Neck pain

Abstract

Any structure innervated by the cervical spinal nerves can be a primary source of neck pain and referred pain to the head, upper limb or chest wall. The most likely sources of chronic pain are the cervical intervertebral discs and the cervical zygapophyseal joints. Disc pain can be diagnosed by provocative disc stimulation; zygapophyseal joint pain can be diagnosed by local anaesthetic blocks of the cervical dorsal rami. Disc pain can be treated by anterior cervical fusion and zygapophyseal pain by percutaneous radiofrequency neurotomy.