Who is it evaluated for?
Clinical evaluation may be useful for individuals whose neck pain recurs frequently, who experience pain or numbness radiating to the arm, or who feel significant strain at a desk or in daily life.
How is it planned?
Range of motion, neurological examination, posture, and daily loading are evaluated together. Imaging is added when necessary; exercise, rehabilitation, ergonomics, and, in appropriate cases, other pain treatments are planned individually.
Common causes of neck pain
Muscle and connective tissue strains, prolonged static positions, facet joints, disc degeneration, cervical disc herniation, nerve root irritation, and more rarely, inflammatory, infectious, or neoplastic conditions can lead to neck pain. It should not be forgotten that degenerative changes seen on imaging are not always the sole cause of pain.
What is a cervical herniated disc?
Compression of cervical disc material on a nerve root or, more rarely, on the spinal cord can cause pain radiating to the arm, numbness, tingling, or weakness. The treatment decision should not be made based on the MRI scan alone, but together with the neurological examination, the duration of symptoms, and the impact on daily life.
When is imaging necessary?
Current 2025 guidelines emphasize that routine imaging is often not necessary in acute neck pain not suggestive of a structural cause. In cases of progressive neurological deficit, trauma, suspicion of malignancy or infection, or prominent findings of radiculopathy or myelopathy, MRI or an appropriate imaging modality becomes more meaningful.
Exercise and movement
Especially in chronic neck pain, activation and exercise therapy are among the fundamental approaches. Neck-scapular region strengthening, range of motion, postural awareness, and daily activity modifications can be planned individually. The type and intensity of exercise should be adjusted according to the pain pattern and accompanying neurological findings.
Medication and physical therapy options
Short-term analgesic or anti-inflammatory treatments may help with symptom control in some individuals. Manual therapy, exercise, and multimodal physical therapy approaches can also be evaluated in selected patients. Rather than long-term passive treatment, methods that increase the individual’s own movement capacity generally provide a more sustainable basis.
Interventional pain treatments
Cervical epidural injections, facet joint interventions, or medial branch radiofrequency applications can be evaluated in certain pain patterns. Proper target selection and the concordance of imaging and clinical findings affect the contribution of these methods.
Ozone and complementary methods
Paravertebral and other local ozone applications are among the methods investigated in neck and spine-related pain. Some clinical series and studies report positive results; however, protocols and patient groups may vary. Therefore, the application may be evaluated as a supportive approach in selected patients after reviewing the primary diagnosis and standard treatment options.
Which findings require more urgent evaluation?
- Progressive weakness in the arm or hand
- Gait disturbance or imbalance
- Noticeable new loss of hand dexterity
- Pain following severe trauma
- Fever or signs of systemic infection
- New neck pain accompanied by a history of cancer
- Unusual, progressively worsening pain that awakens from sleep at night
Our approach in our Bodrum clinic
In neck pain, we first aim to differentiate mechanical pain, radiculopathy, myofascial pain, and possible spinal cord/nerve root involvement. The examination, neurological findings, imaging when needed, and the individual’s functional level are evaluated together. The goal is to create a plan that maintains movement and uses targeted interventional options when necessary, while reducing unnecessary tests and procedures.
For the general approach, you can review the Pain Treatment guide.
References
- El-Allawy A, et al. Clinical Practice Guideline: Nonspecific Neck Pain. Dtsch Arztebl Int. 2025. PMID: 40665902.
- ACR Appropriateness Criteria® Cervical Pain or Cervical Radiculopathy: 2024 Update. J Am Coll Radiol. 2025. PMID: 40409873.
- Lim TH, et al. Nonpharmacological Spine Pain Management in Clinical Practice Guidelines. J Orthop Sports Phys Ther. 2025. PMID: 39680669.
Written and medically reviewed by: Dr. Kerem Çağlayan
Last medical review: September 10, 2026
Disclaimer: This content is general health information; it is not personal diagnostic or treatment advice.
