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Pain and weakness in the legs - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   Hi
User :   Hello
Doctor :  
How can I help you?
User :   I have strong symtoms after a lumbar puncture
Doctor :  
What symptoms do you have ?
User :   pain in both legs, buttocks and I feel weakness in my legs
User :   the LP was in Feb 2009
Doctor :   Ok
Doctor :  
Were the above sx started only after LP
User :   yes I don't have this symptoms before...
Doctor :  
Ok, why was the LP done?
User :   before I only have had back pain over a long time, the LP was needless the doctor did it because he thought it could be myelitis
User :   but it wasn't the LP was without any result
Doctor :   Ok

Doctor :  
What is your age
Doctor :  
Do you have headache?
User :   44 I have a MRI and no problem's with disc's!!!
Doctor :  
Good
Doctor :  
So the back pain has no diagnosis yet
User :   I only have had headache after the LP for 7 days
Doctor :  
What is the frequency of the back pain
User :   I don't hve this back pain....it is gone but after the PL I have this problems with my legs
Doctor :  
Ok what is the doctor's opinion after examining you with such symptoms
User :   he has no idea..........
Doctor :  
Do you have increased pain after a walk or prolonged stand
User :   the pain changes, sometimes in both legs and sometimes in one leg....walking is diffcult but mor difficult is to stand
User :   I have less pain at night............
Doctor :  
Any other medicines that you use
Doctor :  
How much time does the pain stay when it starts typically?
Doctor :  
What do you usually do to reduce the intensity of pain?
User :   it starts if I walk and stand
Doctor :  
Do you smoke?
User :   seldom I have pain if I sit down
Doctor :  
or have alcohol
User :   Nonsmoker no alcohol
User :   the symptoms starts 3 or 4 days after the LP I'm very sportive before
Doctor :  
Are you over weight
Doctor :   Which place do you stay? What is your occupation

User :   No 1,78m weight 64 kg but I lost weight after the LP now it's 58 kg but I eat normal
User :   I'm a photographer
User :   could it be a nerveproblem after the LP?
Doctor :   I am still evaluating it to be the muscular problem
Doctor :  
Does the pain increase as you walk
Doctor :  
and does the pain reduce if you stop and sit
User :   but untill the LP I don't have any muscle problems I'm very sportive.....
User :   yes if I walk and stand the pain increase it is better if I sit
User :   standing is also painful and I feel weakness
Doctor :  
Do you have increased pain if you press your calf muscles or the thigh muscles
Doctor :  
while you sit
User :   yes I feel also pain in the calf muscles and the leg pain also on the rear side of the legs
User :   If I press the calf it is painful
Doctor :   Ok, It is more of muscular problem than nerve problem. However you have to see a Rheumatologist

Doctor :  
for complete evaluation
Doctor :  
It can be coincidental that the present symptoms started after LP, having said that a nerve problem can co exist
Doctor :   Do you have blood pressure, Diabetes?
User :   No I was in perfect health before the LP
User :   I know I don't have Rheuma
Doctor :  
Ok fine
User :   could it be the LP caused an inflammation?
Doctor :  
It could be
Doctor :  
Which specialist did you consult?
Doctor :  
Did you take a second opinion from similar specialist
User :   Neurologist and he did another MRI 4 month after the LP without any result......
Doctor :  
Ok
User :   If there is an inflammation would I have always pain? the only thing I have 24/7 is weakness but pain changes
Doctor :  
Any other tests and opinions
Doctor :  
Inflammation can cause pain, weakness
Doctor :  
The inflammation could be episodic too
Doctor :  
when there is an episode of inflammation
Doctor :  
then there shall be pain
User :   maybe Arachnoiditis??
Doctor :  
Arachnoiditis is a layer over the spinal cord
Doctor :   the layer can be inflammed after LP
User :   only because the needle stuck it
User :   ?
User :   MRI show it or not?
Doctor :   MRI should show immediately
Doctor :  
after long term inflammation it may not show
User :   my MRI was made 4 month after the LP without any result...
User :   and the MRI was with contrast
User :   medium
Doctor :  
Ok
User :   what would you suggest?
Doctor :   MRI is most specific
Doctor :  
if it is not able to find any abnormality
Doctor :  
the doctor has no suspicion in the mind then he rules out a nerve problem
Doctor :   I would ask you take a second opinion from a different Neurologist
User :   sorry :o) I ask also another specialist without any result
User :   and the doctors told me it isn't Arachnoiditis but they have no idea.......
User :   I hang in balance.......
Doctor :  
Ok
Doctor :  
I can understand your concern
Doctor :  
Right now you have to be positive in yoru approach
Doctor :  
You should learn to cope up with the pain that you have
Doctor :  
You should learn your own ways to reduce the pain
Doctor :  
You should not be worried about the nerve problem
Doctor :  
If you still have nerver problme inthe mind it causes you more pain
User :   but I'm afraid of the weakness, could it be that the symptoms gone sometimes?
User :   could it be only a nerve irritation? How much is the risk that it is Arachnoiditis? Is it rather a rare condition?
Doctor :  
I do not think it is Arachnoiditis
Doctor :  
It is seen in MRI
Doctor :  
It could possibily be a nerve root irritation but the doctor can easily find it
Doctor :   Did the doctor say if it is a muscular problem?

Doctor :  
IS the weakness increasing since then?
User :   I have had a muscle biopsy also but it was without any result too...........
Doctor :   Oh is it?
User :   yes......alos needless like the Lp
User :   After the LP at first I have had weakness in the right leg and 2 or 3 weeks ago in both, and since 3 month it is the same situation
Doctor :   ok

User :   only pain changes I think that the pain was more in the beginning, still there but sometimes not so bad.
User :   What can I do?
Doctor :  
Symptomatic treatment with
Doctor :   painful legs in warm water
Doctor :  
for 10 minutes
Doctor :  
rubbing with pain balms
Doctor :  
Massaging with the rubefacients
User :   and the against weakness?
Doctor :  
Physiotherapy
Doctor :  
Physiotherapist will help you
Doctor :  
with some exercises
Doctor :  
which will cope up with yoru occupation
Doctor :   Physical rehabilitation specialist shall help you with the exericse also

User :   ok so Ihave a chance that is not an Inflammation?
User :   Is nerve damage possible after LP?
Doctor :   It might not be an inflammation

Doctor :  
It is possible
Doctor :  
but it does not look like nerve damage for you
Doctor :  
after LP
User :   what do you think about that I have only pain of the rear side of my legs?
User :   and I feel alway tired
User :   not able to put on weight.....
Doctor :  
Shall I research on your problem and get backto you after sometime
Doctor :  
when you come to the chat
Doctor :  
in next 48 hrs
User :   It would be very nice
Doctor :  
I got your entire history
Doctor :  
now
Doctor :  
Let me reasearch on it
Doctor :  
and help you
User :   but how I can reach you? normaly I can't
Doctor :  
Ok
Doctor :  
Over chat
Doctor :  
you can come on chat anytime
User :   choose the doctor in this chat
Doctor :  
You can ask for Dr.Mazumdar
Doctor :  
whenever you chat if I am available I can take up your chat
Doctor :  
Ok
User :   ok
Doctor :  
Please fill the feedback form say done.
User :   ok
Doctor :   Thansk for consulting
User :   I hope I get an answer for my problems......
Doctor :  
I shall get back to you with some information
Doctor :  
if any
Doctor :  
I could find
Doctor :  
Ok
Doctor :  
Bye
User :   bye
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