block). In all cases, a knowledge of the anatomy and the etiology of neck pain is required for definitive treatment.

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Ideally, the cause of a patient’s neck pain is determined by a careful history, physical examination, appropriate radiologic and laboratory tests, and diagnostic nerve blocks.1 It is vital to be aware of the more serious disorders that can cause neck pain and that require urgent referral to a specialist. Table 27-1 lists many causes of neck pain.

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Table 27-1 Classification of Neck Pain

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