Neurologist verses Orthopedics

[ladydi61]

I have been seeing a orthopedic physician for 2 1/2- 3 yrs now and im not sure if I should continue with him or visit a neurologist.The onset began appx. 2 yrs ago,severe skull pain,neck pain,migraines.My family physician sent me to the orthopedic physician and he diagnoised me with Cervical Spondylosis and Degenitave Disk Disease.I could not sit for any period of time and when i did i could not turn my head/neck or i would get a "catch"it felt like I was tied to a rope and was running and was suddenly stopped because the rope suddenly tightened up".The pain was so bad i had to stand very still for hrs. and in tremendouse pain,he begab epidural injections every 2 weeks for a total of 8,those lasted for 13 months before the symptoms returned,i went back to recieve more injections but was told i could not because too much could cause more harm than good.So he decided to do steroid injections(right C4,5 C6,7)That seemed to work for ???2 weeks then i started experiencing loss of control in my right arm when i would reach up or out,neck aches(dull pain,ache)then dizziness and headache,now im haveing cramps and spasms in my front right upper chest area and my arm and hand on right aches and my leg(right,gets a pain while driving from butt cheek down back of upper leg)my hand is having spasms and i cant sit for a long period of time(10 mins)I am sceduled to have a Medialbranch blockperformed in 2 weeks and am hesitant because i was not told the after affects or what this procedure could possibly make worse.I was given muscle relaxant and Norco but only take when i really have to because they cause extreme drowsiness.Please help...The confusion is terrible and on top of the pain im miserable.I had a cousin killed in an auto accident because he turned his head to check for traffic before exiting the parking lot and a nerve got pinched and hewas hit by a semi so this issue is very scary for me and my family.

[Dr. A. Srivastava]

Thank you for your question. Most likely, your symptoms may be due to Cervical spondylosis or due to nerve irritation in the cervical (neck) spine because of injury/prolapse where contact between the edges of the vertebrae can cause neck pain. In few people, this pain may be referred and perceived as occurring in the back of head, shoulders, arms or chest, rather than just the neck. Other symptoms may include vertigo, nausea (dizziness) that you felt. Other symptoms are like neck pain and stiffness can be intermittent. It will be best that you consult a neurologist who would like to prescribe painkillers, steroid and muscle relaxants. Other treatments could be cervical orthosis such as a soft cervical collar/stiffer neck brace to restrict neck movement. In addition, the doctor may also suggest cervical traction, if condition is severe. Hope this helps.

[ggreg]

Sure, go to a neurologist.  The spasms and aches in your arm and upper chest are the from nerves that are coming out of your cervical spine.  But the pain in your hip and upper leg are from your lower spine somewhere OR the hip joint itself.  Anyhow, since the risks of the new block scheduled in two weeks are worrisome to you, seeing a neurologist would sort of act as a second opinion, so you could put off that block until you can get in to see the neuro.  

Those appointments are sometimes hard to get, that is, you may have to wait as much as two months to get in there.  I am not sure what the treatment is supposed to be for someone with degenerative disk disease... usually a hurt spine is given moderate treatment, to include rest, medications, maybe a brace or collar to support the back or neck, and medicines, plus eventually physical therapy, but for you, the latter might make it worse.  If those don't work, surgery sometimes becomes an option.  So, if later on surgery comes into the picture, all the more reason to seek a second doc to have on the case at this stage.  

When someone comes into an ER with a broken bone, an orthopedist is called in.  When a person has seizures or brain injury, a neurologist is called in.  But they each understand the spine's anatomy as well as the other.  In your case, your spine is goofed up, but you have a nerve component to your disk disease, so that's how come it's okay to go to the neurologist, in addition to the orthopedist.