What Type of Advanced Imaging is Best for Diagnosing Neck Pain?

If you strain your neck, you’ll probably experience some pain, but with time, it will likely resolve on its own. However, if you have ongoing neck pain from a degenerative disease or trauma that is interfering with your ability to function normally, you should seek medical care. When you do, your doctor may choose to use some type of advanced imaging to help diagnose your neck pain.

Let’s take a closer look at what you can expect.

Medical History and a Physical Exam Come First

Before any diagnostic testing takes place, your doctor will obtain your medical history and perform a thorough physical exam. This will help your doctor determine what type of imaging, if any, is most appropriate for you.

• Medical history: An important part of diagnosing neck pain is determining what caused it. Is it due to a specific trauma or has it been progressive? Your doctor will want to know how long it has been occurring, if any activities make the pain worse, and if you’re experiencing any additional symptoms, such as numbness, tingling, or weakness. A history of any other medical conditions or other changes to your overall health are worth noting.
• Physical exam: Your doctor will generally perform a full physical exam, checking your lungs, heart, and abdomen. Your neck and back will be checked for any deformity, noting areas of tenderness or changes in range of motion. Reflexes, strength, and sensation in different areas of your body will also be assessed.

Advanced Imaging May Come Next

If your pain has persisted for years or if your doctor has any areas of concern after learning your history and conducting the physical exam, imaging studies may be ordered. When diagnosing neck pain, the three kinds of imaging you are most likely to encounter include:

• X-ray: A neck X-ray, or cervical spine X-ray, uses radiation to get a flat picture of dense structures in your neck like bones and joints. If your doctor is concerned you might have a fracture or some kind of bony deformity, especially if you had an accident or some kind of trauma, an X-ray may be ordered. An X-ray is often the step taken to see if additional imaging should be ordered.
• Computerized tomography scan (CT scan): This is a special kind of X-ray that uses a computer to provide cross-sectional images. For the neck, the CT scan is useful. This allows your doctor to see the bones and discs in your neck. It may help your doctor detect even small changes in the bones and help see any calcifications.
• Magnetic resonance imaging (MRI): In addition to bones, an MRI is able to show soft tissues in the neck which aren’t visible in an X-ray or CT scan. Using radio waves and a magnetic field, it can help detect things like herniated discs or damage to ligaments. If you have neurological changes in addition to your pain, an MRI can provide useful information.

Advanced imaging can be very helpful when diagnosing neck pain, but there is not necessarily one “best” method. It can vary on a case-to-case basis. In fact, it’s important to realize that sometimes imaging can produce false positives, where an anatomical alteration is identified but isn’t actually the source of any pain.