Which Specialist to See After a Spine Injury: A Guide for Patients

After accidentally injuring your spine, which specialty should you consult?

Three months ago, while sitting in a chair, I accidentally bumped my spine (the impact point was approximately at the junction of the thoracic and lumbar regions) while changing my position.
Since then, I have been experiencing numbness and pain in my legs (primarily in the right leg).
Sometimes the entire leg feels numb, other times only specific areas, and at times I feel like I can't sense my right leg at all, as if I were walking on one leg.
A week later, I went to a rehabilitation clinic for a lumbar X-ray and was informed that there were no significant issues with the bones, but I had a 7.4-degree scoliosis.
After rehabilitation, my leg pain worsened, so I stopped attending.
Due to the lack of improvement, I visited a neurology outpatient clinic at a major hospital last week.
The doctor believed that my symptoms were caused by the scoliosis and referred me to orthopedics to evaluate whether I need a brace or surgery, and also arranged for a full spine X-ray.
However, after thinking it over at home, I have several questions: 1.
My symptoms appeared only after the injury.
I recall that the rehabilitation doctor also mentioned he did not believe my scoliosis was caused by this impact.
After researching online, I found that it could possibly be a spinal cord injury.
Do you think that is a possibility? 2.
Given my current symptoms and the process by which they developed, should I consult orthopedics (to address the scoliosis), neurosurgery (to address a potential spinal cord injury), or family medicine (to have a comprehensive evaluation by a physician)?

Niming, 10~19 year old female. Ask Date: 2024/03/10

Dr. Ye Qianyu reply Family Medicine

Hello! For acute issues, it is recommended that you see an orthopedic specialist, preferably one who deals with spinal problems.
The sensation loss in your right foot corresponds to the lumbar or even sacral regions.
It is advisable to provide a complete description of your symptoms to the physician for assessment and treatment.

Reply Date: 2024/03/10

More Info

After experiencing a spine injury, especially one that has led to symptoms such as numbness and pain in the legs, it is crucial to seek the appropriate medical specialists to ensure a comprehensive evaluation and treatment plan. Given your situation, here are some insights and recommendations regarding which specialists to consult and the rationale behind each choice.

Understanding Your Symptoms
Your symptoms, which include numbness and pain in the right leg, could potentially be linked to a few different underlying issues. The fact that these symptoms began after a specific injury suggests that there may be a connection between the trauma and your current condition. While the X-ray indicated no significant bony issues, the presence of a 7.4-degree scoliosis could be contributing to your symptoms. Scoliosis can sometimes lead to nerve compression or irritation, particularly if the curvature is significant enough to alter the alignment of the spine.

Possible Specialists to Consult
1. Orthopedic Surgeon: Given that your primary concern seems to be related to the structural integrity of your spine, an orthopedic surgeon specializing in spinal disorders would be an appropriate choice. They can evaluate the degree of scoliosis and determine if it is contributing to your symptoms. They may also assess whether any surgical intervention is necessary, such as spinal fusion or the use of a brace to correct the curvature.

2. Neurosurgeon: If there is a suspicion of spinal cord injury or nerve root compression, a neurosurgeon would be essential for a detailed evaluation. They can perform advanced imaging studies, such as an MRI, to assess the spinal cord and surrounding structures for any signs of injury or compression that may not have been visible on X-rays. If there is evidence of nerve damage or compression, they can discuss potential surgical options to relieve pressure on the nerves.

3. Physiatrist (Rehabilitation Specialist): A physiatrist specializes in physical medicine and rehabilitation. They can provide a comprehensive approach to managing your pain and improving function through non-surgical means. This may include physical therapy, pain management techniques, and rehabilitation exercises tailored to your specific needs. They can also coordinate care between different specialists.

4. Family Medicine Physician: If you are unsure where to start, a family medicine physician can provide a holistic evaluation of your health. They can assess your symptoms, review your medical history, and refer you to the appropriate specialists based on their findings. This can be particularly helpful if you have other health concerns that need to be addressed.

Addressing Your Concerns
1. Possibility of Spinal Cord Injury: While your symptoms began after the injury, it is essential to consider that not all spinal injuries result in visible damage on X-rays. Spinal cord injuries can sometimes manifest as neurological symptoms without obvious bony abnormalities. An MRI would be the best imaging modality to assess for any soft tissue injuries, including those affecting the spinal cord or nerve roots.

2. Choosing the Right Specialist: Given your symptoms and the complexity of your condition, starting with an orthopedic surgeon or a neurosurgeon would be advisable. They can provide a focused assessment of your spine and determine if the scoliosis is indeed contributing to your symptoms. If they find that your condition is more related to nerve issues, they may refer you to a neurosurgeon or a physiatrist for further management.

Conclusion
In summary, after a spine injury, it is crucial to seek the right specialists to address your symptoms effectively. An orthopedic surgeon or neurosurgeon would be the most appropriate first steps, given the potential for structural or neurological issues. Additionally, a physiatrist can provide valuable rehabilitation support. It is essential to communicate your symptoms clearly and advocate for the necessary imaging studies to ensure a comprehensive evaluation of your condition. Early intervention can significantly impact your recovery and quality of life.

Similar Q&A

When to See a Rehabilitation Specialist vs. an Orthopedic Doctor?

When should you see a rehabilitation specialist? When should you see an orthopedic specialist?

Dr. Pan Yingda reply Rehabilitation
When you don't want to undergo surgery, you can consult a rehabilitation specialist, who can be considered an orthopedic specialist from a certain perspective.

Which Medical Specialist to See After a Bike Accident Injury?

Hello, doctor. Yesterday, I slipped while turning my bike in a parking lot, and my bike ran over my left ankle. At the time, I only felt some pain in my left hip and the back of my thigh. However, when I got home and tried to sleep, I noticed that whenever I lay on my left side, ...

Dr. Cai Dongqi reply Family Medicine
Hello, if you are experiencing persistent pain, it is recommended that you consult a rehabilitation specialist. Wishing you a speedy recovery.

Understanding Spinal Compression: When to See a Neurosurgeon or Rehab Specialist

Hello, doctor. My mother fell on her buttocks at the beginning of February and experienced incontinence and inability to move. After an X-ray in the emergency department, it was determined that she had a spinal compression and needed to rest. If her condition did not improve, she...

Dr. Zhao Shaoqing reply Neurosurgery
You can consult a neurologist for evaluation.

Tailbone Pain: Should You See an Orthopedist or a Rehabilitation Specialist?

Since the end of June, I have been experiencing pain in my coccyx when sitting, whether watching movies or sitting on the bed, to the point that I have to keep shifting positions. Should I see an orthopedic specialist or a rehabilitation specialist?

Dr. Zhou Jianwen reply Rehabilitation
Orthopedics or Rehabilitation Medicine are both acceptable.