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

For a sprain/strain, seek prompt medical care if one or more of following presentations occur; movement of the neck or back associated with a popping sound with pain and muscle spasm or inability to stand and bear weight on the spine because of a feeling of instability or pain. Inadequate or delayed treatment of a severe sprain/strain may result in long-term joint damage or chronic pain.

SCREENING AND DIAGNOSIS

The evaluation of a neck or back sprain/strain should include a history and physical examination. Examination may reveal swelling, tenderness and or muscle pain. Your attending physician may order X-rays to rule out a fracture or other bone injury either of which can accompany a sprain/strain. More severe involvement may require an MRI study. MRI offers superb imaging of soft tissues.

NATURAL HISTORY AND PROGNOSIS

Most sprain/strain injuries involving the neck or back resolve with time and limited treatment. More involved sprain/strains may require treatment and physical rehabilitation. In rare cases, a severe sprain/strain may require surgical intervention.

COMPLICATIONS

The complications associated with a sprain/strain vary depending on the severity and the region of the injury. Potential complications include: 

• Chronic pain and stiffness
• Chronic spinal segment dysfunction (abnormal segmental movement)
• Deconditioning of muscles surrounding the area of injury, due to pain and limitation of activity.
• A severe sprain /strain may be associated with chronic joint or spinal segment instability (too much movement)