Back and Hip Pain: When to See a Neurologist or Orthopedist - Neurology

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When dealing with back and hip pain, especially following an injury or strain, it is essential to understand the underlying causes and when to seek specialized medical attention. Based on your description, it seems you have experienced a significant injury during exercise, which has led to ongoing discomfort and symptoms such as pain, tingling, and numbness in your legs.

Understanding Your Symptoms
Your symptoms of "heat" and pain in the lower back and hips, along with the tingling sensation in your feet, suggest that there may be nerve involvement, possibly due to a herniated disc or other spinal issues. The fact that you have already undergone X-rays, which indicated damage to your lumbar vertebrae and surrounding structures, is a crucial step in understanding your condition.

When to See a Specialist
Given your history and the persistence of your symptoms, it is advisable to consult a specialist. Here are some guidelines on when to see a neurologist or an orthopedist:
1. Neurologist: If you experience symptoms such as numbness, tingling, or weakness in your legs, it may indicate nerve compression or damage. A neurologist can perform a thorough neurological examination and may recommend further imaging studies, such as an MRI, to assess the condition of your spinal nerves and discs. They can help diagnose conditions like sciatica, which may arise from a herniated disc pressing on the sciatic nerve.

2. Orthopedist: If your primary concern is related to the structural integrity of your bones and joints, or if you suspect that your pain is due to arthritis or other degenerative conditions, an orthopedist would be the appropriate specialist. They can evaluate your X-rays and may suggest treatments such as physical therapy, medications, or even surgical options if necessary.


Treatment Options
In the meantime, here are some general treatment options that may help alleviate your symptoms:
- Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around your spine and hips, improve flexibility, and reduce pain. A physical therapist can tailor exercises to your specific needs and monitor your progress.

- Pain Management: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen), can help manage pain and inflammation. If your pain is more severe, your doctor may prescribe stronger medications.

- Activity Modification: Avoiding activities that exacerbate your pain is crucial. While staying active is important, you may need to modify your exercise routine to include low-impact activities that do not strain your back or hips.

- Heat and Cold Therapy: Applying heat can help relax tight muscles, while cold packs can reduce inflammation. Alternating between the two may provide relief.

- Ergonomic Adjustments: If your work or daily activities involve prolonged sitting or standing, consider adjusting your workspace to promote better posture and reduce strain on your back and hips.


Conclusion
Given your ongoing symptoms and the potential for nerve involvement, it would be wise to follow up with a neurologist for a comprehensive evaluation. They can help determine if there is any nerve compression or other neurological issues that need to be addressed. If the neurologist rules out nerve issues, then consulting an orthopedist may be the next step to explore structural problems in your spine or hips.
Remember, early intervention can lead to better outcomes, so don’t hesitate to seek further medical advice if your symptoms persist or worsen. Your health and well-being are paramount, and addressing these issues promptly can help you return to your regular activities with less pain and discomfort.