Confused by my GP

Hello :wave: new member and first time poster. Feeling very anxious and confused and hoping some lovely people might be able to shed light on a couple of things for me.
I went to the chiropractor two weeks ago for ongoing issues with the left side of my body, which I thought originated from a lower back injury. However she told me that the neurological exam she performed showed some worrying signs and that she would be writing a letter to my GP to recommend a referral to a neurologist, especially as one of my parents has PPMS.
Due to covid my GP would only initially speak to me over the phone. During the conversation she said she would send me for a spinal mri. I was surprised and confused that she didn’t want to see me in person to perform a neurological exam herself. I also questioned if I would also receive a brain mri but she said she couldn’t do that at this stage. She also mentioned that a referral to a neurological would take ages without an mri first. The chiropractor specifically mentioned suspicion of an upper motor neuron lesion.
Should I be pushing for a GP neurological exam and / a brain mri in addition to the spinal, or is this simply the expected first step?
Thanks for reading


Taking the word of a chiropractor that you ‘could’ have MS seems a little bit overly trusting to me.

The fact that your parent has MS makes it a tiny bit more likely that you’d also get it, but only a bit (see Risk of developing MS | MS Trust ) A chiropractor is not qualified to diagnose a neurological disease of any kind.

Then again, your GP isn’t being all that sensible either (IMO). Sending you for a spinal MRI isn’t necessarily going to get you any further forward in determining what might be wrong with you. In that I completely agree with you. A spinal MRI without brain is a bit pointless, and of course a GP can’t diagnose neurological diseases either.

I don’t really understand why a GP would think a spinal MRI would hasten a referral to neurology where an examination wouldn’t. Even just a proper discussion with you about symptoms should be enough for a referral. And what happens if the spinal MRI shows nothing untoward? Will the GP refer you to a neurologist anyway? If so, what’s the point of the MRI? And if not, what does s/he think happens next?

Sorry, I’ve come over all bossy and questioning (it’s a bad habit, please forgive me).

With regard to your last question, I think you should be asking that your GP refer you to a neurologist irrespective of a spinal MRI. The GP may have made his/her mind up that a brain MRI isn’t necessary right now, and it’s their budget which pays for tests!!

So, again, IMO you should see a neurologist. Have a proper neurological examination, have the tests the neurologist believes are necessary and try not to worry too much about MS. If that’s even possible!

Good luck. Oh and welcome to the forum. Please don’t let my questioning your chiropractor and GP put you off, we are generally nice, kind and empathetic! Honest.




In my opinion, you should try to get a referral to a neurologist for them to do an examination. Sue is not being bossy, it may well be a budget issue for the GP, but it is not their nervous system that might be compromised. It will cost them a lot more in the long term if they could prevent things getting worse by doing stuff now.
Good luck

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As someone who was misdiagnosed for 10 years with lumbar spinal stenosis, I can say with absolute certainty that YOU NEED A HEAD MRI as well as the full spine. As Ssssue said, it’s about money. Unusual that a GP is ordering MRI’s at all - normally the specialist the GP refers you to will order it. But spinal without head scan is a WASTE OF TIME. An MS diagnosis relies on them detecting lesions and whilst there can be lesions in the spine, they are most likely to be found in the brain.

For what it’s worth, with my misdiagnosis, nobody thought to scan my brain. It was an osteopath who watched me walk and described a “neurological gait” that could not possibly be caused by trapped nerves in the lower back. I reported back to my neurologist (& neurosurgeon - that’s another story…) and got a head scan 3 days later. I think they were scared they were about to get sued for negligence.

Go back to GP and demand either a head scan or a second opinion. Be belligerent! They can’t take the risk that you could be right.

Good luck! :slight_smile:

Thank you all for taking the time to reply with your thoughts. I really appreciate it. Glad my gut instinct that things should have been handled differently was at least right. There is definitely a clear consensus that I should push for a neurologist referral, which I will definitely do! Thank you again x

I actually think your GP is doing OK. Neuro referrals take an age in some parts, and it is typical for the first MRI to be commissioned (if it ever is) by the hospital specialist, not the GP. So you might be getting ahead of the game here. BY the way, GP are often a bit rusty and unconfident when it comes to doing neurological assessments themselves, and your GP might just have a very realistic view of his/her chances of making a good job of it!

I do agree in the main Alison. But think the neuro referral should be done as well as the MRI. After all, what’s the GP going to do post spinal MRI. If the GP isn’t confident about a neurological exam (and there’s absolutely no reason why they should be), then the sooner a neuro assessment is done the better.


I agree with Alison. The smart GPs are doing the MRI referrals themselves as it gets the patient well ahead in the queue. If something is shown on the MRI scan then the referral will hopefully be taken more seriously than if referred ‘cold’ without any hard evidence. The risk nowadays is that a referral first will be triaged out, and back to the GP, with just a letter, and nothing done at all. Or they suggest having a scan done but without a consultation appointment - and that has taken weeks to get that response, so now they are weeks behind in the queue for MRI, compared with if the GP had requested an MRI straight off. With referrals to a neurologist now taking half a year or more in parts of the country, this seems a sensible route the GP is taking.

There may be budget / over-demand issues / and/or NICE guidance which is why the GP can only ask for either a spine or a brain MRI at this stage.

The GP appears to respect that the chiropractor has skills and professionalism and has listened to them, and not felt the need to repeat the tests.

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Hello and thanks for looking to the Forum for ideas. Your description of events is a bit different to mine as I approached my GP with a symptom (right hand tremor) who then referred me to a Consultant Neurologist for a further opinion. I’m glad they did so as that set off a trail of investigations that ended up a year later with a diagnosis of PPMS. One of the first of these was an MRI scan. I think that your GP should be making the referral to the Neurologist & let them decide what needs to be done next. It’s a tricky one though. Is it a group practice? If so, perhaps you could arrange a telephone consultation with another GP to get a second opinion on the way forward. Your Chiropractor has been very switched on. Good luck.