Discogenic neck pain often centralizes with which movement?

• A. Extension
• B. Flexion
• C. Lateral flexion
• D. Rotation

Answer: (A)

Centralization is the phenomenon where distal symptoms move toward the spine with a specific movement, signaling a disc-related issue. In discogenic neck pain, extending the neck places the posterior part of the intervertebral disc under load, which can cause posterior protrusion of disc material toward the central canal. This shift tends to pull symptoms back toward the neck rather than radiating distally into the arm, so the patient’s radicular pain centralizes with extension. Clinically, this pattern helps distinguish disc derangements from other causes of neck pain and guides treatment toward extension-based strategies. Flexion, rotation, or lateral flexion are more likely to worsen or maintain distal, radiating symptoms because of how they interact with the foraminal and nerve-root mechanics in the cervical spine.