Numbness in Outer Thigh: When to See a Neurologist or Surgeon? - Neurology

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Numbness in the outer thigh can be a concerning symptom, especially when it occurs bilaterally, as you described. Given your situation, it's important to understand the potential causes and when to seek further medical evaluation from a neurologist or a surgeon.

The outer thigh numbness you are experiencing could be attributed to several factors. One common cause is meralgia paresthetica, which is a condition resulting from compression of the lateral femoral cutaneous nerve. This nerve provides sensation to the skin of the outer thigh. Compression can occur due to various reasons, including obesity, tight clothing, prolonged sitting, or even certain medical conditions like diabetes. The fact that you mentioned the numbness is limited to the outer thigh and does not involve pain or other symptoms is consistent with this condition.

Since you have been undergoing physical therapy for over six months without significant improvement, it may be time to consider further evaluation. Here are some steps you can take:
1. Consult a Neurologist: A neurologist specializes in conditions affecting the nervous system. They can perform a thorough neurological examination to assess the function of your nerves and identify any underlying issues. They may also recommend diagnostic tests such as nerve conduction studies or electromyography (EMG) to evaluate the electrical activity of your muscles and the function of your nerves.

2. Consider Imaging Studies: Depending on the neurologist's findings, they may recommend imaging studies such as an MRI or CT scan of the lumbar spine to rule out any structural issues, such as herniated discs or spinal stenosis, that could be contributing to your symptoms.

3. Evaluate for Other Conditions: Given that you mentioned taking vitamin B12 supplements, it’s also important to consider whether there might be a deficiency or other metabolic issues at play. Conditions such as diabetes, thyroid disorders, or vitamin deficiencies can lead to peripheral neuropathy, which may present as numbness.

4. Surgical Consultation: If the neurologist suspects that there is a structural issue causing nerve compression, they may refer you to a surgeon for further evaluation. Surgical intervention might be necessary if there is a significant compressive lesion or if conservative management fails to provide relief.

5. Lifestyle Modifications: In addition to seeking medical advice, consider lifestyle changes that may alleviate symptoms. This includes maintaining a healthy weight, avoiding tight clothing, and ensuring proper ergonomics in your daily activities.

In summary, given the persistence of your symptoms and the lack of improvement with physical therapy, it would be prudent to consult a neurologist first. They can provide a comprehensive evaluation and guide you on the next steps, which may include further testing or referral to a surgeon if necessary. Early intervention can be key in managing symptoms effectively and preventing potential complications.