Neck Pain After Elbow Impact: When to See an Orthopedic or Neurosurgeon?

The cervical spine was struck by an elbow?

Hello, doctor.
On July 23, I was hit in the neck by an elbow, and it hurts a lot.
I currently cannot tilt my head back to wash my hair without pain, and resting my head on a pillow also causes discomfort; I can only keep my head down, and lying flat is more comfortable.
My current symptoms include a stiff and painful neck when turning my head, numbness in my left leg while sleeping, difficulty tilting my head back, and discomfort when sitting or standing with my neck upright.
All of these activities cause pain.
Should I see an orthopedic specialist or a neurosurgeon? What kind of treatment can I expect during the consultation? Approximately how long will it take to recover?

Sandy, 20~29 year old female. Ask Date: 2019/07/25

Dr. Li Yongheng reply Orthopedics

Hello, you can go to the orthopedic or neurosurgery outpatient clinic for an X-ray examination.
Based on the X-ray results, the physician will provide you with appropriate recommendations.
Wishing you a speedy recovery.

Reply Date: 2019/07/25

More Info

Neck pain following an elbow impact, especially when accompanied by symptoms such as difficulty in moving the head, pain while lying down, and numbness in the leg, can be concerning. Given the nature of your injury and the symptoms you are experiencing, it is crucial to seek medical attention promptly.
In your case, both orthopedic and neurosurgical specialists can provide valuable insights, but the choice may depend on the specific symptoms and their severity. Orthopedic surgeons specialize in the musculoskeletal system, which includes bones, joints, ligaments, tendons, and muscles. They can assess any potential injuries to the cervical spine (neck) and surrounding structures, such as fractures, sprains, or strains. On the other hand, neurosurgeons focus on the nervous system, including the brain and spinal cord. If there is a concern about nerve compression or damage, a neurosurgeon may be more appropriate.

Given your symptoms—particularly the numbness in your left leg and the pain when moving your head—it would be prudent to start with an evaluation by an orthopedic specialist. They may perform a physical examination and order imaging studies, such as X-rays or an MRI, to assess the condition of your cervical spine and any potential nerve involvement. If the orthopedic evaluation suggests that there is a significant issue with the spinal cord or nerve roots, they may refer you to a neurosurgeon for further evaluation and management.

In terms of treatment, the approach may include conservative measures initially. These can involve:
1. Rest and Activity Modification: Avoiding activities that exacerbate your pain is essential. This may include limiting neck movements and avoiding heavy lifting.

2. Physical Therapy: A physical therapist can design a rehabilitation program to strengthen the neck muscles, improve flexibility, and promote proper posture. This can help alleviate pain and prevent future injuries.

3. Medications: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and reduce inflammation. In some cases, your doctor may prescribe stronger medications or muscle relaxants.

4. Heat and Ice Therapy: Applying ice to the affected area can help reduce swelling, while heat can relax tense muscles.

5. Injections: If conservative measures fail, corticosteroid injections may be considered to reduce inflammation and pain.

As for your recovery timeline, it can vary significantly based on the severity of your injury and how well you respond to treatment. Minor strains may improve within a few weeks, while more severe injuries could take longer to heal. It is essential to follow your healthcare provider's recommendations and attend follow-up appointments to monitor your progress.

In summary, given your symptoms, it is advisable to see an orthopedic specialist first. They will evaluate your condition and determine the best course of action, which may include referral to a neurosurgeon if necessary. Early intervention can lead to better outcomes, so do not delay seeking medical attention.

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