After some advice as my local GP has not been helpful at all. About 5 weeks ago I got sudden on set of pain in my neck, thought I had pulled a muscle and the GP agreed, two weeks later no better so GP’s, they said time would heal, another week no better but I started to get pins and needles in my shoulder, arm and leg, all left side, another GP visit, no joy.. no help. 4 days ago it got a lot worse, at times I could not feel my arm or leg, now 2 days ago the side of my face went numb as well, GP again, no joy no explanation….. now today the pain in my shoulder is horrendous, my arm is permanent pins and needles, the leg is not as bad but pins and needles still come and go. They did a test for stroke but said not likely as I still had strength, no blurry vision etc. So any advice what it could be? Treatment etc or should I just walk into the hospital as the GP is not helping. Im getting a tad worried now and feel lost as I dont know where to go other than the GP

I am a Vet and although not an expert in human medicine and no way is this my professional opinion does sound like something to get investiagted further. Poss with the leg and arm numbness and “pins & Needles” could there be some nerve compression originating in your neck region. Did this start suddenly? It doesn’t necc mean fracture etc as I get sciaticia in my legs d.t an old slipped disc and I get it now and agin but If I were you I would either see a different Doc for a 2nd opinion or got to casuatly and get them tyo work you up ?

Be direct, tell the GP to refer you to a specialist… what kind of specialist I have no idea.

Good Luck.

Ask your GP to see if you can be referred to a specialist, orthopaedics might be the right one sounds like a trapped nerve but can’t say for sure as can’t see you. Walking into a Hospital will get you referred back to your GP.

My wife had similar problems & needed an op, fusion [or something] in her neck

Go see someone else – all the people we saw were very keen to hear of anything like pins & needles & specifically asked about it

Yeh agree with Drac but I would have though they would have referred him already although I think GP’s have targets for keeping referrals down? Maybe I am wrong and synical – yeh phone them to get referred but I think In my experience sometimes thats easier said than done?

Yep – as above you need to put your foot down here.

It could quite easily still be a soft tissue injury putting pressure on the nerves but, this far down the line with it still getting worse, I’d either insist on a 2nd opinion or brace yourself for a few hours at A&E.

Really they should of done but no mention of it so guess they didn’t bother for some strange reason.

brace yourself for a few hours at A&E.

Won’t help it’s on going problem so will be pointed back to GP.

ive seen 3 gps at the same practice, im at the end of my tether and 4 weeks of bad pain is becoming a nightmare…. I have been on diclofenac and diazapan no help, yesterday they said give it another 3-4 weeks….. its getting worse not better!

Spanky, have you fallen recently? I slip sideways on sheet ice off of my roadbike and landed on the side of my head- it pulled my neck and a Chiroptactor/osty-thingy (no idea what he is)- sorted this out.

not for a while, I fell of a year and a half ago and broke my wrist, also hit my head, also about 3 monts ago i fell off sideways and broke ribs but no neck etc pain then

simple – ask for referral or go to A&E

go back to your GP again. GF is having similar things at the moment and has had MRI scan for it after seeing a neurologist – they thought it was compression on the spinal cord from an obsruction like a prolapsed disk. I take it you don’t have anything like BUPA cover?

Spankmonkey, broken ribs can be really distracting. When I landed on the side of my head it didnt hurt- the noise of my helmet clanging (strangely) distracted me more. I didnt mention anything about my neck at the session and he pointed out that I was holding it at an angle and all the muscles down one side etc were knotted (or some other term)- after some massaging then some movements (clicks)- it was all sorted.

Spankmonkey, I had the same with a knee problem, I knew it needed an athroscopy (had 2 before years back), 3 visits to the GP various bits of advice, I finally just asked for the referal, GP cant refuse to refer you however they do seem reluctant.

I get my athroscopy next week.

Decent Chiropractor will ask for X-rays before treating you.

