When to See a Neurosurgeon

If you have ongoing back pain, neck pain, weakness, numbness or a new brain or spine diagnosis, you may wonder if you need to see a brain and spine specialist. A neurosurgeon can review your symptoms, imaging and treatment history to help decide whether monitoring, medication, therapy, surgery or another type of care may be the best next step. 

For stroke warning signs, severe head injury or loss of bladder or bowel control with back pain, get emergency care right away.

What does a neurosurgeon treat?

A neurosurgeon may evaluate and treat conditions affecting the:

• Brain
• Spine
• Spinal cord
• Nerves in the arms, hands, legs or feet
• Blood vessels in and around the brain or spine

Common conditions include:

• Brain tumors
• Spine tumors
• Herniated discs
• Spinal stenosis
• Degenerative disc disease
• Pinched nerves
• Sciatica
• Neck or back pain with nerve symptoms
• Brain aneurysms
• Head injuries
• Spinal cord injuries
• Nerve compression 

Need to speak with a specialist? Find a Banner Health neurosurgeon near you and schedule a consultation.

Does seeing a neurosurgeon mean I need surgery?

Seeing a neurosurgeon does not always mean you need surgery. Many people see a neurosurgeon for spine surgery evaluation or consultation only. Neurosurgeons are trained to decide when surgery may help and when nonsurgical care, more testing, monitoring or referral to another specialist may be a better option.

Surgery may be considered when symptoms are severe, worsening, or caused by pressure on the brain, spinal cord or nerves or when a condition could become dangerous without treatment.

When brain symptoms may need a neurosurgeon

A neurosurgical evaluation may be recommended if you have:

• A brain tumor or mass found on imaging
• A known or suspected aneurysm that needs evaluation by a brain aneurysm specialist
• A blood vessel problem in the brain, such as an AVM
• Hydrocephalus (fluid buildup in the brain)
• Chiari malformation (structural issues in the base of the skull)
• Abnormal imaging after a head injury
• Seizures that do not get better with treatment
• Ongoing symptoms after a brain bleed or traumatic brain injury
• New neurologic symptoms that may be related to a structural problem

When spine symptoms may need a neurosurgeon

Seeing a neurosurgeon for spine problems may be helpful if you have:

• Neck or back pain that does not improve with nonsurgical care
• Pain that travels down the arm or leg
• Numbness, tingling or weakness in an arm, hand, leg or foot
• Trouble walking, balance problems or frequent falls
• Loss of hand coordination or difficulty buttoning shirts, writing or gripping objects
• Spinal stenosis, herniated disc or nerve compression on imaging
• Spinal cord compression
• Spine tumor, infection or fracture
• Symptoms that are getting worse despite physical therapy, medication or injections

When nerve symptoms may need a neurosurgeon

A neurosurgeon may evaluate certain nerve problems if they are severe, worsening or linked to nerve compression symptoms, such as:

• Nerve pain that travels from the spine into the arm or leg
• Weakness in the hand, foot, arm or leg
• Foot drop
• Numbness or tingling that does not improve
• Severe carpal tunnel or other peripheral nerve compression
• Nerve injuries after trauma
• Nerve tumors
• Pain that affects daily activities despite treatment

Symptoms that need emergency care

Call 911 or get emergency care right away for:

• Signs of stroke, such as sudden balance trouble, vision changes, face drooping, arm weakness or speech difficulty
• Sudden, severe headache 
• Head injury with loss of consciousness, repeated vomiting, confusion, seizure, worsening headache or weakness
• New weakness, numbness or paralysis
• New loss of bladder or bowel control with back pain
• Numbness in the groin, inner thighs or saddle area
• Severe back or neck pain after a fall, crash or injury
• Trouble walking after an injury
• Trouble breathing after a neck or spine injury
• New seizure or a seizure that lasts longer than usual 

Neurologist vs. neurosurgeon: What’s the difference?

These two specialties often work together. Some people see a neurologist first, then a neurosurgeon if imaging, symptoms or treatment response suggest surgery may be needed. Some people are referred directly to neurosurgery after emergency care, imaging or diagnosis.

