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 when spinal pain 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

SCREENING AND DIAGNOSIS

The evaluation of lumbopelvic deconditioning is best accomplished by physical examination and functional testing. The physical examination will include assessment of posture and muscle function. Additional assessment may include gait evaluation, balance assessment and more advanced assessment of muscular performance using standardized and uniquely designed protocols. Sometimes advanced technology is used to quantify reaction time, low back stability, muscular power, torque and endurance.

PROGNOSIS

The prognosis is excellent for those individuals who commit to participating in a regular exercise (conditioning) program. Those who have a severe underlying  disease process may not have as good a prognosis but will still benefit from participating in an progressive lumbopelvic exercise program.

COMPLICATIONS

The complications associated with longstanding lumbopelvic deconditioning include poor posture, degenerative disc disease, intervertebral disc herniation, lumbar facet syndrome, spinal stenosis and multifactorial low back pain. Core muscle weakness predisposes the low back to injury.