Chronic Neck and Back Pain: Seeking the Right Specialist

Shoulder, neck, and lower back pain?

Hello, doctor.
I previously experienced gastroenteritis around November 2008, for which I saw a doctor and took medication for a week, after which I did not return for a follow-up.
In March of this year, the gastroenteritis symptoms reappeared.
Upon examination with an ultrasound, it was found that I have mild edema in the stomach.
At that time, I experienced nausea regardless of what I ate, and even drinking water would trigger the urge to vomit.
I also felt a foreign body sensation in my throat and tightness in my chest.
Whenever I thought about vomiting, the sensation would return.
Additionally, I have daily soreness in my lower back and neck/shoulders, and taking pain relievers and muscle relaxants has not improved the situation.
The soreness in my lower back and neck/shoulders has been present since November 2008.
I have seen various specialists and taken muscle relaxants, but there has been no improvement.
Currently, the feeling of nausea persists, and I have issues with the gastroesophageal junction not closing properly.
Could you please advise me on which specialty I should consult to address my lower back and neck/shoulder pain, and how the function of the gastroesophageal junction relates to my persistent nausea, which is significantly affecting my daily life and work?

Long, 30~39 year old female. Ask Date: 2009/03/23

Dr. Sun Yizhen reply Internal Medicine

We recommend that you consult the hospital's information desk, where the staff will provide further advice based on your age, gender, and clinical symptoms.

Reply Date: 2009/03/23

More Info

Chronic neck and back pain can be a debilitating condition that significantly affects one's quality of life. Based on your description, it seems you have been experiencing a combination of gastrointestinal issues and musculoskeletal pain for an extended period. The interplay between these symptoms can be complex, and it is essential to approach this situation with a comprehensive understanding of both the physical and potential psychological factors involved.

Firstly, your history of gastrointestinal problems, particularly the episodes of gastroenteritis and the sensation of nausea, suggests that there may be an underlying issue that needs to be addressed. The feeling of having a foreign body in your throat and the persistent nausea can be indicative of conditions such as gastroesophageal reflux disease (GERD) or esophageal motility disorders. These conditions can lead to discomfort that might be perceived as neck or shoulder pain due to referred pain patterns. It is crucial to consult a gastroenterologist who can evaluate your symptoms further, possibly through endoscopy or other imaging studies, to determine the exact cause of your gastrointestinal distress.

Regarding your chronic neck and back pain, it is important to consider that prolonged discomfort in these areas can often be linked to poor posture, muscle strain, or even stress-related tension. Since you mentioned that you have been taking muscle relaxants and pain medications without significant improvement, it may be beneficial to explore physical therapy. A physical therapist can provide tailored exercises to strengthen the muscles supporting your neck and back, improve your posture, and teach you techniques to manage pain more effectively.

Additionally, you may want to consider consulting with a pain management specialist. These professionals can offer a multidisciplinary approach to pain management, which may include physical therapy, medication management, and possibly interventional procedures if necessary. They can also help you explore alternative therapies such as acupuncture or chiropractic care, which some patients find beneficial for chronic pain relief.

It is also worth noting that psychological factors can play a significant role in chronic pain. Stress, anxiety, and depression can exacerbate physical symptoms and create a cycle of pain and discomfort. If you feel that emotional factors may be contributing to your condition, speaking with a psychologist or psychiatrist may provide additional support and coping strategies.

In summary, the best course of action would be to:
1. Consult a Gastroenterologist: To address your gastrointestinal symptoms and evaluate for conditions like GERD or esophageal motility disorders.

2. Seek Physical Therapy: To develop a personalized exercise program aimed at strengthening your neck and back muscles and improving your posture.

3. Consider Pain Management: A pain management specialist can provide a comprehensive approach to your chronic pain, exploring various treatment modalities.

4. Evaluate Psychological Factors: If applicable, consulting with a mental health professional can help address any emotional components contributing to your pain.

By taking these steps, you can work towards a more holistic approach to managing your symptoms and improving your overall quality of life. Remember, it is essential to communicate openly with your healthcare providers about all your symptoms, as this will help them tailor their approach to your specific needs.

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