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Suggest Treatment For Back Pain
Question: Hello Doctor .My mom is 60 years old and has been suffering from back pain for more than two years. Her movement has become very limited and doctors are suggesting surgery due to nerves compression . she doesn't wanna have a surgery due to her age and blood pressure problem. Medicines and Physiotherapy are of no use.
The findings of the reports are as follows.
1)Central and Bilateral P Disc protrusion. L4 L5 superior migration
2)C3 C4, C4 C5, C5 C6 Grade 1 Disc Bulge
3)C5 C6 intervetebral Grade 2 disc dessication.
Right now she's having the following medicines.
Vitamin D , Pregaba M , Myoril 8mg but still the pain does not subside. And when she gets up from sleep the pain is worst .
Please help
The findings of the reports are as follows.
1)Central and Bilateral P Disc protrusion. L4 L5 superior migration
2)C3 C4, C4 C5, C5 C6 Grade 1 Disc Bulge
3)C5 C6 intervetebral Grade 2 disc dessication.
Right now she's having the following medicines.
Vitamin D , Pregaba M , Myoril 8mg but still the pain does not subside. And when she gets up from sleep the pain is worst .
Please help
Brief Answer:
Please upload images
Detailed Answer:
Hi XXXXXXX I have gone through your question and understand your concerns.
Your mother is likely to have disc bulging which is causing her symptoms.Please upload the MRI images so that I can evaluate them and explain you in detail.
She may require surgery if there is weakness of lower limbs, sensory loss, severe pain, reflex loss, or bladder or bowel involvement.
Drugs can be increased in order to provide relief. She should continue doing physiotherapy.
Hope you found the answer helpful. Please do get back to with the images, if feasible.
Wishing you both good health.
Regards,
Dr Neeraj Kumar
Please upload images
Detailed Answer:
Hi XXXXXXX I have gone through your question and understand your concerns.
Your mother is likely to have disc bulging which is causing her symptoms.Please upload the MRI images so that I can evaluate them and explain you in detail.
She may require surgery if there is weakness of lower limbs, sensory loss, severe pain, reflex loss, or bladder or bowel involvement.
Drugs can be increased in order to provide relief. She should continue doing physiotherapy.
Hope you found the answer helpful. Please do get back to with the images, if feasible.
Wishing you both good health.
Regards,
Dr Neeraj Kumar
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hello
The surgery is out of question because of her age and the success rate of surgery is very less. Sometimes the pain subsides but most of the time she is in a lot of pain. I will try uploading the images later in the day.
She has a lot of problem when she gets up from sleep early morning and evening. After physiotherapy the pain increases a lot and she cries in pain.
Doctor please suggest the best possible medicine in the meantime which can reduce the pain and has minimal side effect.
The surgery is out of question because of her age and the success rate of surgery is very less. Sometimes the pain subsides but most of the time she is in a lot of pain. I will try uploading the images later in the day.
She has a lot of problem when she gets up from sleep early morning and evening. After physiotherapy the pain increases a lot and she cries in pain.
Doctor please suggest the best possible medicine in the meantime which can reduce the pain and has minimal side effect.
Brief Answer:
pregaba M can be increased for 150 mg
Detailed Answer:
Hello XXXXXXX
Surgical advice can only be given by knowing the neurodeficit, sensory loss, reflex loss and the amount of compression on the cord or exiting roots.
The report surely mentions compression of roots at lumbar region.
The pregaba M can be increased for 150 mg and nortryptiline 10 mg can also be added.
continue rest medication.
Pain killers can also be added for some duration.
I will advise again after you upload Mri images in pdf or jpeg format.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
pregaba M can be increased for 150 mg
Detailed Answer:
Hello XXXXXXX
Surgical advice can only be given by knowing the neurodeficit, sensory loss, reflex loss and the amount of compression on the cord or exiting roots.
The report surely mentions compression of roots at lumbar region.
The pregaba M can be increased for 150 mg and nortryptiline 10 mg can also be added.
continue rest medication.
Pain killers can also be added for some duration.
I will advise again after you upload Mri images in pdf or jpeg format.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hello Doctor
I have uploaded the reports and few images. Could not upload properly as i dont have a soft copy for the same. One thing she needs to know that whenever she gets up from sleep in morning , the pain is the most unbearable at that time and it takes 1 hour to settle. What is the reason for this and please also suggest best medicine for pain relieve with minimal side effects as its very disheartening to see her in pain sometimes.
I have uploaded the reports and few images. Could not upload properly as i dont have a soft copy for the same. One thing she needs to know that whenever she gets up from sleep in morning , the pain is the most unbearable at that time and it takes 1 hour to settle. What is the reason for this and please also suggest best medicine for pain relieve with minimal side effects as its very disheartening to see her in pain sometimes.
Brief Answer:
Continue prescribed medication
Detailed Answer:
Hello XXXXXXX
I have gone through your images.
Axial images are also required to give a true pictures. (axial images are box with rounded cord and structures).
The Mri report and one of the sagittal image is showing L4-5 disc prolapse with migration in pre dural space. The amount of roots or cord compression can only be ascertained by axial images.
For pain relief you can give
Tab myoset D once in night ---can be given twice
Tab rejusite once in night.
Cap sompraz empty stomach morning
Local volitra spray
Tab Tryptomer 10 mg night
Please discuss about these with the treating doctor.
continue physiotherapy.
Is she having any joint related problems like swelling and pain of small joint of hand.
Morning pain may be due to weaning effects of medication given in night or some disc with facet joint involvement.
Hope you found the answer helpful.
do get back to me for further queries.
Regards
Dr Neeraj Kumar
Neurologist
Continue prescribed medication
Detailed Answer:
Hello XXXXXXX
I have gone through your images.
Axial images are also required to give a true pictures. (axial images are box with rounded cord and structures).
The Mri report and one of the sagittal image is showing L4-5 disc prolapse with migration in pre dural space. The amount of roots or cord compression can only be ascertained by axial images.
For pain relief you can give
Tab myoset D once in night ---can be given twice
Tab rejusite once in night.
Cap sompraz empty stomach morning
Local volitra spray
Tab Tryptomer 10 mg night
Please discuss about these with the treating doctor.
continue physiotherapy.
Is she having any joint related problems like swelling and pain of small joint of hand.
Morning pain may be due to weaning effects of medication given in night or some disc with facet joint involvement.
Hope you found the answer helpful.
do get back to me for further queries.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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