January 29, 2019
Clinical Contributors to this Story
Tamir Tawfik, M.D. contributes to topics such as Neuroscience.
By Brianna McCabe
There are certain challenges that come with aging: your hair thins, your hearing dwindles and your muscles hurt.
Among adults, 60% to 80% will have issues with back pain at some point in their lives and 20% to 70% will deal with neck pain. Tamir Tawfik, M.D., a neurosurgeon at Hackensack Meridian Health Medical Group, explains that not all pain in these areas should be of concern, though. “For instance, if you had a hard day of work which entails manual labor, back and neck pain could be expected,” he says. “In fact, it’d be natural for your body to feel sore and achy.”
In these cases, most episodes of pain are the result of muscle spasms or inflammation and will resolve within 24-48 hours with little to no intervention.
“However, there are certain scenarios where you shouldn’t just shrug off your pain and hope an over-the-counter pain medication does the job,” explains Dr. Tawfik.
According to the neurosurgeon, here are some signs that you should visit your primary care physician for further evaluation on your back and neck pain:
- You have bouts of numbness. That constant ‘pins and needles’ feeling or even those moments of complete loss of feeling can signal an issue with your nerves, suggests Dr. Tawfik. “This can be related to issues such as spinal stenosis or a herniated disc, both which require medical attention, a proper diagnosis and treatment plan,” he says. “Don’t wait. This can lead to later complications such as permanent nerve damage.”
- You have spontaneous onsets of pain. “For example, if you are sleeping at night and you notice that you are having shooting pains into your arm, you can be facing larger issues such as a cervical disc herniation or enlargement of joints or ligaments,” he shares.
- You have incontinence. If your pain is coupled with the loss of bladder or bowel control, you need urgent medical attention. “Your nerves might be compressing on the spine and affecting your organs,” warns Dr. Tawfik.
- You had a recent traumatic injury. “If you experienced trauma, such as being in a car accident or having a severe fall, you should consult with your care team immediately,” he says. “There are muscle, bone and neurological elements that should be evaluated to rule out any detrimental effects, such as fractures or encroachment on the nerves.”
- You have constant pain. According to Dr. Tawfik, if the pain is relentless, intolerable and affects your daily activities, you should seek medical advice. “There is no specific timeframe to say, ‘After x number of days you should seek care,’” he says. “You know your own body.” Don’t prolong the waiting period, though, as a condition can worsen over time, he adds.
- You also have a fever. “A fever can be something called osteomyelitis discitis or an epidural abscess. In other words, you can have an infection that enters the bloodstream and enters your bones or disc spaces of the spine,” he clarifies. As the fever is prolonged or neglected, especially if the individual is diabetic or on certain medications, the condition can worsen.
When evaluating back pain, Dr. Tawfik typically asks his patients the following questions:
- Can you please describe the pain? (Is it sharp? Electrical in nature? Is it focal or does it travel to other limbs?)
- Where is the pain felt?
- How long has the pain been present?
- Does anything make the pain worse?
- What types of pain management have you tried?
- What makes the pain better, if anything?
- Do you have any pain when walking? (If so, what is the distance you can walk without pain? For how long can you walk? When you do walk, is it so painful that you have to stop at a certain point?)
When evaluating neck pain, Dr. Tawfik typically asks his patients the first six aforementioned questions in addition to the following:
- Is the pain associated with numbness or weakness?
- Do you have any trouble with balance? Are you walking normally?
- How is your finger dexterity? (Are you able to pick up things and not drop them out of your hands? Can you open a jar? Are you having any trouble buttoning your buttons?)
“Everyone’s pain is relative,” continues Dr. Tawfik. “It is important to be open and honest with your care team and be as descriptive as possible. Then, and only then, can you as a patient get everything you want out of a consultation. You will get answers – and you will get help.”
Dr. Tawfik practices at Hackensack Meridian Health Medical Group – Neurosurgical and Spine Specialists in Toms River (300 West Water Street). If you would like to schedule an appointment with Dr. Tawfik, call 732-455-8640. To find a provider near you, visit HackensackMeridianHealth.org.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.