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What Causes Pain In Lower Back Radiating To Legs?
Question: Dear Doctor,
I am a 26 year old male.
I started having the common cold/flu at around december 10,2014.
Here is my MAIN CONCERN:
While having the cold/flu on the morning of december 15,2014 I started to develope a quite severe lower back pain and I also had pain shooting up on both of my legs.It would really hurt whenever I coughed on that day.I was not able to sleep whatsoever and had to lie down facing on my LEFT side.
On december 16,2014 the pain on my lower back went away,but to date that was the worst day because I had a sciatica attack,I was not able to stand straight the whole day and I was basically immobile and the sciatic nerve pain was only manifesting on my right leg (severe stabbing pain behind the thigh).I had to sleep on my left side again (still had the flu).
On december 17,2014 things seemed to have greatly improved,my sciatica nerve pain on my right leg has dissapeared,I am able to stand almost normally again and walk (but not run).But a new problem has arised,on the LEFT side of my buttocks and on my genital area,numbness has taken over! I am unable to feel my penis and buttocks (left side) and very mild on my LEFT leg til now.I am able to stand and walk without any lower back or leg pain.
What could this numbness be doctor? I would not want to think that this could be an indication of early CES (Cauda Equina Syndrome).
Could this numbness developed because I was sleeping on my left side the previous nights? What could have caused all of this symptoms to have appeared? Is it because of the flu virus? My main concern as of now is this numbness.
I had a CT scan done on november 29,2014 because of constipation issues after a course of meds. The only relevant findings were on my spine; L4-L5 has a disk bulge (not hernia),and also noted was that there's a POSSIBLE (no definite answer) disk protrusion on L5-S1.
The flu has subsided as of now.
I have also done an MRI scan yesterday night,the only significant findings on the the initial result showed nothing major (only a mild buldge on L4-L5 and L5-S1).
Mild.
I am currently able to walk and stand,my only problem now is this numbness in my genital and buttocks (left side).
No sciatic or lower back pain as of now,although my back is a bit stiff.
Is it because of the flu virus which triggered all of this happen?
When I walk I could feel some warm sensation and pain on my left leg.
I could still urinate and have bowel movments (but urine is passing out slowly).
Before the numbness started I was always sleeping on my left side,and I was stuck in severe traffic for almost four hours in the road.
Could this be prudenal nerve issues?
I would not want to think that I have Cauda Equina Syndrome.
I am a 26 year old male.
I started having the common cold/flu at around december 10,2014.
Here is my MAIN CONCERN:
While having the cold/flu on the morning of december 15,2014 I started to develope a quite severe lower back pain and I also had pain shooting up on both of my legs.It would really hurt whenever I coughed on that day.I was not able to sleep whatsoever and had to lie down facing on my LEFT side.
On december 16,2014 the pain on my lower back went away,but to date that was the worst day because I had a sciatica attack,I was not able to stand straight the whole day and I was basically immobile and the sciatic nerve pain was only manifesting on my right leg (severe stabbing pain behind the thigh).I had to sleep on my left side again (still had the flu).
On december 17,2014 things seemed to have greatly improved,my sciatica nerve pain on my right leg has dissapeared,I am able to stand almost normally again and walk (but not run).But a new problem has arised,on the LEFT side of my buttocks and on my genital area,numbness has taken over! I am unable to feel my penis and buttocks (left side) and very mild on my LEFT leg til now.I am able to stand and walk without any lower back or leg pain.
What could this numbness be doctor? I would not want to think that this could be an indication of early CES (Cauda Equina Syndrome).
Could this numbness developed because I was sleeping on my left side the previous nights? What could have caused all of this symptoms to have appeared? Is it because of the flu virus? My main concern as of now is this numbness.
I had a CT scan done on november 29,2014 because of constipation issues after a course of meds. The only relevant findings were on my spine; L4-L5 has a disk bulge (not hernia),and also noted was that there's a POSSIBLE (no definite answer) disk protrusion on L5-S1.
The flu has subsided as of now.
I have also done an MRI scan yesterday night,the only significant findings on the the initial result showed nothing major (only a mild buldge on L4-L5 and L5-S1).
