Which Medical Specialty Should I See for My Neck and Shoulder Pain?

Which department should I see?

Hello Doctor: I have been experiencing shoulder and neck pain for six months! I work in a school library, so I often have to lift books.
The pain in my shoulder started before last summer, and during the summer break, I went to a traditional Chinese medicine clinic for cupping therapy.
However, shortly after the school year began, my shoulder discomfort returned.
Recently, I noticed that my neck has also started to feel uncomfortable.
I have to ask someone to help me apply topical pain relief ointment every night, and during the application, I experience significant pain around my collarbone and the joints connecting my arms.
Although the ointment provides some relief, the discomfort returns by the next afternoon.
I would like to know which specialty I should consult for this issue.
Additionally, I fell in the bathroom either last year or the year before.
I landed directly on my buttocks, and my left knee was bent and pressed against the floor.
At that time, I was only concerned about my knee pain and didn't pay attention to my buttocks.
Since then, I have found that I can only sit for a short period on a motorcycle or chair; sitting too long causes pain in my buttocks, and I cannot stand up immediately.
The pain is always located in my coccyx area.
Could this pain be related to my previous fall? (I have not seen a doctor for this injury since it happened.)

Yu, 20~29 year old female. Ask Date: 2016/01/19

Dr. Gao Qingyun reply Family Medicine

Hello, please have an orthopedic specialist examine and assess the cause of the pain for treatment.
Currently, it is difficult to determine the cause of the pain based on the available information.
Wishing you peace and health.
Sincerely, Dr.
Gao Qingyun, Director of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2016/01/19

More Info

Based on your description of persistent neck and shoulder pain, along with the history of a fall that may have impacted your coccyx (tailbone), it is advisable to consult a medical professional who specializes in musculoskeletal disorders. The symptoms you are experiencing could be related to several underlying issues, including muscle strain, ligament injuries, or even nerve compression.

Recommended Medical Specialties
1. Orthopedic Specialist: An orthopedic doctor specializes in the diagnosis and treatment of musculoskeletal injuries, including those affecting the spine, shoulders, and joints. Given your history of pain and the physical demands of your job, an orthopedic evaluation could help identify any structural issues, such as rotator cuff injuries or cervical spine problems.

2. Physical Medicine and Rehabilitation (PM&R): Also known as physiatry, this specialty focuses on restoring function and improving quality of life for patients with musculoskeletal and neurological conditions. A physiatrist can provide a comprehensive evaluation and develop a rehabilitation plan that may include physical therapy, medication management, and other non-surgical interventions.

3. Neurologist: If your symptoms include numbness, tingling, or radiating pain, a neurologist can evaluate for nerve-related issues. They can assess whether there is any nerve compression or radiculopathy, particularly if the pain is radiating down your arms or into your hands.

4. Chiropractor: While not a medical doctor, chiropractors specialize in spinal manipulation and can help alleviate pain through adjustments and other manual therapies. They can also provide guidance on posture and ergonomics, which may be beneficial given your work environment.

5. Pain Management Specialist: If your pain is severe and persistent, a pain management specialist can offer various treatments, including injections, medication management, and alternative therapies to help manage your symptoms effectively.

Potential Causes of Your Symptoms
1. Muscle Strain: Repetitive lifting and moving of books in your job may have led to muscle strain in your shoulders and neck. This can cause discomfort and pain that may radiate to other areas.

2. Cervical Spine Issues: Given the neck pain and the history of a fall, there may be underlying cervical spine issues, such as herniated discs or cervical spondylosis, which can lead to nerve compression and pain.

3. Coccyx Pain: The pain in your tailbone area could be related to your fall. Coccyx injuries can cause significant discomfort, especially when sitting for prolonged periods. This pain can sometimes radiate to the lower back and hips, affecting your overall mobility.

Next Steps
- Seek Evaluation: It is important to see a healthcare provider who can perform a thorough physical examination and possibly imaging studies (like X-rays or MRI) to assess your condition accurately.

- Physical Therapy: A physical therapist can develop a tailored exercise program to strengthen the muscles around your neck and shoulders, improve flexibility, and address any postural issues.

- Pain Management: Discuss pain management options with your healthcare provider, which may include medications, topical treatments, or injections if necessary.

Conclusion
Given the complexity of your symptoms and their duration, it is essential to seek medical attention promptly. A multidisciplinary approach involving orthopedic specialists, physiatrists, and possibly neurologists will provide you with the best chance for recovery and pain relief. Additionally, addressing any ergonomic issues at your workplace may help prevent further aggravation of your symptoms.

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