Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
128 Doctors are Online

Can severe pain persistent since 6 years in lower back extending to left leg and left arm be treated ?

User rating for this question
Very Good
Answered by

Orthopaedic Surgeon
Practicing since : 2000
Answered : 170 Questions
Question
A case of left lower back pain since last 6 years. MRI Impression, “Desication of L5/S1
disc with circumferential bulging & narrowing of left neural recess at L5/S1 disc level”.
Since last 2 year the pain has been aggravated towards left feet and left palm. Pain has
become severe at back as well as feet and palm. Feels as if the nerves/veins at feet and
palm are twisting/squeezing day to day and it is gradually in the rise. Unable to hold/
press the left feet/leg equally in the ground as the right one while walking. The case is
same with the left palm. The veins of left feet and palm are more distinctly visible to the
eyes than the right one. The surface area at lower back seems to be little bit risen/swollen
but can not judge it accurately. Request advise clinical remedy.
Posted Wed, 11 Apr 2012 in Back Pain
 
 
Answered by Dr. Atul Wankhede 17 hours later
Dear XXXXXXX

Thanks for your query.

Your MRI is specifically showing a disc pathology that is a circumferential bulge causing pressure over the exiting nerve roots,more on left than right i suppose(since you have prominent symptoms on left leg). The pain you experience sure seems like a radiculopathy.

I have no doubts about the disc pathology at this stage,neither should you. You will have to take a course of anti inflammatory-muscle relaxant combination to relieve the protective muscle spasm if any, begin lumbar traction, short wave diathermy at a physiotherapist(for 5-7days) and once pain free start back strengthening exercises. If this works out fine carry on the exercises life long, if not..dont wait much longer and get operated for disc removal(laminectomy,discectomy) at earliest before any more damage is done. Meanwhile also concentrate on weight reduction(if you are obese),maintain upright posture at all times,use firm mattress to rest,DO NOT bend forward or lift anything heavy.

I hope this answers most of your queries.Feel free to ask any thing you fail to understand.

good luck
Above answer was peer-reviewed by
 
Follow-up: Can severe pain persistent since 6 years in lower back extending to left leg and left arm be treated ? 4 days later
Ref my Transaction ID: hcmg0000 dated 12 Jul 2011.
Ref Transaction ID: hcmg 0000 dated 17 Jul 2011.

In reference to your reply dated 13 Jul 11, I would like to say few more things. First of all inadvertently I failed to inform earlier that MRI report also says that Haemangiomas in L1, T10 vertebral bodies noted. This week I have already met with one Neuro&Spine surgeon and one Neurologyst. First one stated that the compression/bulge at L5/S1 is mild so this may not be the root cause of the problems, so he referred to Neurologist for Electro Myogram & Nerve Conduction test.
The Neurologist opined that there is no such significant observation found with the nerve and muscles of leg and hand those related to that disc except at one nerve area but that may be due to stimulation factor. Now after consulting back to the Neuro& Spine surgeon he says that it is due to the Haemangiomas, so you need to go for Vertobroplasty.

Now I am confused due to no such sure cause of the problem. I have uploaded my reports so that my case can be studied from a better angle. Hence request to go through all the reports and give your final opinion/advise. Thanking you.

Mamata Sahu
MRI Impression:
1. Desication of L5/S1 disc with circumferential bulging & narrowing of left neural recess at L5/S1 disc level.
2. Haemangiomas in L1, T10 vertebral bodies noted.
A case of left lower back pain since last 6 years. Since last 2 year the pain has been aggravated towards left leg and left hand. Pain has become severe at back as well as left side of left leg and hand. Feels as if the nerves/veins at feet and palm are twisting/squeezing day to day and it is gradually in the rise. Unable to hold/press the left feet/leg equally in the ground as the right one while walking. The case is same with the left palm. The veins of left feet and palm are more distinctly visible to the eyes than the right one and the surface area at lower back seems to be little bit risen/swollen, these are my observations but I may not be sure of its accuracy. Request advise clinical remedy.

Mamata Sahu, Bhubaneswar, Mob-0000.
 
 
Answered by Dr. Atul Wankhede 9 hours later
Hi XXXXXXX

Thanks for writing back.

Thanks for providing us with your exact reports. I beg to differ from your neurologist. The first sentence of MRI report itself suggests that its not just a circumferential bulge , but a DESSICATION of disc at L5-S1 level causing pressure over the exiting nerve root. This is an evidence of refered pain, weakness and altered sensations in left leg. Fortunately Haemangioma, though an incidental finding, can give rise to local symptoms and not distal, as in your legs.
Vertebroplasty is a big decision, should be done depending upon the size, impending neural or stability catastrophe and of course pain. Take another opinion before going ahead with that. In my opinion its unnecessary unless proved otherwise.
As stated earlier I suggest anti inflammatory-muscle relaxant combination, traction and SWD for a week at physiotherapist, a lumbar brace if you may, and back strengthening exercises after pain subsides. Also follow previously given instructions.
May I request you to mail us the soft copies of MRI plates for more accuracy.

Here's wishing you an early recovery. Good day.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions

The user accepted the expert's answer

Ask an Orthopaedic Surgeon

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor