Ankle Numbness: When to See a Neurologist or Orthopedist

Numbness in the ankle?

Doctor, lately when I lie down, I feel a noticeable tingling and swelling sensation on the outer sides of both ankles.
Since I often sprain my ankles, I went to a traditional Chinese medicine clinic for an examination, and they mentioned it might be a herniated disc.
Given this situation, should I see a neurologist or an orthopedic specialist? Thank you, doctor.
🙏

Xiao Le, 30~39 year old female. Ask Date: 2022/06/08

Dr. Jiang Junyi reply Neurology

Dear Ms.
Hsiao-Leh,
You mentioned, "With a herniated disc, should I see a neurologist or an orthopedic specialist?" The spine is subjected to repetitive stress, particularly from improper activities such as bending to pick things up or prolonged bending and twisting, which can exert abnormal pressure on the intervertebral discs, leading to herniation.
A herniated disc may cause localized inflammatory responses resulting in back pain, and it can also compress nerve roots, causing radiating numbness and pain down one leg.
I recommend that you visit either a neurology or orthopedic clinic for nerve conduction studies and follow-up treatment.
Thank you for your inquiry.
If you have any further questions, feel free to discuss!
Wishing you good health and happiness,
Dr.
Chien-Yi Chiang, Taoyuan Hospital

Reply Date: 2022/06/08

More Info

When experiencing numbness or tingling sensations in the ankles, especially if it is accompanied by a history of ankle sprains, it is essential to consider the underlying causes. The symptoms you describe—tingling and a "numb" feeling in the outer sides of your ankles—could be indicative of several conditions, including nerve compression or irritation, which may stem from issues in the lower back, such as a herniated disc, or from localized problems in the ankle itself.

Given your history of ankle sprains, it is plausible that the numbness could be related to a mechanical issue in the ankle joint or surrounding soft tissues. However, if the symptoms are also associated with lower back pain or if they radiate from the back down to the legs, it may suggest that the problem originates from the lumbar spine. Conditions such as lumbar disc herniation can lead to nerve root compression, resulting in symptoms that manifest in the legs and feet.

In your case, the recommendation would be to first consult with a neurologist. A neurologist specializes in conditions related to the nervous system, including nerve compression syndromes, neuropathies, and other neurological disorders. They can perform a thorough neurological examination and may recommend diagnostic tests such as an MRI of the lumbar spine or nerve conduction studies to assess the function of the nerves in your legs and feet.

If the neurologist determines that the numbness is due to a structural issue in the ankle itself, they may refer you to an orthopedist. An orthopedist specializes in the musculoskeletal system, including bones, joints, ligaments, and tendons. They can evaluate any potential injuries or chronic conditions affecting the ankle, such as ligament damage or osteoarthritis, and recommend appropriate treatment options, which may include physical therapy, medication, or possibly surgical intervention if necessary.

It is also worth noting that if you experience any additional symptoms such as weakness in the legs, loss of bladder or bowel control, or severe pain, you should seek medical attention promptly, as these could be signs of a more serious condition requiring immediate intervention.

In summary, start with a visit to a neurologist to rule out any nerve-related issues, especially considering your symptoms and history of ankle sprains. Depending on the findings, you may then be referred to an orthopedist for further evaluation and management of any orthopedic concerns. Early intervention can help prevent further complications and improve your overall quality of life.

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