Sudden Left Leg and Neck Pain: When to See a Neurologist?

Sudden pain in the left foot and left neck, resulting in limping and inability to walk normally?

Hello, Doctor: On Christmas Eve last year, after my company's year-end party, I took the bus home.
When I got off, I suddenly felt pain in my left leg (from my thigh to my calf).
The pain intensified when I walked and put weight on it.
About 3-4 days later, I experienced stiffness and pain in my neck, making it difficult to turn my head.
I took Tylenol for two weeks, but it did not relieve the pain.
Last week, I visited an acupuncture specialist for treatments on my neck and lower back.
After the acupuncture, I regained some mobility in my neck, but the pain shifted from the left side to the right side, although it was not as severe as before.
However, after the acupuncture on my lower back, the pain in my entire left leg worsened, making it difficult to walk.
Should I see a neurologist, a neurosurgeon, an orthopedic specialist, or a rehabilitation specialist?

kim, 40~49 year old female. Ask Date: 2014/02/24

Dr. Gao Chunde reply Neurology

If the pain in your left foot follows the distribution of a nerve root and is accompanied by related muscle weakness, consider the possibility of a lesion in the lumbar spine.
If neck stiffness and pain are also present, this could indicate inflammation within the spinal cord.
However, it may also simply be due to muscle inflammation or lumbar nerve root compression.
It is recommended to consult a neurologist for a thorough examination to determine the issue.

Reply Date: 2014/02/24

More Info

It sounds like you're experiencing a complex set of symptoms that could be related to multiple underlying issues. Given the sudden onset of pain in your left leg and neck, as well as the progression of symptoms, it is essential to approach this situation carefully.
From your description, the initial pain in your left leg that intensified with walking could suggest a few possibilities. It might be related to a musculoskeletal issue, such as a strain or injury to the muscles or ligaments in your leg. Alternatively, it could indicate a neurological issue, such as nerve compression or irritation, particularly if the pain radiates or is accompanied by other symptoms like numbness or tingling.

The subsequent development of neck pain and stiffness raises additional concerns. Neck pain can often be associated with cervical spine issues, such as herniated discs, arthritis, or muscle strain. If the neck pain is severe and limits your range of motion, it could suggest a more serious condition that requires further evaluation.

Considering that you have already sought treatment from acupuncture and experienced some relief, it indicates that there may be a muscular component to your pain. However, the fact that your symptoms have shifted from one side of your body to the other and that your left leg pain has worsened after treatment suggests that a more comprehensive evaluation is necessary.

In terms of which specialist to see, here are some recommendations:
1. Neurologist: If you suspect that your symptoms may be related to nerve issues, such as sciatica or cervical radiculopathy, seeing a neurologist would be beneficial. They can perform neurological examinations and possibly recommend imaging studies like an MRI to assess for any nerve compression or other neurological conditions.

2. Orthopedic Surgeon: If your symptoms are primarily musculoskeletal, an orthopedic surgeon specializing in the spine or lower extremities could evaluate your condition. They can assess for any structural issues in your spine or joints that may be contributing to your pain.

3. Physical Medicine and Rehabilitation (PM&R) Specialist: A PM&R specialist, also known as a physiatrist, focuses on rehabilitation and non-surgical treatment of musculoskeletal and neurological conditions. They can provide a comprehensive approach to managing your pain and may recommend physical therapy, which could be beneficial for both your neck and leg pain.

4. Physical Therapist: Regardless of which specialist you choose to see, working with a physical therapist can be incredibly helpful. They can develop a tailored exercise program to strengthen the affected areas, improve flexibility, and alleviate pain.

In summary, given the complexity of your symptoms, starting with a neurologist might be the best course of action to rule out any serious neurological issues. If they determine that your symptoms are more musculoskeletal in nature, they can refer you to the appropriate specialist. It’s crucial to address these symptoms promptly, especially since they have impacted your ability to walk and perform daily activities.
Lastly, ensure that you communicate all your symptoms clearly to your healthcare provider, including the timeline of your pain, any changes in sensation, and how your symptoms have evolved. This information will be vital in guiding your diagnosis and treatment plan.

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