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

SCREENING AND DIAGNOSIS

Spinal segment evaluation is best assessed by a spine specialist/physician highly skilled in manual palpation of the spine. The physican must be very knowledgeable in biomechanics of the spine. A good example a physician with expert training is the chiropractic physican. The physican will place his hands on the spine and move up and down the spine to assess movement at each spinal level and to assess the soft tissue response to segmental movement.

X-ray may be used to evaluation of the structural integrity of the spine and to assess for abnormal patterns of segmental movement. To accomplish this, positional X-ray views need to be taken. This often includes weight bearing flexion, extension and lateral bending views. The X-ray findings are correlated with the physical examination and spinal palpation findings. Advanced imaging such as CT and/or MRI may be used to help determine why there are certain signs or symptoms associated with a spinal segment or spinal region.

NATURAL HISTORY AND PROGNOSIS

The prognosis is good with early detection and intervention.

COMPLICATIONS

Potential complications include:

• Chronic spinal segment dysfunction
• Recurrent or persistent focal discomfort or pain
• Possibility of progressive degenerative process at the involved spinal segment
• Compensatory abnormal movement (biomechanics) at adjacent spinal segments
• Immobilization degeneration
• Muscular imbalance