明确导致颈部疼痛的原因（例如原发性或转移瘤）和其合并的神经损害情况是非常重要的。 对于颈部疼痛的诊断方法目前还不及腰背部疼痛研究的深入，但推荐类似的诊断方式。
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定义
颈部疼痛可分为以下4类[1]Guzman J, Haldeman, S, Carroll LJ, et al. Clinical practice implications of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders: from concepts and findings to recommendations. Spine (Phila Pa 1976). 2008;33(suppl 4):S199-S213.http://www.ncbi.nlm.nih.gov/pubmed/18204393?tool=bestpractice.com
流行病学
颈部疼痛的发生率低于腰背部疼痛；因此对于颈部疼痛的研究不及腰背部疼痛深入。[2]Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin. 2007;25:353-371.http://www.ncbi.nlm.nih.gov/pubmed/17445733?tool=bestpractice.com 预计颈痛显著发作的终身患病率为 40%-70%。[3]Devereaux MW. Neck pain. Prim Care. 2004;31:19-31.http://www.ncbi.nlm.nih.gov/pubmed/15110156?tool=bestpractice.com 美国一项国家调查显示，5.9%的受调查者受到约至少1个月的颈部疼痛的困扰，而受到腰背部疼痛困扰的约为10.5%。[4]Maurer K; U.S. Department of Health, Education, and Welfare. Basic data on arthritis knee, hip and sacroiliac joints in adults ages 25-74 years: United States, 1971-1975. Vital Health Stat 11. 1979;213:1-31.http://www.cdc.gov/nchs/data/series/sr_11/sr11_213.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/15810262?tool=bestpractice.com 芬兰的一项调查显示，颈部疼痛终身患病率为71%。有13.5%的女性和9.5%的男性受到颈部疼痛困扰时间可达大于3个月。[5]Makela M, Heiliovaara M, Sievers K, et al. Prevalence, determinants, and consequences or chronic neck pain in Finland. Am J Epidemiol. 1991;134:1356-1367.http://www.ncbi.nlm.nih.gov/pubmed/1755449?tool=bestpractice.com 另外一项来自挪威的调查显示，以往约有34.4%人群受到颈部疼痛困扰，13.8%的人群颈部疼痛时间超过6个月。[6]Bovim G, Schrader H, Sand T. Neck pain in the general population. Spine (Phila Pa 1976). 1994;19:1307-1309.http://www.ncbi.nlm.nih.gov/pubmed/8066508?tool=bestpractice.com 高达20%-40%的急性颈部疼痛患者发展为慢性颈部疼痛。[7]Carette S. Whiplash injury and chronic neck pain. N Engl J Med. 1994;330:1083-1084.http://www.ncbi.nlm.nih.gov/pubmed/8127339?tool=bestpractice.com
从18至30岁阶段到中年人群（50-55岁），颈部疼痛的发生率是增加的。 一些研究显示，其发生率在50-55岁之后有所下降；而其他研究显示其发生率有轻微上升或保持稳定。[4]Maurer K; U.S. Department of Health, Education, and Welfare. Basic data on arthritis knee, hip and sacroiliac joints in adults ages 25-74 years: United States, 1971-1975. Vital Health Stat 11. 1979;213:1-31.http://www.cdc.gov/nchs/data/series/sr_11/sr11_213.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/15810262?tool=bestpractice.com[5]Makela M, Heiliovaara M, Sievers K, et al. Prevalence, determinants, and consequences or chronic neck pain in Finland. Am J Epidemiol. 1991;134:1356-1367.http://www.ncbi.nlm.nih.gov/pubmed/1755449?tool=bestpractice.com[6]Bovim G, Schrader H, Sand T. Neck pain in the general population. Spine (Phila Pa 1976). 1994;19:1307-1309.http://www.ncbi.nlm.nih.gov/pubmed/8066508?tool=bestpractice.com[8]van der Donk J, Schouten JS, Passchier J, et al. The associations of neck pain with radiological abnormalities of the cervical spine and personality traits in a general population. J Rheumatol. 