Neck pain

	Headline
History	Red flags - meningism, B s/s, immunocompromise, IV drug use, steroid use ➥ History of trauma/sudden onset? → typically maximal at 48h ➥ Motor/sensory s/s - think dermatomal/myotomal distribution ➥ disturbed consciousness: THINK C-SPINE
Examination	ROM of neck, trigger points in muscle, upp limb neuro o/e, shoulder o/e
Diagnostic investigations	High energy trauma → is this trauma call-worthy? Needs immobilisation?
Differentials	fracture, abscess, tumour, vertebral artery dissection, inflammatory arthritis, cervical spondylosis, cervical disc herniation, referred pain (quinsy/tonsillitis, shoulder...), acute dystonia (torticollis)
Immediate management	acute neck pain without neuro signs - expect 50% to resolve in 3m ➥ radiculopathy - expect resolving in 6/12
Ongoing management

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