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

Neck pain is one of the symptoms of meningitis, a relatively rare but very serious contagious infection. You need urgent medical care if you have neck pain with:

• High fever
• Sensitivity to light
• Irritability
• Severe tenderness with neck movement

SCREENING AND DIAGNOSIS

The evaluation of neck pain should begin with a thorough medical history and a physical examination. Emphasis is placed on direct assessment of the neck as well as assessment of the chest and shoulder regions. Neurological evaluation of the trunk and lower extremity regions helps determine whether there is spinal cord compromise within the neck. Manual palpation of the neck helps determine the location and degree of abnormal spinal segment mobility. The following list includes additional tests which may be ordered by your attending physican.

• X rays
• Magnetic Resonance Imaging (MRI
• Computed Tomography (CT) scan
• Bone scan
• Blood tests

If neck pain is associated with upper extremity pain, numbness and/or weakness further assessment may include needle electromyography and nerve conduction studies.