Neurologists are medical doctors who diagnose and treat disorders of the brain, spinal cord, peripheral nerves, muscles, and nerves controlling the senses. Many people wonder if neurologists also treat issues with the neck, since the neck contains crucial nerves and vertebrae that connect to the spine and brain. While neurologists focus on the central nervous system, they may also deal with cervical spine and neck problems that relate to nerve damage or neurological conditions.
What is a neurologist?
Neurologists are medical specialists who have completed medical school and then 3-4 years of residency training specifically in neurology. Their training focuses on diagnosing and treating diseases and disorders related to the central nervous system. This includes:
- Brain
- Spinal cord
- Nerves
- Muscles
- Senses (sight, hearing, taste, smell, touch)
Some of the common conditions treated by neurologists include:
- Stroke
- Multiple sclerosis
- Epilepsy
- Parkinson’s disease
- Alzheimer’s disease
- Headaches and migraines
- Numbness and tingling
- Muscle weakness
- Dizziness and vertigo
- Sleep disorders
- Cognitive disorders
- Neuromuscular diseases
Neurologists have specialized expertise in how the nervous system works and they use this knowledge to diagnose and treat complex conditions affecting the brain, spinal cord, nerves and muscles.
Do neurologists treat the neck?
The neck contains crucial nerves, vertebrae, muscles and blood vessels that connect the brain to the rest of the body. So problems with the cervical spine or neck region can potentially have neurological effects.
For this reason, neurologists may diagnose and treat certain neck conditions that involve damage or compression of nerves or neurological symptoms. However, they do not deal with all routine neck injuries or pain.
Here are some examples of when a neurologist may treat neck issues:
- Cervical radiculopathy – Compression of spinal nerves in the neck, causing pain, numbness or weakness in the shoulder, arm or hand.
- Cervical spondylotic myelopathy – Spinal cord compression in the neck due to arthritis or disc herniation.
- Cervical spinal stenosis – Narrowing of the spinal canal in the neck, putting pressure on the spinal cord.
- Peripheral neuropathy affecting the neck – Nerve damage causing neck pain, spasms or neuropathy.
- Multiple sclerosis – Autoimmune disease that can cause lesions in the cervical spinal cord.
In cases like these that involve spinal cord compression, nerve impingement or neurological symptoms in the upper body, a neurologist may be consulted. They can order tests to evaluate nerve function and damage.
However, for issues like common neck strains, pinched nerves without neurological effects, or neck pain from poor posture or sleeping positions, a neurologist would not need to be involved. These types of routine neck problems can be evaluated by primary care doctors, chiropractors, physical therapists or orthopedists instead.
Diagnosis and treatment methods
When a patient comes to a neurologist with possible neck issues, here are some of the diagnostic and treatment methods they may use:
Diagnostic testing
- Reflex, strength, and sensory testing
- Nerve conduction studies
- Electromyography (EMG)
- MRI of the cervical spine
- CT scan
- X-rays
These tests allow neurologists to evaluate nerve function and pinpoint the location of any nerve compression, spinal cord damage, or problems with vertebrae and discs in the neck.
Treatments
- Prescribing medications like steroids, pain medications or muscle relaxants
- Cervical epidural steroid injections
- Recommending physical therapy
- Using a soft or rigid neck brace
- Surgery (rarely needed) to decompress pinched nerves or address cervical spine instability
The neurologist will choose treatment options aimed at reducing inflammation around compressed nerves in the neck and preserving neurological function. In severe cases, they may refer the patient to an orthopedic surgeon or neurosurgeon for procedures to stabilize the cervical vertebrae or decompress the spinal cord.
When to see a neurologist for neck problems
See a neurologist for neck pain, stiffness or neurological symptoms if you experience:
- Persistent numbness, tingling or weakness in the arms, hands, fingers
- Shooting pains from the neck down the arm
- Muscle wasting in the shoulder or hand
- Loss of dexterity or dropping objects
- Abnormal reflexes
- Bowel or bladder dysfunction
- Balance problems or difficulty walking
These types of neurological red flags can indicate an impinged nerve or spinal cord compression in the neck. A neurologist can help diagnose the cause and determine if surgical treatment is needed.
You can see your primary care doctor first, but ask for a referral to a neurologist if your symptoms are severe or fail to improve with conservative treatment. MRIs or nerve conduction tests may be warranted.
When to see another type of doctor
You don’t necessarily need to see a neurologist for:
- Stiff neck or pulled neck muscle from injury or poor posture
- Pinched nerve in neck causing localized pain but no neurological symptoms
- Occasional numbness or tingling with certain neck positions that resolves quickly
- Popping sounds in the neck without pain or neurological symptoms
In these situations, you can often be treated by:
- Primary care physician
- Physical therapist
- Chiropractor
- Massage therapist
- Orthopedist
Conservative rest, ice, heat, OTC pain medication, massage and gentle stretches may resolve symptoms. If problems persist, request an x-ray or MRI through your doctor. Only seek a neurology referral if you develop definite neurological symptoms.
Takeaway
In summary, neurologists are specially trained to manage disorders involving the brain, spinal cord, nerves and muscles. While they do not treat routine neck strains and pain, neurologists may diagnose and treat cervical spine issues that affect neurological function, such as:
- Nerve compression causing radiating pain and weakness
- Spinal cord compression
- Vertebral damage leading to instability
- Neurological disorders affecting nerves in the neck
Neurologists have expertise in assessing nerve damage and compression. They can order advanced diagnostic tests and provide conservative treatments or specialty referral if spinal surgery is required. See a neurologist for neck pain along with numbness, muscle wasting or loss of coordination in the arms and hands. But simple neck stiffness or pain can often be managed by other providers first.
Conclusion
While neurologists specialize in disorders of the central nervous system, they may play a role in diagnosing and treating certain cervical spine conditions that affect neurological function and nerve health. Their expertise is beneficial for evaluating neurological symptoms and guiding appropriate diagnostic tests and treatment plans. But routine neck strains and discomfort without neurological deficits can usually be managed effectively by other medical providers, without needing to see a neurologist.