As a neurosurgeon, many people do not know the appropriate time to make an appointment to come and see me. There is a point that is too early for me to help, but also waiting too long can cause irreversible damage to your body. Here are some clear cut reasons to call soon:
If you have an infection, a known tumor, or cancer.
Your neck pain has become unbearable, despite use of anti-inflammatory medication.
If your neck pain is causing further suffering down the arm.
If you are experiencing arm or hand weakness of ANY degree, including numbness and/or tingling in the hand or arm.
If an x-ray has shown neck or back pain due to slippage of the bones.
Low back pain with suffering similar to anything listed above is also cause to come in and see me.
Please keep in mind that whatever feeling and strength you lose may never come back. This is why it is important to see a neurosurgeon as soon as possible if you have these symptoms.
In cases of lower levels of pain or discomfort, I may not be able to help with a surgery. These include:
If you are experiencing neck or back pain that is isolated only in those areas without arm or leg pain, numbness and/or weakness.
However, if these symptoms are associated with a fever, trauma, or cancer, you should make an appointment to see me.
As a general rule, persistent back or neck pain for over 6 months- despite the use of medications and therapy- probably should be evaluated by a physician. Significant arm or leg pain associated with any numbness and or weakness warrants evaluation by me.  Neck or low back pain alone rarely needs evaluation by a neurosurgeon unless associated with fever, trauma or cancer.
However, not everyone will be automatically admitted to surgery. Only these “red flags” require surgery by a neurosurgeon. Otherwise, your symptoms can be treated with proper conservative care.