Leg Numbness and Back Pain: When to Seek a Second Opinion

Numbness in the legs and lower back pain?

Hello, doctor.
Recently, I've been experiencing lower back pain and my legs feel sore and numb.
I visited a neurologist, but the doctor only tapped my knee (the reflex test we learned in middle school) and concluded that my issues are related to muscle problems rather than nerve issues.
Is it really possible to make such an easy determination? Should I consider switching to another hospital for further examination?

Chen Junpin, 20~29 year old female. Ask Date: 2019/01/04

Dr. Jiang Junyi reply Neurology

Hello, based on your description, it is important to consider symptoms related to nerve compression due to a herniated disc, which may also occur as a result of sudden injuries, such as twisting the waist, bending to lift heavy objects, or experiencing excessive force, for example, falling from a ladder or landing directly on the spine.
A herniated disc can lead to localized inflammatory responses causing back pain and may compress nerve roots, resulting in radiating pain and numbness extending to one side of the lower limb.
The symptoms are often located in the posterior thigh, lateral calf, and even in the dorsum of the foot and toes.
Nerve root compression can also lead to sensations of tingling and numbness, sensory deficits, diminished reflexes, and muscle weakness.
It is advisable for you to visit a neurology clinic for evaluation, where the physician will provide medication and rehabilitation treatment based on your condition.
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2019/01/04

More Info

When it comes to leg numbness and back pain, it's essential to understand that these symptoms can arise from a variety of underlying issues, ranging from muscular problems to more serious neurological conditions. Your experience with the neurologist, where the examination seemed limited to a reflex test, raises valid concerns about whether a comprehensive evaluation was conducted.

Firstly, it’s important to recognize that while reflex tests can provide some insight into neurological function, they are not definitive on their own. A thorough assessment should include a detailed medical history, a physical examination that assesses not just reflexes but also strength, sensation, and range of motion, and possibly imaging studies such as MRI or CT scans if indicated. These steps help to rule out or confirm conditions such as herniated discs, spinal stenosis, or other issues that could be compressing nerves and leading to your symptoms.

Given that you are experiencing both back pain and leg numbness, it is crucial to consider the possibility of conditions like sciatica, which can occur when the sciatic nerve is compressed, often due to a herniated disc or spinal stenosis. This can lead to pain, numbness, or weakness in the legs. Other potential causes could include peripheral neuropathy, which affects the nerves outside the brain and spinal cord, or even issues related to the lumbar spine itself.

If you feel that your concerns were not adequately addressed during your visit, seeking a second opinion is a reasonable course of action. A different healthcare provider may offer a more comprehensive evaluation and potentially different diagnostic tests that could lead to a clearer understanding of your condition. It’s also beneficial to consult with a specialist who focuses on spine health, such as an orthopedic surgeon or a neurosurgeon, especially if your symptoms persist or worsen.

In addition to seeking further medical evaluation, consider keeping a symptom diary. Document when the pain and numbness occur, their intensity, any activities that exacerbate or relieve them, and any other relevant information. This can provide valuable insight to your healthcare provider and assist in making a more accurate diagnosis.

In summary, while reflex testing is a part of neurological assessments, it should not be the sole basis for diagnosing conditions related to back pain and leg numbness. If you feel unsatisfied with the evaluation you received, it is entirely appropriate to seek a second opinion. A thorough examination, possibly including imaging studies, will help clarify the cause of your symptoms and guide appropriate treatment options. Remember, your health is paramount, and advocating for yourself in the healthcare system is crucial.

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