Cervicalgia DiagnosisPatients with cervicalgia will usually undergo a thorough examination of the spine, along with a neurological examination of the upper limbs, and the doctor will normally take a neurological history to assess any signs of nerve issues. Lower limbs may also be affected if there is spinal cord compression in the neck and the doctor will take any signs of an abnormal gait, as well as bowel or bladder problems into consideration.
Tender points in the neck muscles, intervertebral joints, and between the shoulders may be observed during a physical examination, and localized nodules or tight musculature may be evident. Signs of heat in the muscles or joints can demonstrate an underlying inflammatory problem, which may be due to an acute injury or a condition such as rheumatoid arthritis. Where excruciating pain is felt upon light pressure being placed on a tender point in the neck or between the shoulders this may lead the physician to suspect fibromyalgia if other symptoms such as fatigue and constant full-body pain exist.
The doctor performing a physical examination may check for Lhermitte’s sign which indicates a neurological problem. This is an electric-shock-type sensation that occurs upon flexion of the neck with the sensation radiating down the spine and into the limbs. Upper spinal cord compression and altered motor neuron function in the lower limbs will be checked including any incidence of up-going plantar reflex (Babinski’s sign), or Hoffman’s reflex in the thumb. Changes in sensation of vibration and problems with joint position, coordination, and other reflexes can all offer insight into the cause or pathological development of cervicalgia.
Diagnostic Tests for Cervicalgia
In cases where evidence of neurological deficit is found during initial physical examination the patient will usually be referred for further testing by a neurologist, including an electromyelogram in many cases. Diagnostic imaging tests such as MRI and CT scans, along with X-Rays, and ultrasound, are also used to observe degenerative problems in the cervical spine, the presence of tumors pressing on the spinal cord or causing blood vessel or nerve compression, and numerous other issues not outwardly observable. Such imaging techniques are not always required, especially in cases where a clear cause and effect seems to be evident, such as an awkward sleeping posture, exposure to a prolonged cold draught, or tension and lack of stretching or exercise in the normal daily routine of a person presenting with cervicalgia.
In some cases circulation in the neck may be monitored, particularly where a patient is suffering migraines, visual disturbances, and dizziness alongside the cervicalgia. Malaise, unexplained weight loss, and fever are not symptoms of cervicalgia and should be investigated thoroughly as these are suggestive of infection, an inflammatory disease such as rheumatoid arthritis, or the presence of cancer. Specific ‘red flags’ exist for those presenting with cervicalgia, with patients showing new symptoms before the age of twenty, or after fifty-five, more likely to have a serious underlying problem. Changes in sensation, or weakness developing in more than one dermatome or myotome also increase the likelihood of a serious issue being at work.
Cervicalgia ICD 9 Diagnosis Code
723.1 is a billable ICD-9-CM medical code that can be used to specify a diagnosis on a reimbursement claim.
Next Learn About: Cervicalgia Symptoms
Last Updated: 04/25/2011