MRI scan of the cervical spine (neck): why it is done and what to expect

The cervical spine is the part of the spine in the neck. It is made up of bones (vertebrae) separated by soft cushions of tissue (discs), and it surrounds and protects the spinal cord and the nerves that run to the shoulders and arms. An MRI scan of the cervical spine uses a magnetic field and radio waves to build detailed pictures of all of those structures without X-rays.

The NHS describes an MRI scanner as a large machine with a short tunnel through it and a flat bed that moves through the scanner. For a neck scan the part of the body being imaged sits in the centre of the machine, and you will usually be lying on your back.

Most neck pain does not need a scan. The NHS says it usually lasts only a few weeks and can be eased with painkillers, heat or cold packs, a low firm pillow and neck exercises. It lists the most common causes as the neck becoming locked in an awkward position while sleeping, bad posture, a pinched nerve and an injury such as whiplash.

The NHS advises seeing a GP if neck pain or stiffness does not go away after a few weeks, if painkillers have not worked, if you are worried about the pain, or if you have other symptoms such as pins and needles or a cold arm. For cervical spondylosis, which it describes as a common condition often affecting people over 40 and a normal part of ageing, a health professional may examine the neck and shoulders, test reflexes, watch you walk and, depending on symptoms, arrange X-rays or scans.

An MRI is most helpful when the question is about the soft tissues: whether a disc or bone is pressing on a nerve, or whether the spinal cord is being affected. The NHS says surgery is only considered when a nerve is being pinched by a slipped disc or bone (cervical radiculopathy) or when there is a problem with the spinal cord (cervical myelopathy), so the scan is often part of a specialist assessment before that decision is made.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have severe neck pain that starts suddenly or pain that is getting worse quickly, heaviness or weakness in your arms or legs, pins and needles in an arm as well as pain in your neck or arm, or pain between your shoulder blades.

It says to call 999 if you have new problems walking, loss of bladder or bowel control, sudden lack of co-ordination (for example, with tasks like buttoning a shirt), a face that droops on one side, an inability to lift both arms and keep them there, or difficulty speaking. These can be signs of a medical emergency.

The hospital will tell you if there is anything you need to do. The NHS says you may be asked not to wear anything with metal in it, such as jewellery, a bra, hair clips or hearing aids, to remove coins or keys from your pockets, to change into a hospital gown if your clothes have metal parts such as zips and not to wear make-up. For a neck scan, necklaces and earrings are particularly likely to matter.

You will be asked whether you are pregnant or may be pregnant, are breastfeeding, have had surgery before, have kidney problems, have metal parts in your body such as surgical clips, a pacemaker, dental fillings or bridges, or have allergies including to contrast medium. If you have had previous spinal surgery, mention it, because implants are exactly what the team needs to know about.

If you are anxious or fear small spaces, the NHS advises talking to a healthcare professional at the hospital before your appointment, because you may be able to have a medicine to help you relax and can ask to bring someone with you.

The scan is done by a radiographer, who controls the scanner from another room and can hear and speak to you throughout. You are asked to lie flat and still, and you may be asked to hold your breath during parts of the scan. The NHS says you may be given an injection of contrast medium (dye) to help show more detail. Because neck pain can make lying flat uncomfortable, say so when you arrive; support under the head and knees is often possible.

After the scan you can usually go home straight away. If you had contrast medium, you may be asked to wait for up to 30 minutes in case of a reaction. If you were given a medicine to relax, someone needs to collect you and you should not drive for 24 hours.

The NHS says it usually takes between 1 and 2 weeks to get your results because the images must be looked at by a radiologist, who writes to the doctor who referred you. You may need a follow-up appointment, and if you have not heard anything after a few weeks you should contact the doctor who referred you.

MRI reports are written for doctors and can contain terms that sound alarming but are common. The NHS describes cervical spondylosis as a normal part of ageing, caused by wear and tear to the bones in the spine and the discs in the neck, and says many people do not have any symptoms. A report may therefore describe changes in the discs or joints in someone whose symptoms are mild, or in someone with no symptoms at all.

What matters is whether the findings match your symptoms. Ask the clinician who requested the scan to explain the result in plain terms, and ask what the next step is: exercises, physiotherapy, medicine, a specialist opinion or no further action. The NHS notes that waiting times for physiotherapy on the NHS can be long and that you can also pay for physiotherapy privately.