Which objective finding is related to the development of chronic neck pain?

• A. Hyporeflexia of any upper extremity deep tendon reflexes
• B. Weakness in the hands
• C. Positive upper limb tension test for median nerve
• D. Significant loss of active range of motion

Answer: (B)

Weakness in the hands signals nerve involvement coming from the neck, which tends to develop as cervical pathology becomes more chronic. When cervical nerve roots, especially the lower ones like those that feed the intrinsic hand muscles, are irritated or compressed over time, the result is measurable motor weakness in the hands (for example, reduced grip strength or finger movements). This neurological deficit reflects ongoing radiculopathy or even early myelopathy from neck pathology, making it a concrete indicator that the neck pain has a neuropathic component and has progressed beyond simple mechanical discomfort.

Other options are less specific for chronic neck pathology. Hyporeflexia of upper extremity reflexes can arise from various peripheral nerve issues and isn’t uniquely tied to chronic neck disease. A positive upper limb tension test for the median nerve indicates neural tension but is a provocative test rather than a stable, nerve-innervation deficit. Significant loss of active range of motion can occur with many neck conditions and does not, by itself, confirm neural involvement related to chronic neck pain.