Which specialist should I see for the following pain?
Hello Doctor: I have been experiencing lower back pain for three months.
Currently, I cannot bend over while washing my hair, and light tapping on the outer side of my right thigh causes numbness and pain.
If I sleep on my right side, the pain wakes me up.
The pain worsens in cold weather, and generally, any exertion on my right leg causes discomfort.
I have seen a neurologist, and both X-rays and nerve conduction studies came back normal.
I have taken pain relievers and muscle relaxants, but they have not been effective.
What could be the cause of this? Which specialist should I see next? Thank you.
Xiao Hui, 30~39 year old female. Ask Date: 2016/01/10
Dr. Shi Guozheng reply Orthopedics
It could be due to an issue with the hip joint, so it would be advisable to consult an orthopedic specialist to check for any potential problems.
Reply Date: 2016/01/10
More Info
Based on your description of persistent back and leg pain, it sounds like you have been experiencing significant discomfort for an extended period. Given that you have already consulted a neurologist and undergone X-rays and nerve conduction studies, which returned normal results, it may be time to consider other specialists who can further evaluate your condition.
1. Orthopedic Specialist: Since your symptoms involve the back and leg, an orthopedic doctor specializing in musculoskeletal issues may be beneficial. They can assess for any underlying structural problems, such as herniated discs, spinal stenosis, or other orthopedic conditions that may not have been evident in your previous tests.
2. Physical Medicine and Rehabilitation (PM&R) Specialist: Also known as physiatrists, these specialists focus on rehabilitation and pain management. They can provide a comprehensive evaluation of your pain and develop a tailored rehabilitation program that may include physical therapy, medication management, and other non-surgical interventions.
3. Pain Management Specialist: If your pain persists despite other treatments, a pain management specialist can offer various options, including interventional procedures like epidural steroid injections, nerve blocks, or other advanced pain management techniques.
4. Rheumatologist: If there is a suspicion of an inflammatory or autoimmune condition contributing to your pain, a rheumatologist may be able to help. They specialize in conditions that affect the joints and soft tissues, which could be relevant if you have symptoms suggestive of conditions like fibromyalgia or arthritis.
5. Chiropractor: While not a medical doctor, a chiropractor can provide spinal manipulation and other treatments that may help alleviate back pain. However, it's essential to ensure that any chiropractic care is coordinated with your other medical treatments.
Additional Considerations
- Physical Therapy: Regardless of the specialist you choose, physical therapy can be an effective treatment for back and leg pain. A physical therapist can design a program to strengthen the muscles supporting your spine, improve flexibility, and teach you proper body mechanics to reduce pain.
- Lifestyle Modifications: Consider evaluating your daily activities and ergonomics. Poor posture, improper lifting techniques, and sedentary behavior can exacerbate back pain. Incorporating regular low-impact exercises, such as walking or swimming, can also be beneficial.
- Pain Diary: Keeping a pain diary can help you and your healthcare providers identify patterns or triggers for your pain. Note the intensity, duration, and circumstances surrounding your pain episodes.
- Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture, massage therapy, or yoga. These can be complementary to traditional medical treatments.
Given the complexity of your symptoms and the duration of your pain, it is crucial to continue seeking medical advice until you find a solution that works for you. Don't hesitate to advocate for yourself and request referrals to specialists who can provide the care you need. Your health and comfort are paramount, and there are various avenues to explore for effective management of your persistent pain.
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