Neck pain

• Cervical Strain / Whiplash:
  • Dx: Paraspinal tenderness, normal neuro exam, no red flags.
  • Tx: NSAIDs + early mobilization (Avoid prolonged cervical collar).
• Cervical Radiculopathy:
  • Dx: Shooting arm pain in dermatomal pattern, (+) Spurling test; LMN signs only (C6: biceps/thumb; C7: triceps/middle finger).
  • Tx: Conservative (NSAIDs/PT) for 4–6 weeks. MRI C-spine only if progressive motor weakness or refractory.
• Cervical Spondylotic Myelopathy (CSM):
  • Dx: LMN signs in arms (weakness/atrophy) + UMN signs in legs (hyperreflexia, spasticity, clonus).
  • Tx: Urgent MRI $\to$ Surgical decompression (ACDF/laminectomy).
• Atlantoaxial Subluxation:
  • Risk: Rheumatoid Arthritis (RA) or Down syndrome.
  • High-Yield: Pre-op clearance before intubation requires Flexion-extension C-spine X-rays.