No medical practitioner worth their salt would try and diagnose this over the internet. It could be anything from the first sign of Multiple Sclerosis through to plain anxiety, and anything inbetween. If you’re not happy with the help you’ve had from your GP, go and see them again, or go and register with another practice.

Decent Chiropractor will ask for X-rays before treating you.-

ah it was the t’other one then.

Kramers spot on.

I would NOT go to a bonecruncher of any kind for that as its possible – but not likely you have a disc / spine problem that they could make worse. They are good for some things but be very cautious.

However I think it is likely that it is merely muscle spasm – hence the treatment you have got is correct. I have had exactly those symptoms from muscle spasm in my neck / shoulder / back. Mine was sorted by sports physio / gentle osteopathy but only AFTER I checked with the GP this would be fine

Back to your GP. Wot Kramer says is correct

Had pins and needles after a crash pinched / trapped a nerve in my neck for 9 months and finally got them down to a low hum in my right hand and would definalty say faster is better for a diagnosis.
Go to Bupa – you get what you pay for and no queues for MRI’s etc..
Sadly money talks.
Good luck

After some advice as my local GP has not been helpful at all. About 5 weeks ago I got sudden on set of pain in my neck, thought I had pulled a muscle and the GP agreed, two weeks later no better so GP’s, they said time would heal, another week no better but I started to get pins and needles in my shoulder, arm and leg, all left side, another GP visit, no joy.. no help. 4 days ago it got a lot worse, at times I could not feel my arm or leg, now 2 days ago the side of my face went numb as well, GP again, no joy no explanation….. now today the pain in my shoulder is horrendous, my arm is permanent pins and needles, the leg is not as bad but pins and needles still come and go. They did a test for stroke but said not likely as I still had strength, no blurry vision etc. So any advice what it could be? Treatment etc or should I just walk into the hospital as the GP is not helping. Im getting a tad worried now and feel lost as I dont know where to go other than the GP

Sounds like Bad AIDS to me

i wouldn’t go to chiropracter either.

Your GP does NOT have to refer you at your request, it is at his/her discretion. Although i have never refused to refer someone.

GP’s take part in referal management, meaning that their referals are analysed to see if appropriate or not i.e. are they under or over referring etc.

although I think GP’s have targets for keeping referals down?

cmon you are a vet you must know better than that for gods sake. “sorry mr jones can’t refer you for an [insert procedure or speciality] cos i’ve filled my quota for the month and don’t want a slap on the wrist.

And what training does a chiropracter have to request or read xrays exactly and how would they actually view them? A “decent” chiropracter would advise you go to your GP first.
And yes Kramers advice is correct- different GP or if you’ve done this a different practice.

p.s. the most dissapointing thing about this is that you feel “worried and lost not knowing where to turn to”

The system has failed you. Either try your GP again, see another GP or change practice.

Good luck

#1 GP’s take part in referal management, meaning that their referals are analysed to see if appropriate or not i.e. are they under or over referring etc.

“although I think GP’s have targets for keeping referals down?”

#2 cmon you are a vet you must know better than that for gods sake.

Under or over-referring according to some reference rate, or might one say “target” ??

GP’s taking part in referral management have their referral to each speciality recorded. They can be compared to there partners and their practice can be compared to the locality or to the national average.

So practice A makes 100 referrals to ENT in one year and practice B makes 200,( say per 2000 patients registered per year.)
The trouble comes when you ask is practice A under referring or practice B over referring.
What reference rate do you use?
Is the doctor that makes more referrals a good or a bad doctor?
Does the “rate” that you choose take into account the local prevalence of diseases, experience of the doctor or availability of local services?

Lies damn lies and averages..

As a doctor your not told not to cut your referrals down so that they match a national or local average. Your not told you’ve reached a quota and have to stop…

Yes your right there is a “reference rate” but it’s pushing the truth to call it a target.

You’re encouraged to go through your referrals and read every one along with your colleagues and see if they were appropriate or not. i.e. could you have sent the patient somewhere else, learnt something and managed it yourself, so freeing up appointments for people who really need to see a consultant.

