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 .
Comparative local anaesthetic blocks in the diagnosis of cervical zygapophysial joint pain
& NA ; The utility of r and omised , double‐blind , controlled , comparative local anaesthetic blocks for the diagnosis of cervical , zygapophysial joint pain was studied in 47 patients with chronic neck pain following whiplash injury . Each patient was investigated with radiologically controlled blocks of the medial branches of the cervical , dorsal rami to anaesthetise the target cervical , zygapophysial joint . The blocks were performed using either lignocaine or bupivacaine , r and omly allocated , and the patients ' responses were assessed in a double‐blind fashion . Any positive response was subsequently assessed by repeating the block with the complementary anaesthetic . Only those patients experiencing a longer period of pain relief from the bupivacaine were considered to have true‐positive responses . Forty‐four patients had pain relief from two blocks at a single level , of whom 34 had longer pain relief from bupivacaine . This result is unlikely to have occurred by chance ( P = 0.0002 ) . The duration s of pain relief obtained from the anaesthetics were consistent with the known characteristics of these drugs with bupivacaine lasting significantly longer than lignocaine ( P = 0.0003 ) . A subgroup of 13 patients were identified with unexpected , prolonged responses to one or both of the anaesthetics . Comparative , diagnostic blocks are a valid technique in the identification of painful zygapophysial joints , and constitute an implementable alternative to normal saline controls
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 .