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Spine and Back Health

Neck and Back Pain

10/30/2008

Question:

I have had several injuries from falls, vehicle accidents and such. For about 18 months I have had chronic pain on the left side of my neck, at the base of my skull down to C-5. I have pain generating from both the middle of my back and the lower lumbar area as well. Walking even a short distance now cause acute pain in my feet and lower legs. What would be the best type of physician for me to see for effective treatment? To date little of what has been done is truly helping.

Answer:

Hello, thank you for your question. My response may or may not be very helpful, since you didn't specify exactly what you've had done so far. Diagnosing and treating people with multiple simultaneous pain complaints is very difficult. You might be forced to focus in on whatever area is causing the most pain and deal with that for now.

Treatment usually starts with someone's primary care physician, who will typically order appropriate diagnostic tests, physical therapy, and/or pain medications. If that doesn't work, the next step is often evaluation by a pain management physician, who will sometimes recommend more aggressive treatments such as spinal injections (cortisone injections).

If that still doesn't work, it is sometimes appropriate, especially if you have abnormal test results such as an MRI, to be referred to see a spine surgeon. You won't get very far going to a surgeon unless you've already attempted the other treatments first, or unless you have a specific neurological problem. I hope this helps. Good luck.

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Response by:

David J Hart, MD David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University