Back Pain: When to See a Specialist for Relief - Neurology

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Back pain can be a complex issue, especially when it involves multiple areas such as the chest, shoulder, and spine. Based on your description, it seems that your pain started with discomfort in the left side of your chest, which then progressed to pain between your shoulder blade and spine. This kind of pain can often be attributed to musculoskeletal issues, but it can also be related to nerve compression or other underlying conditions.

Given the symptoms you've described, it would be advisable to see a specialist who can provide a comprehensive evaluation. Here are some steps and considerations for seeking relief from your back pain:
1. Primary Care Physician (PCP): Your first step should be to visit your primary care physician. They can perform an initial assessment, take a detailed history of your symptoms, and conduct a physical examination. Your PCP can also rule out any serious underlying conditions that may require immediate attention.

2. Orthopedic Specialist: If your PCP suspects that your pain is related to a musculoskeletal issue, they may refer you to an orthopedic specialist. Orthopedic doctors specialize in the diagnosis and treatment of conditions related to bones, joints, and muscles. They can provide further imaging studies, such as X-rays or MRIs, to assess for any structural problems.

3. Neurologist: If there is a suspicion of nerve involvement, such as radiculopathy (nerve pain that radiates from the spine), a neurologist may be consulted. They can perform nerve conduction studies or electromyography (EMG) to evaluate nerve function.

4. Physical Therapist: Regardless of the specialist you see, physical therapy can be an essential part of your recovery. A physical therapist can develop a personalized rehabilitation program to strengthen the muscles around your spine, improve your posture, and enhance your flexibility. This can help alleviate pain and prevent future episodes.

5. Pain Management Specialist: If your pain persists despite conservative treatments, a pain management specialist may be able to offer additional options, such as injections or advanced pain management techniques.

6. Chiropractor: Since you mentioned seeing a chiropractor for manipulation, it's important to ensure that any adjustments are performed by a licensed professional. While chiropractic care can be beneficial for some individuals, it may not be suitable for everyone, especially if there are underlying conditions that could be exacerbated by manipulation.


When to Seek Immediate Care
You should seek immediate medical attention if you experience any of the following:
- Severe or worsening pain that does not improve with rest or over-the-counter medications.

- Numbness, tingling, or weakness in your arms or legs.

- Loss of bladder or bowel control.

- Pain that radiates down your legs or is associated with significant weakness.


Conclusion
Back pain can stem from various causes, including muscle strain, poor posture, nerve compression, or even referred pain from other areas. It's crucial to approach your symptoms holistically and seek the appropriate medical advice. By starting with your primary care physician, you can ensure that you receive a thorough evaluation and are directed to the right specialist for your specific needs. Remember, early intervention can often lead to better outcomes and a quicker return to your normal activities.