What is a Neurological Test for Neck Pain?

Neck pain is a common condition that can originate from muscles, joints, nerves, or other structures in the neck. When neck pain is severe or persistent, it is often recommended to have a neurological exam performed. A neurological exam helps determine if the neck pain is coming from an issue with the nerves or spinal cord rather than just the muscles or bones.

During a neurological exam for neck pain, a physician will test muscle strength, reflexes, and sensation in the arms, hands, and legs. The goal is to see if there is any weakness, numbness, or lack of coordination that could indicate a compressed or damaged nerve in the neck.

Some of the key components of a neurological exam for neck pain include:

Motor Tests
The physician will have the patient move their limbs in different directions against resistance to evaluate muscle strength. This includes motions like bending and straightening the arms and legs, turning the hands over, curling the fingers, and moving the feet up and down. Decreased strength or difficulty completing the motions can signal a nerve issue.

Reflex Tests
Common reflexes like the biceps, triceps, knee jerk and ankle jerk reflexes will be tested with a reflex hammer. Abnormal or absent reflexes can occur if nerves are damaged.

Sensation Tests
The doctor will check sensation in the arms, hands, fingers, legs and feet using light touching, pin pricks, or vibration. Numbness or decreased sensation can indicate nerve compression.

Coordination Tests
The patient may be asked to perform coordinated movements like touching their finger to their nose or running their heel down their shin. Impaired coordination signals a problem with the nerves and brain communicating.

Posture Evaluation
Standing balance and posture will be observed. Difficulty with balance can suggest nerve dysfunction.

Cranial Nerve Exam
Cranial nerves control facial movements and sensations. The doctor will have the patient smile, clench their jaw, and check facial sensations to make sure these nerves are intact.

In some cases, imaging like an MRI may be ordered to get an internal view of the cervical spine and determine if there is disc herniation, bone spurs, or anything else visibly compressing the spinal cord or nerves.

If the neurological exam is normal, the neck pain is likely originating from muscle or joint issues rather than neurological problems. If abnormal results are found, the physician can determine which nerves are impacted and if any treatment is needed for nerve compression injuries.

In summary, a neurological exam is an important diagnostic tool for evaluating neck pain. It provides vital information on whether nerves are functioning properly or if they are being compressed and damaged, causing symptoms to radiate into the limbs. This helps doctors determine the underlying cause and best course of treatment.