When should I consider referring a patient with neck pain for specialist assessment?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Consider referring a patient with neck pain for specialist assessment in the following situations:

  • If any red flags suggesting serious spinal abnormality or other concerning pathology are present, refer urgently or arrange immediate assessment depending on clinical judgement ,,.
  • If the patient has cervical radiculopathy with severe or progressive motor weakness or sensory loss, seek immediate specialist advice ,.
  • If cervical radiculopathy symptoms have persisted for 4–6 weeks or more, or if there are objective neurological signs, refer for MRI confirmation and consideration of invasive procedures or surgery ,.
  • If neck pain has lasted more than 12 weeks and has not improved with primary care management, consider referral to a pain clinic for multidisciplinary management .
  • Consider referral for psychological therapy if there are psychological symptoms or risk factors, or if pain is chronic .
  • Consider referral to occupational health if neck pain is related to work .

Do not routinely refer patients with non-specific neck pain without red flags; instead, provide reassurance, advice on activity, analgesia, and physiotherapy .

Related Knowledge Topics

Educational content only. Always verify information and use clinical judgement.