Neurologist

• Treats nervous system conditions without surgery
• May manage migraines or headaches, seizures, movement disorders, neuropathy, autoimmune neurologic conditions and memory concerns
• May order tests, medications and therapy
• Often works with neurosurgeons

Neurosurgeon

• Treats nervous system conditions and performs surgery when needed
• May treat brain tumors, aneurysms, spine compression, head injuries and nerve compression
• May recommend surgery, monitoring or nonsurgical care
• Often works with neurologists and other specialists

You may need a referral if imaging shows a brain or spine problem

Not every imaging finding needs surgery. A neurosurgeon can help explain what the finding means, whether it matches your symptoms and what options may be safest.

You may be referred to a neurosurgeon if imaging shows:

• A brain mass or tumor
• A spine tumor
• A brain aneurysm or blood vessel abnormality
• Bleeding in or around the brain
• Spinal cord compression
• Severe spinal stenosis
• Herniated disc pressing on a nerve
• Spine fracture or instability
• Hydrocephalus
• Chiari malformation
• Infection involving the brain, spine or spinal cord

What to expect at a neurosurgery consultation

At your appointment, the neurosurgery team may:

• Review your symptoms and how they affect daily life
• Review your medical history and past treatments
• Look at imaging, such as MRI, CT scans or X-rays
• Perform a neurologic exam to check strength, sensation, reflexes, balance and coordination
• Explain whether the condition appears stable, urgent, or worsening
• Discuss nonsurgical and surgical options
• Recommend more testing if needed
• Help you understand risks, benefits, recovery, and next steps
• Many patients leave their first visit with reassurance that surgery is not needed

How Banner Health can help

At Banner Health, our neurosurgeons work with neurologists, spine specialists, imaging teams, rehabilitation providers and other specialists to provide neurosurgery care for conditions that affect the brain, spine and nerves. 

Your care may include diagnosis, monitoring, minimally invasive procedures, surgery, recovery support and follow-up. We can help you understand whether neurosurgery is the right next step or whether another type of care may be more appropriate.

Make an appointment with a Banner Health neurosurgery specialist to learn what treatments might help if you have a brain, spine or nerve condition.

Frequently asked questions about seeing a neurosurgeon

When should I see a neurosurgeon for back pain? 

You may need a neurosurgical evaluation if back pain travels down your leg, causes weakness, numbness or trouble walking or does not improve with nonsurgical care. Seek emergency care if back pain comes with new loss of bladder or bowel control or numbness in the groin or saddle area.

When should I see a neurosurgeon for neck pain?

You may need evaluation if neck pain travels into the arm, causes weakness or numbness, affects hand coordination or is linked to spinal cord or nerve compression on imaging.

Do I need a neurosurgeon for a brain tumor?

Many people with a brain tumor or brain mass are evaluated by a neurosurgeon. The neurosurgeon can explain whether surgery, biopsy, monitoring, radiation or other treatments may be appropriate.

Can a neurosurgeon treat nerve pain?

Yes. Neurosurgeons may treat nerve pain when it is caused by compression, injury, a tumor or another structural problem. Not all nerve pain needs surgery.

Can I see a neurosurgeon without a referral?

This may depend on your insurance plan and the clinic. Some plans require a referral from a primary care provider, neurologist or another specialist.

What should I bring to a neurosurgery appointment?

Bring your medication list, imaging reports, copies of MRI or CT images (if done outside Banner Health) and a list of symptoms, treatments you have tried and questions for your care team.

Should I see a neurosurgeon or orthopedic spine surgeon?

Both neurosurgeons and orthopedic spine surgeons treat spinal conditions.  Neurosurgeons specialize in conditions affecting the brain, spinal cord and nerves, and can also perform spine surgery.  Orthopedic spine surgeons specialize in structural aspects of the spine. Your primary care provider can help determine which specialist is most appropriate, and many common conditions can be treated effectively by either specialty.