Screening protocol s have high predictive values to detect cervical spine fracture in alert , low-risk patients seeking emergency care after blunt neck trauma .
Computerized tomography ( CT ) scans had better validity ( in adults and elderly ) than radiographs in assessing high-risk and /or multi-injured blunt trauma neck patients .
In the absence of serious pathology , clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression .
One exception is the manual provocation test for cervical radiculopathy , which has high positive predictive value .
There was no evidence that specific MRI findings are associated with neck pain , cervicogenic headache , or whiplash exposure .
No evidence supports using cervical provocative discography , anesthetic facet , or medial branch blocks in evaluating neck pain .
Reliable and valid self-report question naires are useful in assessing pain , function , disability , and psychosocial status in individuals with neck pain .
CONCLUSION The scientific evidence supports screening protocol s in emergency care for low-risk patients ; and CT-scans for high-risk patients with blunt trauma to the neck .
In nonemergency neck pain without radiculopathy , the validity of most commonly used objective tests is lacking .
OBJECTIVE To critically appraise and synthesize the literature on assessment of  neck pain .
SUMMARY OF BACKGROUND DATA The published literature on assessment of neck pain is large and of variable quality .
There have been no prior systematic review s of this literature .
Ambulatory Electromyogram Activity in the Upper Trapezius Region: Patients With Muscle Pain vs. Pain‐free Control Subjects
Study Design This study compared the  ambulatory electromyogram activity of persons reporting pain in the shoulder and cervical regions with an equal group of persons not reporting such pain .  Ambulatory electromyogram data were obtained over 3‐day periods . In addition , all participants completed several st and ard psychological question naires . Objectives The results were analyzed with inferential statistics to determine whether subjects reporting significant pain in the shoulder and cervical regions had greater ambulatory electromyogram activity than an equal number of subjects not reporting pain . Summary of Background Data Considerable controversy exists regarding the role of muscle activity in the etiology and maintenance of muscle pain disorders . Given the availability of ambulatory recording devices that can provide a detailed record of muscle activity over an extended period of time , the present research was conducted to determine whether persons reporting shoulder and cervical pain could be differentiated from a group of normal subjects . Methods All subjects ( N = 20 ) completed a battery of tests with st and ardized psychometric instruments and then were fitted with ambulatory electromyogram monitors to record  electromyographic activity of the upper trapezius region of the dominant side ; the time , duration , and amplitude of electromyogram activity greater than 2 μV was recorded . The monitors were worn during normal working hours ( mean , 6.2 hours per day ) over 3 consecutive days . In addition to wearing the monitors , all subjects completed hourly self‐ratings of perceived muscle tension during the recording periods . Results As expected , subjects with muscle pain reported significantly more pain ( mean , 4.9 ) than did the normal control subjects ( mean , 0.9 ) , t(15 ) = 3.29 , P < 0.01 . However , patients with muscle pain did not have greater average electromyogram activity ( mean , 6.4 μV ) over the 3‐day period as compared to the normal controls ( mean , 7.1 μV ) , t(18 ) = ‐0.25 , P < 0.80 . Self‐monitoring of perceived muscle tension also did not reveal differences between pain subjects and the normal control subjects ( P < 0.75 ) . Conclusions Ambulatory measurements of electromyogram activity did not differentiate persons reporting upper trapezius or cervical pain from those that did not report such pain . Persons reporting pain are also not distinguishable from normal control subjects on a variety of self‐report measures . These results raise questions regarding the role of ambulatory electromyogram recordings in the evaluation and treatment of muscle pain disorders
Screening protocol s have high predictive values to detect cervical spine fracture in alert , low-risk patients seeking emergency care after blunt neck trauma .
Computerized tomography ( CT ) scans had better validity ( in adults and elderly ) than radiographs in assessing high-risk and /or multi-injured blunt trauma neck patients .
In the absence of serious pathology , clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression .
One exception is the manual provocation test for cervical radiculopathy , which has high positive predictive value .
There was no evidence that specific MRI findings are associated with neck pain , cervicogenic headache , or whiplash exposure .
No evidence supports using cervical provocative discography , anesthetic facet , or medial branch blocks in evaluating neck pain .
Reliable and valid self-report question naires are useful in assessing pain , function , disability , and psychosocial status in individuals with neck pain .
CONCLUSION The scientific evidence supports screening protocol s in emergency care for low-risk patients ; and CT-scans for high-risk patients with blunt trauma to the neck .
In nonemergency neck pain without radiculopathy , the validity of most commonly used objective tests is lacking .
OBJECTIVE To critically appraise and synthesize the literature on assessment of  neck pain .
SUMMARY OF BACKGROUND DATA The published literature on assessment of neck pain is large and of variable quality .
There have been no prior systematic review s of this literature .