Neck pain without arm pain (or with arm pain, no neurology)

Mechanical neck pain without neurological deficit.

Eligibility

At least one must be met for the patient to be eligible for referral.

Standard history and examination; X-ray (AP & lateral cervical spine) if symptoms persist; CT/MRI if indicated

FBE, ESR, CRP if inflammation suspected; consider Ca/phosphate, protein electrophoresis, immunoglobulins, PSA, rheumatoid serology by clinical suspicion

Routine referral criteria

Determine Category 2 or 3 urgency.

Persistent functional impairment or time off work despite physiotherapy, activity modification and analgesia/NSAIDs

Usually managed in primary care

Physiotherapy
Activity modification
Analgesics and NSAIDs (see ACC guidelines)