Brief Answer:
Have you tried any of the following ideas?

Detailed Answer:
Good afternoon. I am a neurologist from XXXXXXX OH and would like to suggest a few things regarding your problem.

I understand you are suffering painful muscle cramping in the right calf and have daily painful symptoms. Back muscles are seizing (start distally and move upward) and you cannot raise your head from the bed at times.

You've been told that there are imaging findings as well which show DDD. Medications include gabapentin 600 TID, Tramadol 50mg. PRN, and Motrin/Tylenol in an alternating pattern of 800/1000 mg.



In a patient with your symptoms I would typically be obtaining a much more detailed history on medications which have been tried in the past and their effects as well as medications that have caused undesirable consequences. I'd also want to be sure that whatever medications have been tried have been attempted at maximum doses so I'd want a full medication history including dosages and frequency of delivery. It also doesn't appear from what you've written that you've had any modalities tried such as TENS units, CORSETS, SOOTHEAWAY devices, TRACTION of the spine, ACUPUNCTURE, BIOFEEDBACK and PHYSICAL THERAPY, and especially AQUATHERAPY. If so, I would want to get a good history on any of the modalities and then, see what hasn't been tried yet. You mention that you've tried a chiropractor but I don't know whether or not that means you've tried using one and it failed (i.e. no longer going) or did it work partially but you had to stop due to finances, etc. And also, how about the use of hot packs or hot baths vs. ice packs or hydrobaths (ie- jacuzzi therapy).

Have you ever had an EMG/NCV study performed on your low back (mainly my concern is the complaint of calf muscle cramping).

In terms of pain medications that you are using are you able to clearly describe the effectiveness of each one of the agents as compared to the other? In other words, what happens if you try lowering the dose of each of the agents individually? Collectively? Have you ever been recommended to perform HYALURONIC ACID INJECTIONS?

I would also like to know a history of sorts as to what activities and types of physical exertion make the pains better and worse? Are there things which you simply cannot do anymore because of this pain? Also, how much do you weigh and what is your height? Has there been a weight increase or loss over the past 12 months of greater than 5% of your total body weight?

If you'd like to respond to any of these questions and write back I'll be happy to give you a few more thoughts. Otherwise, if I've given you ideas you feel you can discuss with your doctor then, by all means check some of what I've said out about your condition of DDD or OSTEOARTHRITIS and all the best to you!

I hope this answer satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with written feedback?

Also, if there are no other questions or comments, I'd appreciate it greatly if you would CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary.

Please direct more comments and questions to me in the future at:

bit.ly/drdariushsaghafi and I would be honored to answer you and continue this discussion.

All the best.


This inquiry has taken 65 minutes of direct physician time in reading, researching, and envoy preparation to patient.

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