Treating Neck Pain: The Role of a Neurologist

Neck pain is an extremely common condition that most people will experience at some point in their lives. While neck pain often resolves on its own or can be managed with rest, over-the-counter medications, and physical therapy, there are times when a neurologist may need to be involved in diagnosing and treating the underlying cause.

When Should You See a Neurologist for Neck Pain?

In many cases, neck pain results from strained muscles or ligaments and does not require specialized treatment. However, if the pain is severe, persistent, or accompanied by other concerning symptoms, it’s important to see a neurologist who can fully evaluate the cause. Reasons to make an appointment include:

  • The pain radiates down one or both arms, or is accompanied by numbness or tingling in the arms/hands. This can indicate a pinched nerve or herniated disc pressing on the spinal cord.
  • You experience weakness or loss of coordination in your arms or legs.
  • You have a history of injury, cancer, or autoimmune disease that could impact the cervical spine.
  • Pain is severe and unrelenting, worsens at night, or causes headaches.
  • Pain began after a fall or other trauma.
  • You have fever, chills, nausea, or unexplained weight loss along with neck pain.
  • Pain does not improve with rest, ice/heat, OTC meds, or physical therapy.

Diagnosing the Cause of Neck Pain

During your first visit, the neurologist will ask about your symptoms, medical history, and perform a physical exam. They will check your posture and range of motion in your neck by having you move your head from side to side and up and down. Reflexes, muscle strength, and sensation in your arms and hands will also be tested.

If a pinched nerve or disc issue is suspected, the neurologist may order imaging tests such as:

  • X-ray to evaluate bone alignment and look for fractures or arthritis
  • CT scan to get a more detailed look at the bone structure
  • MRI to examine soft tissues like nerve roots and discs
  • EMG to analyze electrical activity of nerves and muscles

In some cases, blood tests may be ordered to check for underlying conditions that can cause neck pain, such as rheumatoid arthritis or infections.

Treatment Options a Neurologist May Recommend

Once the underlying cause of your neck pain is determined, the neurologist will outline the best treatment plan. Common recommendations may include:

  • Prescription medications – Muscle relaxants, anti-inflammatories, nerve pain medications, or steroids injected into the spine to reduce swelling.
  • Physical therapy – Stretching, strengthening exercises, massage, and modalities like heat/ice. PT helps improve mobility and relieve muscle tightness.
  • Chiropractic care – Spinal manipulation and mobilization provided by a licensed chiropractor. Especially helpful for realigning joints or vertebrae.
  • Posture correction – Training and cues to maintain proper head/neck positioning throughout daily activities.
  • Cervical traction – A device worn to gently pull and re-align the vertebrae and take pressure off compressed nerves.
  • Epidural steroid injections – Steroids injected directly into the neck to reduce nerve inflammation.
  • Surgery – If more conservative treatments fail and the cause is structural, such as a herniated disc, surgery may be warranted to remove or repair the damaged tissue pressing on nerves.

When to Follow Up

Be sure to follow up with your neurologist as recommended to monitor your progress and recovery. Call the doctor right away if symptoms worsen or any new or worrying signs appear. With appropriate treatment guided by your neurologist’s expertise, most cases of neck pain can be managed for improved comfort and function. Don’t hesitate to seek help for persistent or severe neck pain.