What is the Best Scan for Neck Pain?

Neck pain is an extremely common condition that affects millions of people. There are many potential causes of neck pain, ranging from muscle strains to more serious issues like herniated discs or spinal stenosis. When neck pain persists or is accompanied by other concerning symptoms like numbness or weakness in the arms and hands, your doctor may order imaging tests to help determine the underlying cause. But what is the best scan for evaluating neck pain? Here are some of the main options.

X-Rays

X-rays are usually the first imaging test ordered for neck pain. They can help detect bone-related causes of neck pain like fractures, arthritis, or bone spurs. X-rays involve exposing the neck to a very low dose of radiation to obtain images of the cervical vertebrae and soft tissues. While x-rays are quick and inexpensive, they do not provide information about problems with muscles, nerves or discs. So they have limitations in assessing many common sources of neck pain.

MRI Scan

An MRI (magnetic resonance imaging) scan is probably the best imaging modality for evaluating neck pain that stems from soft tissue injuries like bulging/herniated discs or pinched nerves. MRIs use magnets and radio waves rather than radiation to produce very detailed 3D images of the soft tissues of the neck including the spinal cord, nerves, discs and muscles. MRIs can accurately pinpoint the size, location and cause of disc, nerve or soft tissue injuries that may be responsible for pain. MRIs are non-invasive but they are more expensive and less readily available than x-rays.

CT Scan

CT (computed tomography) scans are sometimes used to complement x-rays in assessing neck pain. They involve an x-ray machine rotating around the head to obtain cross-sectional images of the cervical spine and surrounding tissues. CT scans are better than x-rays at detecting some bone problems and injuries. But they provide less information about soft tissues than an MRI. CT scans use ionizing radiation so they are not recommended for routine evaluation of uncomplicated neck pain in younger patients. Their use is mainly reserved for patients who cannot undergo MRIs.

Bone Scan

A bone scan can help diagnose the cause of neck pain if an injury or arthritis is suspected. It involves injecting a radioactive tracer into the bloodstream that accumulates in areas of increased bone activity. Images are then obtained to highlight areas of potential bone damage. Bone scans are not used routinely but may complement x-rays or MRIs if infections, fractures, arthritis or tumors are suspected.

While various imaging tests have a role in diagnosing neck pain, an MRI scan is generally considered the most useful option. MRIs can accurately evaluate the discs, spinal cord, nerves and other soft tissues that are frequently the source of neck pain. MRIs provide detailed images that can pinpoint the location and cause of many neck problems to help guide appropriate treatment.