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Diabetic, complains of pain in calf muscles. Can it lead to paralysis ? - Online Doctor Chats

Date : 10-Jun-2013
User rating for this question
Very Good Posted in: Diabetes
Answered by

General & Family Physician
Practicing since : 2002
Answered : 106 Questions
Doctor:Good Evening
Doctor:I am Dr. XXXXXXX here.
Doctor:How can I help you?
User:hello Sir
User:good evening
User:i wnated to consult regarding my fathers current situation
Doctor:hello Mr. XXXXXXX please proceed with your query.
User:he is 58 yr old with a history of diabetes
User:since november he was complaing of pain in his calf muscles
User:we went to a neurologist in Dec, he did a ncv test
User:and he suspected that it might be due to diabetes related neuro probelm
User:he started some medications including pain killer
User:and also suggetsed to do a MRI sometinme
User:we did MRI recetly
User:and the physican directed us to a orthopedic
User:the ortho suspecting slip disc
User:and he suggests to go for a surgery
User:but he left the decission to us
User:becaue of his age and diabetic condition
User:just wanted to know ur opinion on the same
User:he also mentioned that pain might subside gradually
Doctor:Let me guide you regarding this.
User:and it can also get worse and can lead to paralysis
User:is that so?
Doctor:I will explain.
Doctor:The slipping of a disc can be a gradual process or sudden.
Doctor:In your father's case, it seems to be gradual.
Doctor:There are two possibilities, that can occur.
Doctor:1. The disc and vertebrae above and below it can get stabilized automatically. In that case, the pain gradually gets better.
Doctor:But, anytime it can cause a pressure on the nerves passing through the slipped area.
Doctor:2. The condition can aggravate and cause more pressure on the nerves, which can sometimes lead to paralysis.
Doctor:That is what your orthopedic surgeon has explained.
User:so wat do u suggest?
Doctor:If surgery is done, it gets better. If your father is having a good control over his diabetes, it is better to get a surgery done.
Doctor:But again, the prognosis of surgery can only be explained by an orthopedic surgeon, after examining your dad.
User:can you please explain what do you mean by good control of diabetes
Doctor:Good control in the sense, if his blood sugars are not too high whenever it is checked.
User:it is usually above normal range but as per his physician it is acceptable for him
Doctor:That is a good control then.
User:and should we wait for sometime to check if it gets any better
Doctor:In case he is reluctant to go for surgery, you can try proper ayurvedic treatments which might help in stabilizing the joint.
Doctor:I can understand the dilemma you are in.
User:now with pain killers and all he doesnot have pain while walking little while but after that it starts paining
Doctor:May I know his weight?
User:he doesnot complain of pain normally.while atnding or sitting
User:he should be approx 60-63 kgs
User:so doctor what do you suggest us at tis point of time
User:i can forward you his mri report....
Doctor:As you said, he is not in pain now,
Doctor:I believe you can wait.
User:do you want to have a look at his report?
Doctor:You can send the report to YYYY@YYYY with subject as Attn- Dr. XXXXXXX
User:sure sir
Doctor:Please keep you chat window open. meanwhile, I will have a look at the report too.
User:sure sir..i ahve sent it please have a look
Doctor:I have not received it yet. It will be forwarded by the customer care team to me immediately.
User:and also doctor my father stays in Guwahati, it will be great if you can suggest some doctor whom we can refer there....
Doctor:I have received it. Let me go through it. Please remain online.
User:sure sir
Doctor:Sure, I will guide you regarding that.
Doctor:I have gone through his Nerve conduction studies, MRI, lab report and the doctor's notes.
Doctor:Let me guide you regarding how you can take this forward.
User:ok sir
Doctor:Nerve conduction studies shows, nerve changes, probably due to diabetes.
Doctor:MRI shows disc protrusion.
Doctor:So, for the time being he needs to follow some strict measures.
Doctor:1. Regular medicines for diabetes.
Doctor:Should control his diet to prevent soaring up of blood sugar.
Doctor:2. Only mild to moderate movements is permitted.
Doctor:He should not walk for long distances.
Doctor:Bed rest will allow the pain to subside.
Doctor:If he can't rest for long, then better is to get operated.
Doctor:If there is no pain, or other difficulties, he can wait and watch.
Doctor:If pain is not subsiding, or if he feels more difficult, then surgery will be the option.
Doctor:Have you understood all my suggestions?
User:sir what are the chances that the problem will resolve on itslef
User:yes sir
Doctor:I will not be able to comment on that, as I have not examined him by myself. That can be only explained by his treating doctor.
User:ok sir
Doctor:Disc protrusion does not resolve.
Doctor:It cannot decrease by itself.
Doctor:It may remain stable. But can deteriorate any time.
User:oh will it eventually affect its nervs
Doctor:Yes, if proper care is not taken, it will eventually affect the nerves.
User:will physiotheraphy, or homeopathy helps in this matter
User:or ayrurved
Doctor:Physiotherapy can help to strengthen the muscles of back. Regarding homoeopathy, I will not be able to comment. Ayurveda also can be relieving to an extent.
User:but these are not permanent solutions or are they?
User:so eventually he has to undergo an operation for it
Doctor:Yes, if the situation is getting bad, then he will have to go for surgery. In case he takes good care in walking, weight lifting, movements, position while sitting etc, probably it gets settled and can do without a surgery.
User:and sir how compex is this operation...what i meant is since you might be knowing guwahati is not a big place, so can it be done there?
User:or do we need to take him to some big cities and all?
Doctor:If you opt for surgery, make sure that it is done in a good centre where similar surgeries are done regularly.
User:sir are you aware of some hospital in guwahti which can handle it
Doctor:Kolkata will be the nearest big city to Guwahati.
User:what do you suggest?
Doctor:I am not aware of any big centres in Guwahati.
Doctor:May I know where you are working?
User:i am working in bangalore sir
Doctor:In that case, if he is able to travel, then Bangalore will be good as you are working here.
Doctor:Again, that decision can be taken slowly.
Doctor:For the time being wait and watch would be the best thing to do.
User:ok sir..and hope it might get better on its own
Doctor:Let us pray for it.
Doctor:Have you followed everything I said?
User:are you aware of some doctor in guwahati whom we can consult
User:yes doctor
Doctor:One of our customer care executives will assist you further in finding a good orthpedic surgeon in Guwahati.
Doctor:You will receive a call soon from our customer care team.
Doctor:Can you please confirm your mobile number?
Doctor:Is there anything else I can help you with?
User:so sir if everything works out fine...then he might be able to continue without any operations and all
User:thats all sir.....
User:ok..thank you doctor...for your time
Doctor:Thanks Mr. XXXXXXX for consulting me.
Doctor:I am happy that I could guide you over this matter.
User:it was a great consulting with you...
User:thank you sir
Doctor:Please do leave a feedback after the chat.
User:sure sir
Doctor:Have a nice and relaxed evening!
Doctor:Bye for now.
User:ame 2 u sir
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