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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.

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).

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

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