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Degenerative changes in the lumbar spine, pain killers - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2407 Questions
Doctor :   hi
User :   hi
Doctor :   please proceed with the query
User :   i have got a MRI done yesterday
Doctor :   ok
User :   if you remember we have had a chat earlier on pain in the legs
User :   for which a dobblers test was adviced
User :   however when contacted the doc has asked me to get a lumber spine MRI done
Doctor :   I am not able to recollect, but ys, i remember
User :   the result for which is as under
Doctor :   ok
User :   degenerative changes in the lumbar spine with left paracentral protrusion and caudal migration of disc at l4-l5 level causing bilateral neural neural compromise, more so on the left side
User :   and
Doctor :   ok
User :   disc protrusions at c4-c5 and c5-c6 levels causing indentation over thecal sac
User :   is this this reason for pain in both my legs
Doctor :   yes, this is the reason causing the pain
Doctor :   any pain which affects the spine , wil radiate to the legs as well
Doctor :   can you please brief me about your age , and symptoms you had
User :   age 38 years
User :   male
User :   pain in both my legs
User :   expecially during rest
User :   while walking its fine
Doctor :   ok
User :   i used to smoke earlier
Doctor :   you also said you used to smoke and quit recently ?
Doctor :   ok
User :   however i stopped it from the last month or so
Doctor :   ok
User :   you have adviced zincovit/biotin/diacobol
Doctor :   may i know if you always ride a two wheeler ?
Doctor :   yes , I remeber
User :   no, i ride a car
Doctor :   ok
Doctor :   let me put it across to you
User :   ok
Doctor :   any changes in the back /spine will produce pain in the legs
User :   oh
Doctor :   and smoking is a risk facotr
Doctor :   factor*
User :   ok
Doctor :   it will aggravate pain as well as degeneration
User :   oh
User :   so what do you think i should be doing to get rid of this
Doctor :   this compression will cause compression of nerves and hence the nerve radiates pain to legs as well
User :   ok
Doctor :   you must review this with the orthopedician
Doctor :   you will need a lot of rest
Doctor :   and physiotherapy if advised
User :   ok
Doctor :   and avoid lifting weights , smoking , etc
Doctor :   the treatment for these changes are only symptomatic
User :   oh
Doctor :   ok
User :   what do you think is lyrica 75mg given for
Doctor :   so you may need some pain killers as well
User :   1 at bet time
Doctor :   it is a tab for nerve pain
Doctor :   it is gaba derivative , to put it across given for all conditions where nerve is causing pain
User :   also hefenae - not sure on why these are for
Doctor :   hifenac is aceclofenac
Doctor :   as i said you need pain killers , it is a pain killer, it is given for relieving your leg pain , so take it
User :   ok
User :   so do you advise both these tabs
User :   anything else that you may want me to do
User :   trust a couple of drinks are fine
User :   :-)
Doctor :   i would as you not to do that
Doctor :   it increases your pain
User :   oh i thought it would releive me of pain
User :   i can avoid the dobblers test now right
Doctor :   no , it wil relieve momentarily , later on it will double the pain
User :   can avoid the dobblers test now right
Doctor :   did doctor suggest doppler?
User :   no
Doctor :   ok , as he has examined you , he must not felt the need for the same
User :   ok
Doctor :   so , no need for it
User :   thanks so much doc
Doctor :   as MRI has shown some changes , I feel the problem is with the back now
Doctor :   and not the arterial block as we expected
User :   ok
Doctor :   i suggest you take hese steps
Doctor :   1. complete bed rest/ rest as much as possible
Doctor :   2. posture : when watching Tv/ COMPUTER make sure your with back support
Doctor :   3. physiotherapy if pain does not subside
Doctor :   4. no smoking, no alcohol
Doctor :   5. take pain killers when you feel a need
Doctor :   6. you may be given belt to support the back , if this may be needed
Doctor :   7. never lift heavy weights
Doctor :   8. no two wheeler drive , not even pillion
Doctor :   9. instead to sleeping on very soft cushioned mattress go for hard ones
Doctor :   are you there with me?
User :   yes doc
Doctor :   follow these measures
Doctor :   may i know your height and weight
User :   73 kgs
User :   5 ft 10 inc
Doctor :   ok
Doctor :   you can exercise
Doctor :   after good rest
User :   i go for a brisk walk in the morning
Doctor :   walking , daily physical activty is good
Doctor :   there are few back strengthening exercises , which done daily , will provide good relief
Doctor :   a physiotherapist/ fitness trainer may teach you this
User :   ok
Doctor :   you can learn them once the doctor permits you for the same
Doctor :   did you follow my suggestions?
User :   yes
Doctor :   are there any more questions i can help you with /
User :   yes doc
User :   my wife
Doctor :   please proceed
User :   she is felling very giddy from the past 2 day
Doctor :   ok
User :   has got vomiting sensation
Doctor :   0k
User :   bitter taste in he mouth
Doctor :   ok
User :   appitiate is normal
User :   she feels very tired
Doctor :   ok
User :   energy levels are low
Doctor :   ok
Doctor :   may i know her age ?
User :   35 yrs
Doctor :   since when does she feel giddy?
User :   2-3 days, even now infact
Doctor :   only from 2 days or has this happened earlier as well?
User :   yes about an year back
Doctor :   ok
Doctor :   have they done any tests so far?
User :   no
Doctor :   ok
Doctor :   do you have children?
User :   yes
User :   2
User :   boys, very naughty
Doctor :   when was the last delivery?
User :   2005, oct 15
Doctor :   ok
Doctor :   what is her height and weight ?
User :   5ft 6 inc
User :   67 kgs
Doctor :   ok
Doctor :   apart from this , any fever ? abdominal pain cough, etc?
User :   dry cough - light
User :   no fever
User :   no abdominal pain
Doctor :   how is her cycles?
User :   normal
Doctor :   ok
Doctor :   I would suggest you do these things
User :   ok
Doctor :   she needs a general examination to check for anemia , thyroid , etc
User :   ok
Doctor :   and she needs a routine examination
Doctor :   with a complete blood test
User :   ok
Doctor :   for anemia , cell counts , diabetes , etc
Doctor :   and a urine routine
Doctor :   these are basic tests
User :   ok
Doctor :   if this is normal nothing to worry
User :   ok
Doctor :   she just needs rest and good food
Doctor :   thats is all
User :   will this be covered under the normal medical test
Doctor :   yes , it will
Doctor :   these are basic tests
User :   or is ther some specific test apart from the normal blood/urine/stool ecg and xray
User :   ok
User :   cell counts will be there right
Doctor :   yes
User :   ok
Doctor :   the test includes cell count , hemoglobin for anemia , blood sugar for diabetes , esr , etc
User :   ok
User :   should i get this done and then come back to you
Doctor :   yes , you do it and get me the reports
User :   ok
Doctor :   she may also need an examination
User :   ok
Doctor :   you can go to a general physician
User :   ok
User :   will do
User :   thanks so much for your time doc
Doctor :   pleasure here
Doctor :   i hope you followed my suggestions
Doctor :   she also needs a blood pressure check
User :   yes, i did
Doctor :   which the doctor will do on examination
User :   yes
Doctor :   ok
User :   thanks again and good day
Doctor :   pleasure here
Doctor :   thanks for consulting me
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