Q: I am 21 years old. I have back pain for the last 5 months. I went to a physiotherapist and took TENS (transcutaneous electric nerve stimulation) but it didn’t help me. Now I am in Russia, here I went to a neuropathologist. He prescribed me Meloxicam tablets for 10 days, but it was not helpful. I have pain around the neck (back), below the scapula and lower back. What treatment do I have to take? What is the problem? Should I take x-ray? The doctor has advised me to take a massage. But in India the doctors said don’t go for massage. In India I used Omni gel, it was very effective but for only a few minutes. Please tell me what to do

A:The symptoms which you have described suggest that you have almost continuous pain in the back of your neck, thorax and lumbar region. The pain only responds partially and transiently to analgesics, local analgesic creams and TENS. All these are just symptomatic treatments aimed at relieving your symptoms. They have their value in short term and when the cause of the problem remains unclear. But it appears that you have not been investigated to find out the cause of the pain. Since you are a young man, you are unlikely to be suffernig from any degenerative disease of the spine to account for the pain. More likely, it might be due to some inflammation occurring in and around the structures of your spine (like bone, tendons or cartilages). You have to pay more attention to your pain. Does it occur/ increase on bending, sneezing, coughing? Does it radiate up or down? Is there any morning stiffness? Does it take at least half an hour in the morning to make your back mobile again? Do you have any other joint pains/ rash in the body? Do you have any fever? Does the pain increase in the night? Do your hands/ fingers blanch or become blue while you dip them in cold water? If answer to any of these questions is YES, then you must consult a Rheumatologist/orthopaedician/ Neurologist. After clinical examination, you will probably need few blood tests and imaging.