Mild.
I am currently able to walk and stand,my only problem now is this numbness in my genital and buttocks (left side).
No sciatic or lower back pain as of now,although my back is a bit stiff.
Is it because of the flu virus which triggered all of this happen?
When I walk I could feel some warm sensation and pain on my left leg.
I could still urinate and have bowel movments (but urine is passing out slowly).
Before the numbness started I was always sleeping on my left side,and I was stuck in severe traffic for almost four hours in the road.
Could this be prudenal nerve issues?
I would not want to think that I have Cauda Equina Syndrome.
Brief Answer:
Most likely cause is mild disc prolapse
Detailed Answer:
Hi,
Thanks for your query.
I'm Dr. Sudhir Kumar,
After going through your query I concluded that most likely cause of your symptoms can be mild disc prolapse as pain was initially more on coughing. It is not Cauda Equina Syndrome as there is not much involvement of bladder and bowel. It seems to be due to radiculopathy of S1 nerves.Flu viral may be related to it that some inflammation at spinal level may be caused by virus aggravating the condition and also coughing aggravating it. It seems to me not pudendal nerve issue. I can better help you if you can upload MRI report.
Treatment of it is rest in position of relief(generally lateral position with both hip and knee bend),neurotopics such as mecobalamine and analgesics for pain relief (Diclofenac/ibuprofen three times a day after meals is effective). Sometimes strong analgesic(such as tramadol three times a day after meals) is required. Omeperazole before meals prevent acidity caused by analgesics .You can discuss with your treating Doctor about it.
Hope I have answered your query.
If you have any further questions I will be happy to help.
Wishing you good health.
Take care.
Most likely cause is mild disc prolapse
Detailed Answer:
Hi,
Thanks for your query.
I'm Dr. Sudhir Kumar,
After going through your query I concluded that most likely cause of your symptoms can be mild disc prolapse as pain was initially more on coughing. It is not Cauda Equina Syndrome as there is not much involvement of bladder and bowel. It seems to be due to radiculopathy of S1 nerves.Flu viral may be related to it that some inflammation at spinal level may be caused by virus aggravating the condition and also coughing aggravating it. It seems to me not pudendal nerve issue. I can better help you if you can upload MRI report.
Treatment of it is rest in position of relief(generally lateral position with both hip and knee bend),neurotopics such as mecobalamine and analgesics for pain relief (Diclofenac/ibuprofen three times a day after meals is effective). Sometimes strong analgesic(such as tramadol three times a day after meals) is required. Omeperazole before meals prevent acidity caused by analgesics .You can discuss with your treating Doctor about it.
Hope I have answered your query.
If you have any further questions I will be happy to help.
Wishing you good health.
Take care.
Above answer was peer-reviewed by :
Dr. Raju A.T
Dear Doctor,
I have attached the test results of my MRI scan for your review.
I still have a bit of flu left with very mild coughing and whitish phlegm (not green anymore).
I do not have any back pain or lower back pain whatsoever,but when I cough I could feel some pain on my tail bone.
When I walk I could still feel some pain on my legs my the pain is more intense on my left leg.And also a warm pain sensation on my buttocks (more on the left side).
I still have the numbness on my left buttock and genitalia (more on thr left side).
Doctor,so is cauda equina syndrome ruled out?
How much time would you think it would take for the numbness to go away?
What do you overall think of my results?
What is it that I exactly need to do to recover from this numbness and pain?
How bad is my situation?
Kind Regards
I have attached the test results of my MRI scan for your review.
I still have a bit of flu left with very mild coughing and whitish phlegm (not green anymore).
I do not have any back pain or lower back pain whatsoever,but when I cough I could feel some pain on my tail bone.
When I walk I could still feel some pain on my legs my the pain is more intense on my left leg.And also a warm pain sensation on my buttocks (more on the left side).
I still have the numbness on my left buttock and genitalia (more on thr left side).
Doctor,so is cauda equina syndrome ruled out?
How much time would you think it would take for the numbness to go away?
What do you overall think of my results?
What is it that I exactly need to do to recover from this numbness and pain?
How bad is my situation?
Kind Regards
Brief Answer:
You are having disc prolapse with neuropathy.