To imply there is a target and that is the reason for no referral being made is wrong.

Trouble is there are people who think either through ignorance, fear or just “i want’ness” that the way the system should work is that you go to your GP and demand referral to the service/speciality they want and the same people think that if the GP doesn’t do what he is told then the answer is to just go to A&E.

The same people also complain that it takes too long to be seen in A&E and too long for an outpatient appointments. (Wonder why that might be)

Ah well, i don’t expect insight or a positive response, i’m aware of STW’s opinion of doctors, nurses and the NHS, and despite the post i’m not an apologist for the staff or the oranisation.

Good luck getting sorted out.

And what training does a chiropracter have to request or read xrays exactly and how would they actually view them?

well they have had to convince the GCC that they are competent at “chiropracty” including the interpretation of X-rays – essentially that means that they have undertaken approved training at a recognised institution, which will include radiography in the syllabus.

OK so an initial consultation might cost £40 or so – but it might reassure the “patient” that there is or is not something musculoskeletal wrong. I don’t want to be flippant (well I suppose I do!) but the “patient” has been to see a doctor for something he thought was a pulled muscle – why? what was the expectation that the GP could do for it? he accepted that diagnosis but has been back to see 3 more doctors. Now there may be something seriously wrong that 4 doctors have all managed to miss, or the patient may be either over describing his condition here or under describing the problem at the GP’s surgery. But 20 minutes with a specialist, who has the time to listen to the history in detail and who can’t simply prescribe a medical solution can’t be wrong – s/he may refer back to the GP but then the patient and the GP have a better indication of the possible cause. S/he may be able to fix it. S/he may be able to offer the reassurance that the GP is failing to – that they have seen this many times before and it will get better with time.

Probably more likely to get a sympathetic ear at the Chiropractor than at the GP.

ask your GP again. Describe what’s going on. Maybe Neurology or orthopedics are likely next steps. Avoid the dubious voodoo of chiropractic, acupuncture etc. In terms of finding out more about potential nerve involvement these days I’d be surprised if X-rays were on the cards as MRI should be a better imaging technique for neck soft tissues.

Your GP hasn’t really let you down. Perhaps they are considering a variety of potential diagnoses? Your return and description of how things have gone should help them determine next steps for your care.

Unless you’re suddenly struck down, avoid A&E for chronic complaints like this has become. You’ll really cheese people off.

Have you been checked for sensory or motor deficit by anyone? I’m an Osteopath & if someone came to see me that would be the first thing I did, followed by the strong suggestion that a visit to a neurologist would be in order (unless there was something obviously wrong which was suitable for my type of treatment). X-rays are probably not the investigation of choice, an MRI (or possibly CT) scan of the head and neck would be more use, but more expensive. I’d want it checked & soon.

polarisandy, wasn’t having a go at you really – suppose I could’ve 😉 ed. I work in the NHS too and targets of one sort or another, explicit or implied, occupy us all don’t they ?

I still think it’s fair to say that referral management might well make a GP more circumspect about referrals (either consciously or just Hawthorne effect or whatever it’s called). Not necessarily a bad thing but I suspect eventually behaviour will tend towards the implied “norm”.

(Oh, and to spankmonkey – hope you get sorted soon 🙁 )

No worries.
I need to remember not to post 5 mins after getting in from work.
And yes targets are daily life.

I think referral management helps reduce referrals by making you more
informed rather than circumspect.

Cheers

Spankmonkey, give us a few more clues….. How old are you, any other previous back/neck injuries, any other medical probs???

Sounds like a repeat trip to the GPs or a change of GPs is in order as suggested above. Could be any one of a number of things but nerve type entrapment sounds like it’s up there as a strong possibility. X-rays would be pointless at showing this but may be useful for a number of other causes.

I think the overall message is time to go back and get another opinion from your current (or another) doctor….

