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Neck and back pain are common complaints seen in the ED and have a wide array of causes, ranging from benign to life threatening. Workup of these complaints requires a thorough history with careful attention to risk factors for serious pathology. A complete physical examination includes evaluation of specific nerve roots and dermatomes.

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Neck and back pain are often due to nonspecific musculoskeletal causes, but symptoms may also be attributable to spinal nerve roots (radiculopathy) or the spinal cord itself (myelopathy) (Tables 177-1, 177-2, 177-3). Thoracolumbar pain may be categorized by symptom duration: acute (<6 weeks), subacute (6 to 12 weeks), or chronic (>12 weeks).

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Table 177-1 Symptoms and History Associated with Neck Pain
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Table 177-2 Symptoms and Signs of Cervical Radiculopathies
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Table 177-3 Symptoms and Signs of Lumbar Radiculopathies

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