Neck pain: from patient complaint to informed clinical decision

Neck pain is one of the most common reasons for seeking medical attention and at the same time a clinically heterogeneous syndrome: from short-term mechanical pain to radiculopathy, cervicogenic headache, degenerative cervical myelopathy or other pathology. The key task of the doctor is to safely exclude «serious pathology», determine the leading mechanism of pain and choose the minimally sufficient therapy with an emphasis on preserving function and preventing chronicity. The article summarizes modern evidence-based medicine approaches to the assessment, indications for imaging, treatment of acute/subacute/chronic neck pain, management of cervical radiculopathy and suspected myelopathy. Particular attention is paid to the role of patient education, activity, and multimodal strategies, as well as the pitfalls of excessive pharmacotherapy.

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