Which Medical Specialty Should You Consult for Neck and Shoulder Pain?

Q: Which Medical Specialty Should You Consult for Neck and Shoulder Pain?

Hello： It is recommended to visit the neurology outpatient clinic.

Which specialty should I see for shoulder and neck issues?

Hello Doctor: In my younger days, I often stayed up late using the computer with poor posture, which led to a frequent stabbing pain in the right side of my neck and shoulder.
I didn't pay much attention to it at the time.
Over time, the skin in the area where I felt the pain lost sensation, and my right shoulder and neck became completely stiff.
Consequently, my right neck started to swell, and my entire right face began to feel uncomfortable, especially around the eyes, which felt weak (eyebrows).
I often experienced double vision, and things appeared strange; I couldn't concentrate and felt a constant tension and numbness in my right face, extending to my right shoulder and back.
I am unable to lie down comfortably to sleep or turn my head to the right side, as it causes breathing difficulties and a tickling cough in my throat.
Each time I visited the doctor and had X-rays done, the nerve conduction tests came back normal, and the muscle relaxants prescribed did not help.
This situation often makes it difficult for me to face crowds.
Which specialist should I consult for this condition?

Weiwei, 20~29 year old female. Ask Date: 2016/01/23

Dr. Hou Angting reply Family Medicine

Hello: It is recommended to visit the neurology outpatient clinic.

Reply Date: 2016/01/23

More Info

Based on your description of persistent neck and shoulder pain, along with associated symptoms such as numbness, weakness, and discomfort in your face and eyes, it is advisable to consult a specialist in neurology or orthopedic medicine. Both of these specialties can address the issues related to your symptoms, but they focus on different aspects of the problem.

1. Neurology: A neurologist specializes in disorders of the nervous system, which includes the brain, spinal cord, and peripheral nerves. Given your symptoms of numbness, weakness, and discomfort, there may be underlying neurological issues, such as nerve compression or radiculopathy, particularly if you have a history of poor posture and prolonged computer use. A neurologist can perform a thorough neurological examination, assess your symptoms, and may recommend imaging studies such as MRI to evaluate the cervical spine for any signs of nerve root compression or other abnormalities.

2. Orthopedics: An orthopedic specialist focuses on the musculoskeletal system, which includes bones, joints, ligaments, tendons, and muscles. If your symptoms are related to musculoskeletal injuries or conditions, such as cervical spondylosis or rotator cuff injuries, an orthopedic surgeon can provide a comprehensive evaluation. They may also recommend physical therapy, medications, or, in some cases, surgical interventions if conservative treatments fail.

Given the complexity of your symptoms, it may be beneficial to consult both specialists. A multidisciplinary approach can provide a more comprehensive evaluation and treatment plan. For instance, a neurologist can help determine if there is any nerve involvement, while an orthopedic specialist can address any structural issues in the neck and shoulder region.

Additional Considerations:
- Physical Therapy: Regardless of which specialist you choose to see first, physical therapy should be a part of your treatment plan. A physical therapist can help you with exercises to improve flexibility, strength, and posture, which may alleviate some of your symptoms.

- Imaging Studies: If you haven't already, consider discussing the need for MRI or CT scans with your doctor. These imaging studies can provide detailed information about the structures in your neck and shoulder, helping to identify any potential issues that may not be visible on X-rays.

- Lifestyle Modifications: Since your symptoms may be exacerbated by poor posture and prolonged computer use, consider making ergonomic adjustments to your workspace. Regular breaks, stretching, and strengthening exercises can also be beneficial.

- Pain Management: If you are experiencing significant pain, discuss pain management options with your healthcare provider. This may include medications, injections, or alternative therapies such as acupuncture or chiropractic care.

In summary, for your neck and shoulder pain, consulting a neurologist and/or an orthopedic specialist would be the most appropriate course of action. They can work together to develop a comprehensive treatment plan tailored to your specific needs, helping you regain function and improve your quality of life.

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