1991;18:1884-1889.http://www.ncbi.nlm.nih.gov/pubmed/1795327?tool=bestpractice.com 所有的流行病学研究显示，女性颈部疼痛的发生率高于男性。[4]Maurer K; U.S. Department of Health, Education, and Welfare. Basic data on arthritis knee, hip and sacroiliac joints in adults ages 25-74 years: United States, 1971-1975. Vital Health Stat 11. 1979;213:1-31.http://www.cdc.gov/nchs/data/series/sr_11/sr11_213.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/15810262?tool=bestpractice.com[5]Makela M, Heiliovaara M, Sievers K, et al. Prevalence, determinants, and consequences or chronic neck pain in Finland. Am J Epidemiol. 1991;134:1356-1367.http://www.ncbi.nlm.nih.gov/pubmed/1755449?tool=bestpractice.com[6]Bovim G, Schrader H, Sand T. Neck pain in the general population. Spine (Phila Pa 1976). 1994;19:1307-1309.http://www.ncbi.nlm.nih.gov/pubmed/8066508?tool=bestpractice.com[8]van der Donk J, Schouten JS, Passchier J, et al. The associations of neck pain with radiological abnormalities of the cervical spine and personality traits in a general population. J Rheumatol. 1991;18:1884-1889.http://www.ncbi.nlm.nih.gov/pubmed/1795327?tool=bestpractice.com[9]Lawrence JS. Disc degeneration: its frequency and relationship to symptoms. Ann Rheum Dis. 1969;28:121-138.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1031120/pdf/annrheumd00235-0028.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/4237972?tool=bestpractice.com
从事文书工作、工业和农业的人员罹患慢性颈部疼痛症的风险较专业技术人员已有所增加。 此种情况已在30-65岁人群中出现，但对于大于65岁者，其差异并无统计学意义。[5]Makela M, Heiliovaara M, Sievers K, et al. Prevalence, determinants, and consequences or chronic neck pain in Finland. Am J Epidemiol. 1991;134:1356-1367.http://www.ncbi.nlm.nih.gov/pubmed/1755449?tool=bestpractice.com 一项研究显示，神经根性颈椎病的发生率为83.2/100 000。[10]Radhakrishnan K, Litchy WJ, O'Fallon WM. Epidemiology of cervical radiculopathy: a population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117:325-335.http://www.ncbi.nlm.nih.gov/pubmed/8186959?tool=bestpractice.com
损伤因素是慢性颈部疼痛的一个重要预测因素。[5]Makela M, Heiliovaara M, Sievers K, et al. Prevalence, determinants, and consequences or chronic neck pain in Finland. Am J Epidemiol. 1991;134:1356-1367.http://www.ncbi.nlm.nih.gov/pubmed/1755449?tool=bestpractice.com 此种情况主要出现于颈部挥鞭样损伤；20%-40%挥鞭样损伤将逐渐发展为慢性颈部疼痛。[7]Carette S. Whiplash injury and chronic neck pain. N Engl J Med. 1994;330:1083-1084.http://www.ncbi.nlm.nih.gov/pubmed/8127339?tool=bestpractice.com
研究发现，精神压力是颈部疼痛的一个弱预测因素。[5]Makela M, Heiliovaara M, Sievers K, et al. Prevalence, determinants, and consequences or chronic neck pain in Finland. Am J Epidemiol. 1991;134:1356-1367.http://www.ncbi.nlm.nih.gov/pubmed/1755449?tool=bestpractice.com 感觉缺失和损伤程度也是颈部疼痛的预测因素。[8]van der Donk J, Schouten JS, Passchier J, et al. The associations of neck pain with radiological abnormalities of the cervical spine and personality traits in a general population. J Rheumatol. 1991;18:1884-1889.http://www.ncbi.nlm.nih.gov/pubmed/1795327?tool=bestpractice.com
