A pain by any other name

Being a good doctor means going further than a diagnosis. I remember talking to an acquaintance of mine at a backyard party. He was describing his recent development of neck pain and associated arm and hand pain. He had gone to his primary care physician for this very reason. He was relieved to have had a diagnosis after a very thorough exam and x-ray. He was told that he had "cervical radiculopathy". He was certain that he was on the right path to recovery, since he left the MD with a prescription for opiods.
I remember not being able to hold back a chuckle. My acquaintance asked why I thought it was funny. I replied "I knew you had cervical radiculopathy the very second you described it to me." He seemed astonished. I informed him that the phrase "cervical radiculopathy" only meant that you have neck pain and associated arm and/or hand symptoms. It is a way to classify a condition, and does not specify how one develops it. Nor what to do if you have it.
But I do understand where he was coming from. Sometimes doctors tend to minimize a pain or a problem when they feel that they don't have a good solution for it. They may suggest that the pain will go away on it's own, therefore any treatment beyond medication is unnecessary. The diagnosis of "cervical radiculopathy" meant that there was definitely something wrong, and that there was a good standard operating procedure for dealing with it.
What is even more important, however, is the reason that the person has the "cervical radiculopathy". Why this patient? Why now? Why on just this arm and not the other?

This where having a good doctor is helpful. Asking questions like the person's sleeping position, computer workstation setup, and exercise history are crucial. Looking at the entire body posture is also important. Assessing range of motion and core strength are essential.
After a few weeks of only slight improvement with the opiods, this acquaintance came to my office for the same reason. I was able to determine that his computer workstation did not have a pullout tray. This means that he had to lift his arm too much to mouse with the arm with the pain. Considering he spent 10 hours per day at the computer, this was significant. He also slept on this same side with his arm underneath his head. After a month of treatment, and improvement in his workstation and sleeping position, he was 75% better. His arm pain was completely gone.
I still see this patient periodically, as his 10 hr/day computer usage is still too much for his body to handle, even with improved ergonomics.