During the exam, your doctor will check the range of motion in your neck. To find out if there's pressure on your spinal nerves or spinal cord, your doctor will test your reflexes and check the strength of your muscles. He or she may want to watch you walk to see if spinal compression is affecting your gait.
A variety of imaging tests can provide details to guide diagnosis and treatment. Examples include:
- Neck X-ray. An X-ray may show abnormalities, such as bone spurs, that indicate cervical spondylosis. It is ordered primarily as a screening test to look for rare, serious causes for neck pain and stiffness — such as tumors, infections or fractures.
- Computerized tomography (CT scan). This test takes X-rays from many different directions and then combines them into a cross-sectional view of the structures in your neck. It can provide much finer details than a plain X-ray, particularly of the bones.
- Magnetic resonance imaging (MRI). MRI uses a magnetic field and radio waves and can produce detailed, cross-sectional images of both bone and soft tissues. This can help pinpoint areas where nerves may be getting pinched.
- Myelogram. This test involves generating images using X-rays or CT scans after dye is injected into the spinal canal. The dye makes areas of your spine more visible.
Nerve function tests
In some cases, it may be helpful to determine if nerve signals are traveling properly to your muscles. Nerve function tests include:
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- Electromyogram (EMG). This test measures the electrical activity in your nerves as they transmit messages to your muscles when the muscles are contracting and when they're at rest. The purpose of an EMG is to assess the health of your muscles and the nerves that control them.
- Nerve conduction study. For this test, electrodes are attached to your skin above the nerve to be studied. A small shock is passed through the nerve to measure the strength and speed of nerve signals.
- Bradley WG, et al. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa.: Butterworth-Heinemann Elsevier; 2008. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7506-7525-3..X5001-8--TOP&isbn=978-0-7506-7525-3&uniqId=230100505-57. Accessed April 6, 2012.
- Cervical spondylosis. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00369. Accessed April 6, 2012.
- Takagi I, et al. Cervical spondylosis: An update on pathophysiology, clinical manifestation and management strategies. Disease of the Month. 2011;57:583.
- Shelerud RA (expert opinion). Mayo Clinic, Rochester, Minn. May 4, 2012.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed April 6, 2012.