I look forward to our meetings here at the Coastal Point every month to talk about problems that I want to help you understand.

From visiting with me over the years, you know that I think dialogue is a really important part of a relationship between a physical therapist and a patient. So many times, people come to me with a problem, and they’re trying to figure out what’s causing it. There are some top problems that I am asked about a great deal. So this week, I’m going to share some of the typical questions I am asked by many folks like you, and some information that can be helpful.

Q. I’ve been having problems with back pain and I can’t figure out what’s causing it. How do I get answers?

A. Back pain is no fun. It can be tricky, too, because there are many different potential problems that can cause back pain. In some cases, the cause of back pain can be fractures, muscle strains, arthritis and even infections or certain diseases. If you’re working, you might be in a job that requires you to sit or standing for long periods of time. And, this can also be typical of your routine at home. Long periods of sitting or standing can be causing back pain. You might be doing things at home or in a job that involve a task that requires repetitive motion like bending or repeated lifting. Posture can also be at the root of your back pain because that can involve spinal alignment. Generally, the lower back is the area of the spine that brings about the most symptoms of pain. Because your spine is so key to your mobility, it is absolutely critical to pinpoint the cause so you can get the right treatment.

Q. I started having some twinges and now it’s turned into a full-blown problem with shoulder pain. What could be causing it?

A. Shoulder problems can have many different causes. It can result from habits at home or being in a job where you sit for long periods of time. It can also involve a muscle strain or even repetitive motion because of a hobby. Athletes, including weekend warrior athletes, who play sports like baseball, tennis or golf can also develop problems from the mechanics of their sports. Complicating figuring out what is going on are incidents where shoulder pain seems to have no apparent cause. We also have to look at whether the pain is the result of an injury like a fall or something as seemingly simple as lifting something that is heavy. Did you fall or reach over your head while putting something away? That could be the reason.

Some symptoms that can occur include either a dull pain, a throbbing pain or a sharp sort of stabbing pain. Indications of a shoulder problem can come to light when you experience weakness or a limitation in your range of motion. Symptoms that involve a sense of numbness down an arm or in a hand or fingers or a tingling sensation can also be a sign of a shoulder problem. Something to keep in mind is that some two-thirds of shoulder pain incidents are tied to rotator cuff problems.

Q. Recently, I’ve been having headaches. I’ve never really had them before, so what could be causing them?

A. Headaches can make you miserable and like the other issues we’ve discussed, it’s important to get the right answer. As many of us know, headaches can be caused by sinus problems, stress or even being over-tired. Generally, if a headache starts at the base of your neck and you feel it up your head, or if you feel it around your head and down your neck, there’s a good chance this is a cervical headache. You have some key muscles which run from your upper cervical spine as well as others that run from your shoulder to the base of your head. You also have an important muscle that goes from your collarbone to the bottom of your skull. If you’re having a problem with one of these muscles, this can be the cause of your cervical headache. You could also be having a problem with the upper cervical spine itself that could be the culprit.

At the heart of any of these problems with muscles or your spine are issues that are in turn triggering your cervical headache. It could be the way you position your body during your sleep. It could be the result of how you sit on your couch or in your chair and even how you sit in your car. Something as simple as carrying a heavy purse could be the cause. If you spend long periods of time sitting or even standing at home or at work that could be the trigger, too. About 20 percent of all headaches are cervical headaches and women need to particularly be aware of this because four times the number of women versus men experience a cervical headache.

Finding the answers

We’ll cover some more common issues another time, but for now, I want to remind readers of something I have mentioned many times before. Don’t self-diagnose. I want you to start by getting to a doctor. I feel very strongly about this. One of my big concerns is that different problems can have some similar indications. You also know that I am not a fan of taking chances. Taking chances is never a good thing when it comes to your health and mobility.

Make sure you prepare for your appointment. Start by writing down any medications and supplements you are taking and bring that list with you to your doctor appointment. Remember to write down the details on how and when your problem began. Did you have an injury? Write down how your injury occurred and share any other developments in your health. This is extremely important to give your doctor a full picture for purposes of your diagnosis.

When you go to the doctor, you can expect your medical professional will perform a thorough examination and there can always be the potential for other tests to pinpoint the exact cause of your pain. I recommend that you write down what your doctor tells you about next steps and potential reasons for your problem. Sometimes, it can be a lot of information and it’s hard to absorb all that new information at once. Your notes give you a way to refer back and think about what you’ve been told. Reviewing your notes might bring something else to mind about issues you’ve been having, and it might raise other questions you will want to ask. If you have someone that can go with you to an appointment and you feel comfortable having someone join you, it can add a second set of ears and someone who can take notes, too.

For a number of problems, your doctor may prescribe physical therapy. When you arrive for your first appointment, your physical therapist will likely perform a thorough exam after reviewing the information your doctor has shared. In addition to the relationship a conversation establishes — as those who visit with me here at Tidewater know — I find a conversation really helps to get your input on the challenges, pain level and other potential issues that are impacting you as a patient. I feel strongly that all of this information allows your physical therapist to create a personalized treatment plan that will focus on getting the best possible outcome for you.

Someone once said that the only bad question is an unasked one. Asking questions is a healthy part of the exchange between you and your medical professional including your doctor, your physical therapist and even your pharmacist. It all comes down to being able to have quality of life and making each day as worthwhile as you can. You know that I want the best for you, so get moving and look for the answers that could make a wonderful change in how you live each day.

Bob Cairo is a licensed physical therapist at Tidewater Physical Therapy. He can be reached by calling (302) 537-7260.