Imaging is generally indicated in traumatic causes of neck pain. When indicated, plain X ray with different views is the first imaging investigation that is performed. In non traumatic cases of neck pain, imaging is indicated when there is a risk for infection (IV drug use, immunocompromised individual), age >50 with new onset of pain, presence of constitutional/neurologic symptoms or history of malignancy.

X-ray imaging includes conventional and enhanced methods that can help diagnose the cause and site of back pain. A conventional x-ray, often the first imaging technique used, looks for broken bones or an injured vertebra. A technician passes a concentrated beam of low-dose ionized radiation through the neck and takes pictures that, within minutes, clearly show the bony structure and any vertebral misalignment or fractures. Tissue masses such as injured muscles and ligaments or painful conditions such as a bulging disc are not visible on conventional x-rays. This fast, noninvasive, painless procedure is usually performed in a doctor’s office or at a clinic.