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What can be the reason for long lasting back and neck pain ?

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Orthopaedic Surgeon
Practicing since : 2000
Answered : 170 Questions
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HI DR...MY WIFE IS HAVING LEG AND BACK PAIN FROM LAST 3 YRS(INCREASES AFTR CHILD BIRTH).....I HV CONSULTED A NO OF DRS OF ORTHOPADIC, NURO, AYURVEDIC, HOMEOPATHIC ETC, HV DONE A NO OF TESTINGS LIKE SPINAL XRAY, MRI, BLOOD TEST ETC BUT NO RESULT....
IN EARLY DAYS SHE WAS HAVING ONLY PAIN ON BACK OF LEG....GRADUALLY IT INCREASES TO WHOLE BACK....AND TO NECK....MOSTLY IT STARTS IN NIGHT....IF SHE TAKE ANY PAIN KILLER THEN IT WL OK FOR 2-3 DAYS....IT IS UNBEARABLE NOW......WHEN SHE HD PAIN SHE CANT CONCENTRATE AND CANT DO ANYTHING....NOW SHE IS HAVING IT ALMOST TWICE A WEEK...IF WE GIVE PRESURE TO LEGS, BACK THAN SHE FEEL NICE....
HER REPORTS ARE
1..MRI STUDY AS FOLLOWS----"SMALL CENTRAL DISC PROTRUSION AT C5-C6 LEVEL WITH MILD THECAL IMPINGEMENT..POSTERIOR OSTEOPHYTES ARE SEEN IN THE PERIDISCAL MARGINS AT C5-C6 LEVEL"
2.XRAY--AP & LATERAL VIEW OF LUMBO-SACRAL SPINE...REPOTED..RELATIVE REDUCTION OF L4-L5 &L5-S1 DISC SPACES...
3.HER BLOOD REPORTS ARE NORMAL....1YR BACK SHE HD VIT-D DEFICIENCIES...DR PRESCRIBED FOR INJECTION...NOW VIT-D MORE THAN SUFFICIENT...
IF U NEED ANY REPORT THEN I WL SCAN AND MAIL U..
SO PLZ HELP ME WHAT TO DO....
Posted Mon, 23 Apr 2012 in Back Pain
 
 
Answered by Dr. Atul Wankhede 3 hours later
Dear,

Thanks for the query.

Sorry to know about the sufferings and consultations of different therapist with out any relief.

The reports of Xray is suggestive of decreased disc space most likely resulting from disc prolapse. This in turn presses upon the cord/nerve root at that particular site and inturn leads to pain, tingling numbness, weakness of legs. This is in accordance to the pain your wife is suffering, so to confirm this you need an MRI of lumbo-sacral spine.

The cervical spine seems pretty normal. The pain produced is know as Radiculopathy and needs to be established before we think of suggesting any treatment.

She must be tired of taking medicines so lets not subject her to more, but physiotherapy might work, so think of lumbar traction and diathermy after discussing about this with a Physiotherapist.

You mentioned that this ordeal began after delivery, so I needed to know, did she take any spinal anaesthesia then?

Please mail me the MRI and the X rays reports to YYYY@YYYY with subject:ATTN: Atul Wankhede so as to provide you with specific suggestions. Please do confirm the mailing of the reports by writing here so as to reply you back at the earliest.

Awaiting your reply.

Wish her a speedy recovery.

Regards.
Above answer was peer-reviewed by
 
Follow-up: What can be the reason for long lasting back and neck pain ? 15 hours later
dear sir
i hv mailed you 4 no of mail attaching MRI , Xray, blood reports etc...to minimise scan i hv write down some of findings by hand....i am not sure about spine anesthesia...

plz help me out from this....
 
 
Answered by Dr. Atul Wankhede 15 hours later
Hi,

Thanks for your reply.

The xray's have nothing new to say than we have previously discussed. But the MRI has shed light on some very important facts. Firstly the MRI,almost a year old, is not focussed on lumbar spine, nevertheless a screening of lumbar spine was done that tells us
1. Caudal shift or downward shift of vertebrae (meaning abnormal pulling down of spine),
2. L5 sacralisation (abnormal communication between last lumbar vertebra and the sacrum ).
Both the above points makes the spine vulnerable to reduced mobility and possible nerve entrapment.
3. Anterior and posterior osteophytes at various levels (signs of early degeneration, osteoarthritis, or possibly ankylosing spondylosis )this is very likely to cause pressure over spinal cord and/or spinal nerves. And lastly
4. Disc protrusions at L3-4 L4-5 levels.central protrusions always indent upon cord and not nerve roots.
At an age of 28, she seems to have suffered a lot. This needs further evaluation by MRI Lumbo-sacral spine. In my opinion, this could turn out to be a case of Ankylosing spondilitis. If so we need to do hla b27 test for confirmation and subsequent treatment. Also refer to following WWW.WWWW.WW for more information and its link with pregnancy.
Hope this answers your queries.
I wish her good health
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