Oh, and please don’t come and see me in A&E, I can’t refer you on as government says I’m not allowed so I’ll end up poiting you back to your GP anyway…

I’m a Stop Smoking Specialist so no use to you whatsoever (unless you want some support to pack the fags in). Good luck getting fixed though.

cheers all, I have booked in with another gp next week and am going to demand a referal… i cannot afford bupa with 1 child and a baby so good old nhs it is, although i may check work occy health

Good luck with “demanding” a referral. A decent GP will only refer you if they think it is merited not if you “demand”

GP’s take part in referral management, meaning that their referrals are analysed to see if appropriate or not i.e. are they under or over referring etc.

So to get this right – GP’s are analysed for over or under referring so there “is” an emphasis on what GP’s are referring? Therefore is there not some pressure on GP’s to keep referrals to a sensible limit? That was my point!

Anyway the point is he is still in a lot of pain and its progressing , not static, therefore many other things could be occuring rather than “just ” a trapped nerve or pulled muscles.

BTW Vets also get a raw deal from joe public as they expect everything for free just like the NHS! We are not without critisism.

Part of the problem with general practice is that traditionally there has been very little quality control within the profession and in a minority of cases it’s been where a doctor ended up if they couldn’t do anything else.

So after all the advice your going to see another gp and kick things off by demanding a referral?
Ok.

Fr- no, gp’s are not analysed. If they choose to do so( and I think it’s not common practice) a GP can analyse his/her own referrals. The only pressure comes from yourself to make appropriate referrals. No ones contacts you, speaks to you or points out how many referrals you’ve made.
If I want I can refer to my hearts content without any comeback.

I’m not trying to be obtuse, but a common point of view seems to be that gp’s referrals are capped or measured and the doctor leant on, it doesn’t happen where I work. That’s not to say it won’t ever happen though.
I prefer self policing rather than a stick.

There is, I will admit another incentive where I work and that is the money you save can be spent on other areas of patient care. ( and not before someone starts into the drr’s pocket)

Kramer, given that it only minority of dr’s i guess it must form only a small part of the problem.
This argument has part of it’s root in the days 40-50yrs ago when if you failed your exams you could only enter GP rather than be a brain surgeon.

People used to say “those that can, do. Those that can’t teach”
how do the teachers out there feel about this description of themselves or their profession?

Polarisandy, I was first on this thread to suggest requesting a referral, I would like to point out I did not ever say “demand”, I cannot speak on Spankmonkeys behalf only my own recent findings.

I have had a long and painful history of knee problems from the age of 18 (now 42) I have so far had 2 arthroscopies, 1 ligament reconstruction, and a completely dislocated knee. (the whole thing not the kneecap) when I went to my GP in Feb, I could barely walk on it, I hadn’t hit it, knocked it nor twisted it, I was in a place I had been before, I had a loose or foreign body in the joint causing locking, inflammation and pain, I needed to be referred to a specialist to remove this foreign body by another arthroscopy, it took a further month or more and 2 more visits to the GP at that point I was not demanding, but firmly set on getting referred to an orthopedic surgeon, and I got my referral, in the meantime the body has moved to the outside of the joint and I have a marble sized floating bit on the side of my knee, on occasion this does still slip into the joint and cause me problems, its now June and I finally get the marble removed next Tuesday. With my history I don’t believe I should have had to see the GP so often. 3 different GP’s at that, as you rarely see the same Dr at my practice.

Spankmonkey is in pain, and concerned for his health, and quite rightly so, its his wish to be seen by a specialist of some kind and it should also be his right, he has tried the suggestions of his GP and things are not improving, they are getting worse.

Perhaps you could give him advice on how to approach the subject of referral with his GP?

There is, I will admit another incentive where I work and that is the money you save can be spent on other areas of patient care. ( and not before someone starts into the drr’s pocket)

Maybe thats what I was thinking of rather than a numerical / % of referrals? Money it seems to be the root of a lot of problems in the world or a lack of it 😉