Symptoms:

Symptoms often develop slowly over time, but they may start or get worse suddenly. The pain may be mild, or it can be deep and so severe that you are unable to move.

You may feel the pain over the shoulder blade or it may spread to the upper arm, forearm, or (rarely) fingers.

The pain may get worse:

• After standing or sitting
• At night
• When you sneeze, cough, or laugh
• When you bend the neck backwards or walk more than a few yards

You may also have weakness in certain muscles. Sometimes, you may not notice it until your doctor examines you. In other cases, you will notice that you have a hard time lifting your arm, squeezing tightly with one of your hands, or other problems.

Other common symptoms are:

• Neck stiffness that gets worse over time
• Numbness or abnormal sensations in the shoulders, arms, or (rarely) legs
• Headaches, especially in the back of the head

Less common symptoms are:

• Loss of balance
• Loss of control over the bladder or bowels (if there is pressure on the spinal cord)

Signs and tests:

An exam may show that you have trouble moving your head toward your shoulder and rotating your head.

Your health care provider may ask you to bend your head forward and to the sides while putting slight downward pressure on the top of your head. Increased pain or numbness during this test is usually a sign that there is pressure on a nerve in your spine.

Weakness or loss of feeling can be signs of damage to certain nerve roots or to the spinal cord. Reflexes are often reduced.

DIAGNOSTIC TESTS

A spine or neck x-ray may be done to look for arthritis or other changes in your spine.

MRI of the neck is done when you have:

• Severe neck or arm pain that does not get better with treatment
• Weakness or numbness in your arms or hands

EMG and nerve conduction velocity test may be done to examine nerve root function.