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Numbness On Mid Back. Having Raynauds, Peripheral Neuropathy. Which Specialist Should I Go ?
Question: I am having numbness on mid back just above bra line. I noticed this while drying after showers. I believe this has been going on since my lap chole in February. I do have Raynaud's. I did have a one flare up of peripheral neuropathy I belive in Janurary before my lap chole that sent me to ER. Was taking a shower and my arms/legs stung and I felt like the skin was numb. I called my family doctor and they sent me to the ER where they diagnosed the incident as peripheral neuropathy-idiopathic I belive-unknown cause. I am questioning whether to go to my primary care, neurologist, or a rheumatologist. I am normally of very good health. I have had no major illnesses. I do not smoke. I do not do drugs. I do not drink. I do exercise. Since the gallbladder troubles, I feel somehow this is connected? Not sure where to go. The numbness is very concerning on my back. When it is pinched I can feel pressure but no pain. I am also still having pain that comes and goes in right upper quadrant in front - abdomen. The surgeon stated at f/u it could be muscular related and wrote it off - did not seem worried. I am still having this coming and going. Just want to put all current symptoms. LFTs are normal.
Hello
Thank you for sending your question.
Your question is a good one and I will work on providing you with some information and recommendations regarding the problems you are experiencing.
From the details provided to me it looks to me like these are features of peripheral neuropathy. Peripheral neuropathy can result from problems such as traumatic injuries, infections, metabolic problems, vasculitis and exposure to toxins. One of the most common causes is diabetes.
Raynaud phenomenon (RP) and Neuropathy are closely related to each other. Connective tissue diseases can cause secondary Raynaud's and peripheral neuropathy. However I do not find any relation between neuropathy and bile problems.
My recommendation would be for you to see your Neurologist for a good physical examination and consultation. You may need tests like ENMG, MRI of the spinal cord and blood tests for vasculitis work up. We need to rule out common causes of peripheral neuropathy like diabetes and nutritional disorders. Liver and nutritional deficiency and can cause peripheral neuropathy.
I thank you again for submitting your question. I hope you find my response to be both helpful and adequate.
If you have any additional concerns regarding your question I would be happy to address them.
Sincerely,
Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Thank you for sending your question.
Your question is a good one and I will work on providing you with some information and recommendations regarding the problems you are experiencing.
From the details provided to me it looks to me like these are features of peripheral neuropathy. Peripheral neuropathy can result from problems such as traumatic injuries, infections, metabolic problems, vasculitis and exposure to toxins. One of the most common causes is diabetes.
Raynaud phenomenon (RP) and Neuropathy are closely related to each other. Connective tissue diseases can cause secondary Raynaud's and peripheral neuropathy. However I do not find any relation between neuropathy and bile problems.
My recommendation would be for you to see your Neurologist for a good physical examination and consultation. You may need tests like ENMG, MRI of the spinal cord and blood tests for vasculitis work up. We need to rule out common causes of peripheral neuropathy like diabetes and nutritional disorders. Liver and nutritional deficiency and can cause peripheral neuropathy.
I thank you again for submitting your question. I hope you find my response to be both helpful and adequate.
If you have any additional concerns regarding your question I would be happy to address them.
Sincerely,
Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your very informative response. I did visit my family doctor's office this morning - I had to see the physician assistant. She was not concerned about the numbness area on my back. She gave no answers as to why this was happening or could be happening. She said my glucose while at hospital was very good and always has been. I have been tested for nutrition back in January as my grandmother had pernicious anemia and the ER doctor wanted B12 test ran to rule that out. My B12 at the time was mid 300 range - norm I guess is 200-1000. Other levels were fine. Should I still be concerned and make my own neurologist appointment? My insurance does not require a referral.
Hello
Thanks for the follow up query
From the reports it r clear you are not suffering from diabetes and Vit B12 deficiency. However there are many more nutritional deficiency disorders which can cause peripheral neuropathy. I would prefer you taking multivitamins (B1, B6 & B12) for a period of 6 weeks and to see if your symptoms improve. If not my recommendation for you to see your Neurologist to exclude other causes of peripheral neuropathy.
Wishing you good health.
Sincerely,
Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Thanks for the follow up query
From the reports it r clear you are not suffering from diabetes and Vit B12 deficiency. However there are many more nutritional deficiency disorders which can cause peripheral neuropathy. I would prefer you taking multivitamins (B1, B6 & B12) for a period of 6 weeks and to see if your symptoms improve. If not my recommendation for you to see your Neurologist to exclude other causes of peripheral neuropathy.
Wishing you good health.
Sincerely,
Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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