Leg Numbness: When to See a Neurologist or Orthopedist - Neurology

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When experiencing leg numbness, especially if it has changed in nature or frequency, it is essential to seek medical advice to determine the underlying cause. Given your symptoms of numbness from the thigh to the calf, accompanied by a cold sensation, it is crucial to consider both orthopedic and neurological evaluations.
Numbness in the legs can arise from various conditions, including nerve compression, circulatory issues, or musculoskeletal problems. In your case, the history of previous back pain and numbness suggests that there may be a connection to spinal issues, such as herniated discs or spinal stenosis, which can compress nerves that innervate the legs. The fact that your symptoms have evolved from being occasional upon waking to more frequent during various activities indicates a potential worsening of the underlying condition.

Given the complexity of your symptoms, I would recommend starting with a visit to a neurologist. Neurologists specialize in diagnosing and treating conditions related to the nervous system, including peripheral neuropathies and radiculopathies, which could be causing your leg numbness. They can perform a thorough neurological examination, which may include tests like electromyography (EMG) and nerve conduction studies (NCS) to assess the function of your nerves and muscles. These tests can help identify whether there is nerve damage or compression at specific levels of the spine.

If the neurologist determines that your symptoms are related to structural issues in the spine, they may refer you to an orthopedic specialist or a neurosurgeon for further evaluation and potential treatment options. Orthopedic surgeons focus on the musculoskeletal system, including bones, joints, and muscles, and can provide insight into whether any structural abnormalities in the spine are contributing to your symptoms.

In addition to nerve-related issues, it is also important to consider vascular problems that could lead to numbness and cold sensations in the legs. Conditions such as peripheral artery disease (PAD) can cause reduced blood flow to the legs, leading to numbness, tingling, and coldness. If your neurologist suspects vascular involvement, they may refer you to a vascular specialist for further assessment.

In summary, given your symptoms and their progression, I recommend starting with a consultation with a neurologist. They will be able to conduct a comprehensive evaluation and guide you on the appropriate next steps, whether that involves further neurological testing, imaging studies, or referrals to other specialists. Early intervention is key in managing these symptoms effectively, so seeking medical advice promptly is essential.
Lastly, it is important to maintain an active lifestyle and engage in exercises that strengthen your core and lower body, as recommended by your previous healthcare provider. However, ensure that any exercise regimen is tailored to your current condition and is approved by your healthcare provider to avoid exacerbating your symptoms.