WHEN TO SEE A SPINE SPECIALIST

You should seek the advice of a spine specialist if neck or back pain persists for more than two weeks or if it is progressive in intensity and/or distribution. You should seek immediate healthcare attention if neck or back pain occurs as the result of an injury or if it is associated with serious illness and/or a high fever. Additional signs and symptoms which warrant prompt medical attention include:

• Neck or back pain associated with bowel and/or bladder dysfunction
• Neck or back pain associated with extremity weakness or difficulty with coordination
• Extremity numbness or muscle weakness
• Neck or back pain that is associated with impaired walking (gait) or difficulty with balance
• Numbness, tingling and/or muscle weakness associated with a back or neck injury

If neck or back pain increases when you cough or sneeze you may have a herniated disc. If you experience neck or back pain that persists or progresses you should be seen by a physician.

SCREENING AND DIAGNOSIS

The first step in determining whether you may have a herniated disc is for your doctor to acquire a thorough personal history. He or she will then perform a physical examination which will include the use of various orthopedic and neurological tests. Orthopedic tests will include evaluation for spinal nerve root tension, tests which are often positive if a disc herniation is compressing a spinal nerve and preventing it from gliding. The neurological portion of the examination will include testing of your reflexes, muscle strength, sensation, walking ability and coordination. Your doctor may include a test for sensation and function in the area around the rectum, because this area can be affected by a herniated disk.