A neurologist diagnoses and treats nervous system conditions with medicines, tests and therapy. A neurosurgeon is a surgical specialist for the brain, spine and nerves, who also manages many patients without surgery. For back pain, neck pain, sciatica or a slipped disc, a spine specialist such as a neurosurgeon is usually the right first doctor. For migraine, seizures, tremor or memory problems, start with a neurologist.
What does a neurologist do?
A neurologist is a physician who specialises in conditions of the brain, spinal cord and nerves that are treated medically. Neurologists do not perform surgery. They commonly treat migraine and other recurring headaches, epilepsy and seizures, Parkinson's disease and tremor, memory loss and dementia, multiple sclerosis, peripheral neuropathy (for example, numbness in both feet in people with diabetes), and the medical care of stroke. They often use tests such as EEG and nerve conduction studies.
What does a neurosurgeon do?
A neurosurgeon is trained to diagnose and treat conditions of the brain, spine and nerves, including with surgery when it is needed. In India, a neurosurgeon completes MBBS followed by MCh or DNB in Neurosurgery. Most of a neurosurgeon's spine patients are first treated without surgery, with medicines, physiotherapy, posture changes and sometimes injections. Surgery is considered only when symptoms persist or nerves are at risk.
Neurosurgeons commonly treat: slipped disc, sciatica, lumbar canal stenosis, cervical disc disease and cervical myelopathy, spondylolisthesis, spinal tumours and brain tumours, pituitary tumours, head and spine injuries after accidents, and some nerve compression problems such as carpal tunnel syndrome.
Where does an orthopaedic spine surgeon fit in?
Orthopaedic spine surgeons also treat spine conditions and bring particular expertise in spinal deformity such as scoliosis and in fractures. Neurosurgeons and orthopaedic spine surgeons overlap for many common problems. When the main concern is a compressed nerve or the spinal cord, such as with a slipped disc, sciatica, stenosis or myelopathy, a neurosurgeon's training in nerve tissue is directly relevant.
Which doctor should I see? A symptom guide
| Your symptom | Who to see first | How soon |
|---|---|---|
| Low back pain spreading down the leg, with tingling or numbness | Spine specialist (neurosurgeon) | Within days to weeks; sooner if there is weakness |
| Neck pain spreading into the shoulder, arm or hand | Spine specialist (neurosurgeon) | Within days to weeks |
| Clumsy hands, trouble buttoning, unsteady walking | Neurosurgeon | Soon; this can be spinal cord compression (cervical myelopathy) |
| Weakness lifting the foot (foot drop) | Neurosurgeon | Urgently |
| Back pain with new numbness around the genitals or buttocks, or loss of bladder or bowel control | Emergency department | Immediately |
| Head or spine injury after an accident or fall | Emergency department; neurosurgeon | Immediately |
| Sudden weakness or numbness of the face, arm or leg, slurred speech, or loss of vision | Emergency department (possible stroke) | Immediately |
| Sudden, severe “worst ever” headache | Emergency department | Immediately |
| Recurring headaches or migraine | Neurologist | Routine appointment |
| Seizures or fits | Neurologist | Soon; a neurosurgeon if a scan shows a lesion |
| Tremor, slowness of movement or memory problems | Neurologist | Routine appointment |
| Burning or numbness in both feet | Neurologist (and your diabetologist, if you have diabetes) | Routine appointment |
| A tumour or growth seen on a brain or spine scan | Neurosurgeon | Soon |
Warning signs that need emergency care
Go to the nearest emergency department straight away, or call 108 for an ambulance, if you have: loss of bladder or bowel control, numbness in the saddle area, rapidly increasing weakness in an arm or leg, a head injury with drowsiness, vomiting or confusion, or sudden stroke symptoms. CARE Hospitals, HITEC City has a 24-hour emergency department.
Not sure which doctor you need? Send us your MRI
If you already have an MRI or CT scan, you can share it for review. Dr. Arun Reddy M will look at your scan and symptoms and tell you whether a neurosurgeon, a neurologist or another specialist is the right next step. Many patients who send their MRI are advised that they do not need surgery.