Nerve and Spine
Neck and back pain is the most common cause of disability in the world. Degenerated or herniated discs in the neck and back can pinch on the nerves going into the arms, and legs, respectively. If when you cough, sneeze or strain and have a shock like sensation going into a limb, that is suggestive of a pinched nerve. Based upon what is going on conservative care such as medication to reduced inflammation and spasm, and physical therapy can be indicated. Certain cases can be managed with injections, and certain cases require surgery to recover or preserve vital neurologic function.
The nerves in the arms and legs can be affected by metabolic and nutritional conditions such as diabetes or vitamin deficiencies. This can cause numbness in the feet, and sometimes weakness as well. This is referred to as peripheral neuropathy and can sometimes cause problems with balance and lead to falls. Sometimes a nerve in the arm or leg is compressed in a certain area, such as carpal tunnel where the median nerve is compressed at the wrist. Electrodiagnostic studies will be able to determine if a nerve is affected, how badly, and where, and help to determine what treatment approach is needed.
A detailed history, physical exam and Electromyogram and Nerve Conduction study (EMG/NCON) is how we evaluate for spine and nerve problems. To look for causes of neuropathies, lab testing is usually performed and in rare cases a lumbar puncture may be needed (LP)