system: You are a clinical documentation assistant. Generate only the requested clinical note section using only facts from the dialogue. Do not invent information. If the section is not supported by the dialogue, return N/A.

user: Section: GENHX

Dialogue:
Doctor: How is your pain today?
Patient: Eh it's been a rough few days that's for sure. The pain started almost instantly.
Doctor: I'm sorry to hear that. Have you been taking anything for it?
Patient: I actually saw a chiropractor the other day. My neck pain has been unbearable.
Doctor: Is the pain localized to one area?
Patient: Yeah.
Doctor: And it hasn't radiated to any other part of your body?
Patient: Nope.
Doctor: Are you experiencing a pins and needles sensation at all?
Patient: Not yet.
Doctor: Any back pain?
Patient: Oh yeah. I'd say it's even worse than my neck pain. The pain starts in my lower back and radiates down both legs.
Doctor: Any pins and needles as a result of this back pain?
Patient: No, no pins and needles.
Doctor: Are you experiencing stiffness in your back?
Patient: The stiffness seems to worsen when I exert myself during activities.
Doctor: Has it impacted your sleep at all?
Patient: Honestly, I haven't gotten much sleep since the accident. It's been so difficult to find a comfortable position to sleep in. I've never had back problems until now.
Doctor: This accident sure did a number on you.
Patient: No kidding.
Doctor: You had mentioned experiencing stiffness during strenuous activity. Is it mostly during the day or does it progress into the night?
Patient: Yeah, it's mostly during the day.
Doctor: I see.
Patient: The pain does improve a bit when I lay flat or sit up in a chair.
Doctor: But despite this, your activity continues to be restricted, correct?
Patient: Yeah, correct.
Doctor: I meant to ask if you felt better after chiropractic treatment?
Patient: A little bit, but not much.
Doctor: And would you say your pain has overall gotten worse or remained the same?
Patient: It's stayed more or less the same.
Doctor: And to confirm, you didn't have neck or lower back problems prior to the accident?
Patient: Yeah.

assistant: The patient relates the persistence of pain since the motor vehicle accident. Symptoms began immediately following the MVA. Because of persistent symptoms, the patient subsequently sought chiropractic treatment. Neck pain is described as severe. Neck pain remains localized and is non-radiating. There are no associated paresthesias. Back pain originates in the lumbar region and radiates down both lower extremities. Back pain is characterized as worse than the neck pain. There are no associated paresthesias. Stiffness is provoked by attempts at strenuous activity. The patient also reports difficulty sleeping, unable to find a comfortable position. The patient denies any previous back problems. During the day, the pain is exacerbated by strenuous activities. Pain may be eased by resting or recumbency and sitting. The patient's activity level has been significantly restricted. Some improvement has been noted with chiropractic treatment. Since the onset of the problem, the pain has continued at more less the same level. The patient reports that, prior to the present problem described above, there had been no episodes of neck or lower back pain.