A number of clinical findings may be red flags for a significant structural cause for neck pain. These causes are reported by the KNGF (Joninklijk Nederlands Genootschap voor Fysiotherapie or Royal Dutch Society for Physical Therapy).

Potential red flags for structural pathology underlying neck pain:

(1) history of trauma

(2) risk factors for osteoporosis (advanced age, corticosteroids, etc)

(3) neurologic symptoms (changes in pper or lower extremities, bowel or bladder dysfunction)

(4) signs or evidence of infection (fever, night sweats, sepsis, immunosuppression, IV drug use)

(5) history of or signs for malignancy (unexplained weight loss, advanced age)

(6) headache, dizziness or change in vision

(7) vomiting or difficulty swallowing

(8) autoimmune disorder

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