Differentials for a Pain in the Neck

Cervical spinal pain, also will be referred to as cervical spinal hyperesthesia (CSH), is an abnormal clinical sign commonly associated with compressive or inflammatory diseases of the cervical spinal region. Hyperesthesia denotes an unpleasant behavioral response to a nonnoxious stimulus. As part of a routine neurologic examination, spinal hyperesthesia is evaluated by deep palpation of the spinal epaxial musculature and by detecting movement resistance with flexionhyperextension and lateral flexion of the neck. Anatomic structures that are pain sensitive include the meninges, nerve roots, outer 1/3rd of the disc, joints, boney periosteum and muscles.