Question
Hello Dr. Carr,
Thank you for taking my question.  I have had neck tingling for several years, it would happen on and off, especially after a workout, but recently, it has become pretty uncomfortable, and constant.  Also, my hands and feet have begun having "pins and needles" feelings about 40% of my day.  I finally called my doctor, and met with the NP in the practice.  She said my hands tingling are from severe muscle tension in my neck, pushing on a nerve, but she did not know why my feet were like that.  She put me on Napercin for the swelling in my neck, Amitriptlyne for nerve damage, and had me start physical therapy.  I started the other day, and the therpaist was very concerned regarding my hands and feet (more so my feet)and that the nurse practitioner did not have me go for tests (he said MRI and X-rays) I was wondering your oponion, based on my symptoms, if you thought I should go for a 2nd oponion? He has me kind of nervous, he seemed very concerned, but did not specify why.  I thought I would ask another professional if I really should get a 2nd oponion?
Thank you in advance for your time, and I hope that you have a nice weekend.  I look forward to hearing from you.
Colleen


Answer
Well, Colleen,
I can imagine that if the physical therapist saw signs of nerve weakness or central spine stenosis then I would also suggest a second opinion. Physical therapist are supposed to be known for their ability to verbalize their findings and rational for their suggestions, if this PT cannot articulate why he or she suggests a second opinion, then get another therapist. If you have good reflexes, and a negative babinski's sign, then I would continue with therapy for cervical and first rib mobilization as well as the tight musculature. If the babinski's was positive, go get another opinion immediately. If your PT doesn't know these tests or how to perform them, get another PT.
Thanks for your question.
Dr. Carr DPT,MTC,ATC,CSCS