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What Is The Treatment For Soreness In Lower Back And Neck?

Posted on Fri, 21 Feb 2014

Question: Hello Doctor, My wife and I were rear ended a few years ago, and since then there's been a seemingly endless soreness in my lower back and neck. Our visits to the chiropractor and acupuncturist did little to ease the pain. At it's worst, the pain in my back is completely debilitating, leading me to be bed ridden for up to 6 hours, or even unable to perform my work duties. My pain is legitimate, and I deserve to have it treated. I do not have a primary doctor, and the ones I've consulted with always seem to lean towards a holistic method of healing. I'm sure it works for some people, but I only slept a total of 2 hours last night due to the severe discomfort, and ahead of me is a 9 hour shift behind the bar. When I was hired, I signed an agreement that I would be able to "fully perform all required duties without assistance". As of late, I am not upholding my end, which is leading to fewer shifts that we absolutely rely on. Please recommend the treatment I require to preserve a happy and full life.

Answered by Dr. K. Naga Ravi Prasad (2 hours later)

Brief Answer: You need clinical examination & Evaluation. Detailed Answer: Hi, thanks for writing to XXXXXXX As your symptoms have started followed by a fall, something might have gone wrong (injury to the spinal ligaments, vertebral bodies, spinal cord, protruded intervertebral discs, nerve roots etc) in the vertebral column that is causing you severe and debilitating pain. A direct clinical examination, followed by investigations like Xrays of the painful areas of the spine and MRI scans of the Lumbar and cervical spine will help in establishing the correct cause of your symptoms. Specific management depends on the condition diagnosed. I suggest you to consult an orthopedic surgeon for a detailed evaluation and further management. In the meantime, try the following measures and see if they can help in resolving your pain atleast to some extent - - Take Rest and do not do any activities that cause pain, till the acute pain subsides - Apply ice or a cold pack to the painful area for 15 to 20 minutes, 4 times a day for several days. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin. - Use moist heat fomentation when you are returning to physical activity. Then use it before stretching. Gentle heating can help loosen the muscle - Gentle massaging of the painful area with a painkiller cream may provide swift relief - When the acute pain is gone, start gentle stretching exercises. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times. - Physical therapy may speed up the recovery process. Therapeutic modalities such as Ultrasound, Massaging and specific exercises will be helpful. - Use a lumbosacral back support to stabilize your spinal muscles - Take ibuprofen (Advil) or acetaminophen (Tylenol) to help relieve pain Hope I have addressed your query. Happy to help further Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. K. Naga Ravi Prasad (25 minutes later)

Thank you for the advice doctor, I actually already practice most of those therapies. The X-Ray and MRI I received following the accident, showed no signs of damage yet the pain is indeed present. As I mentioned, I do take over the counter pain relievers, but they do little for my pain. I believe I need prescription strength pain relievers, as I've exhausted all other recommendations. If you are not able to prescribe any for me, perhaps you can recommend a doctor in the Los Angeles, CA area that is open to that method? The pain is having a seriously negative impact on my life, and truly, if I just wanted to get high, I could actually acquire prescription meds faster than a pharmacy could process an order. But I am sincerely seeking controlled treatment by a medical professional who can be more sympathetic to my need to be able to fully function, and less attached to their beliefs in exercising to fix an injury. In all fairness, I tried all that was recommended, yet here I am still weakened by pain after all these years. Please, at the ver least, refer me to physician who is open to medication. That's what it's there for. Thank you again.y

Answered by Dr. K. Naga Ravi Prasad (19 minutes later)

Brief Answer: Consult a Pain medicine specialist. Detailed Answer: Hi, Nice to hear from you. From your response, I could feel your concern for the pain and its negative shade upon your daily life. As your MRI scans turned out to be normal after the accident, I feel that the possible cause of your persistent pain could be due to either weakness or imbalance in the spinal muscles that maintain the tone of the vertebral column. So, I personally feel that PHYSIOTHERAPY for improving the spinal muscle strength and tone might be helpful in solving your problem. Also, I suggest you to consult a Pain medicine specialist to prescribe a most suitable and appropriate analgesic medication for you, to provide a swift relief. To be honest (being a resident of India), I knew no specialist doctor abroad. So, I suggest you to "google" for specialist doctors in your locality for the consultation. There is also one more option which provides significant pain relief in patients with CHRONIC BACK PAIN & NECK PAIN - RADIO FREQUENCY ABLATION (RFA). The degree of pain relief varies, depending on the cause and location of the pain. Pain relief from RFA can last from six to 12 months and in some cases, relief can last for years. More than 70% of patients treated with RFA experience significant pain relief. So, you can search for centres which offer RFA and seek their advice. Hope I have justified your query. I welcome any more clarification Good day

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar