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Is pain above the neck radiating towards the shoulder and spine normal?

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General & Family Physician
Practicing since : 1991
Answered : 2836 Questions
I have been having a pain at the base of my skull that seems to radiate to the left shoulder and down my spine. Aleve and Tylenol don't seem to help much and neither does pain salves. This has been going on for over three weeks.
Tue, 29 May 2018 in Brain and Spine
Answered by Dr. Bonnie Berger-Durnbaugh 43 minutes later
Brief Answer:

Detailed Answer:
Hello and welcome,

Physician's Assistants do not have very much training, particularly lacking in the ability to make differential diagnoses. What the PA can do is order an Xray and then possibly and MRI to see if there is a musculoskeletal cause for what sounds like nerve pain. If you can self refer, I would recommend seeing a physical therapist. They are excellent in diagnosing musculoskeletal problems. In some places, however, they cannot order imaging studies like X-rays, so a PT may refer you back to your primary care provider, which sounds like it is a PA.

So you have a few options depending on what your insurance covers:
1. See the PA, get started with an Xray (neck, upper back) and then go to a Physical Therapist and follow up with your (real) doctor.
2. See a Physical Therapist first if you can get in sooner with one, and then, when they recommend imaging studies which they will most likely want, get that done through your primary doctor.
3. If the pain is intolerable before you get in to see your doctor or PA, go to an urgent care clinic. There they will likely get you started with an X-ray, and give you pain medications to manage the pain until it is diagnosed.

I hope this information helps. Please let me know if I can provide further information.

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