The clinical manifestations of neck disorders range from midline posterior neck pain to the neurologic sequelae of cervical nerve root or spinal cord compression. Axial neck pain may radiate from the base of the skull down to the upper trapezius region. Cervical radiculopathy involves compression of a nerve root with pain radiating down the arm in an anatomic distribution. Cervical myelopathy is characterized by dysfunction of the spinal cord. This may be caused by cord compression, vascular abnormalities, or a combination of both.
Prevalence of neck and referred shoulder/brachial pain has been reported to be 9%. In a series of 205 patients who presented with neck pain and were managed non-operatively, 79% were noted to be asymptomatic or improved at a minimum of 10-year follow-up. Thirteen percent were unchanged, and only eight percent had worsening of their symptoms . Radiographically, 25% of patients in their fifth decade have been shown to have degenerative changes in one or more disks. By the seventh decade, this number increases to over 75%.