Detailed Answer:
Hi
Welcome back
I have studied your query, follow up query and MRI report in detail.
After going through these I concluded that you are having disc prolapse mainly at level of L5,S1. You are having moderate stenosis and with compression of S1 and S2 roots. Your symptoms are due to this. Treatment (conservative) has already been discussed. If symptoms not improve than you may need operative decompression. So you are advised to take rest in already discussed position to avoid operative treatment.
As you have not much bladder and bowel involvement so you are unlikely to have cauda equina syndrome.
Your numbness may take nearly 3 weeks to go. But these are only estimation, it may take much longer. Numbness will recover fast after treatment (Rest/operation).
Rest is most important to recover from numbness.
Mecobalamine help in recovery of numbness.
Your situation is not so bad. It is mild to moderate and not severe.
You can discuss with your Doctor about it.
Hope your query gets answered.
If you have any clarification then I will be happy to help you.
If you have no clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
You are having disc prolapse with neuropathy.
Detailed Answer:
Hi
Welcome back
I have studied your query, follow up query and MRI report in detail.
After going through these I concluded that you are having disc prolapse mainly at level of L5,S1. You are having moderate stenosis and with compression of S1 and S2 roots. Your symptoms are due to this. Treatment (conservative) has already been discussed. If symptoms not improve than you may need operative decompression. So you are advised to take rest in already discussed position to avoid operative treatment.
As you have not much bladder and bowel involvement so you are unlikely to have cauda equina syndrome.
Your numbness may take nearly 3 weeks to go. But these are only estimation, it may take much longer. Numbness will recover fast after treatment (Rest/operation).
Rest is most important to recover from numbness.
Mecobalamine help in recovery of numbness.
Your situation is not so bad. It is mild to moderate and not severe.
You can discuss with your Doctor about it.
Hope your query gets answered.
If you have any clarification then I will be happy to help you.
If you have no clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Hi, I have provided some attachments. Please review them.
Brief Answer:
MRI film confirm what said in MRI report.
Detailed Answer:
Hi
Welcome back
I have studied your query, follow up query ,MRI report and MRI film in detail.
After going through these I concluded that you are having disc prolapse mainly at level of L5,S1 and mild disc prolapse at L4,L5. This film confirm this. Rest already discussed.
Hope your query gets answered.
If you have any clarification then I will be happy to help you.
If you have no clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
MRI film confirm what said in MRI report.
Detailed Answer:
Hi
Welcome back
I have studied your query, follow up query ,MRI report and MRI film in detail.
After going through these I concluded that you are having disc prolapse mainly at level of L5,S1 and mild disc prolapse at L4,L5. This film confirm this. Rest already discussed.
Hope your query gets answered.
If you have any clarification then I will be happy to help you.
If you have no clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Doctor,
I have attached other visual images done from the MRI scan for your visual inspection and review (dated Dec. 18,2014).I forgot to fully upload them before.
This is already the 10th day into this leg pain and numbness (left buttock and left side of the genital area).
I have not done any physical therapy as of yet as I am following your advice of bed rest.
My symptoms so far are:
Pain on the tailbone (L5-S1) sometimes when waking up.
Stiffness on the tailbone.
Legs are still somewhat stiff.
No major leg pain at the moment,but I am really having a hard time finding the best sleeping position.My legs hurt more when I am in bed.Could depend on the quality of the bed and mattress.
I am still able to get an erection and have an ejaculation,but it's just hard to achieve one because of the numbness.It just feels weird.
I am still able to have bowel and bladder movements so far.No straining on the bowel,but urine would just dribble (pass somewhat slowly out compared to before I had these issues).
I can still stand up and walk with no major pain aside from the numbness and stiffness.I have not tried walking long distances as of the moment.
What do you overall think doctor?
Do you think I am improving or worsening?
Do you think my nerves would suffer permanent damage/numbness while being compressed for too long?
I also plan on losing more weight so it would lessen the compression on my nerves.
I just hope that I don't have Cauda Equina Syndrome.
Please let me know what you think doctor,please do not hesitate at all to let me know.
Kind Regards
I have attached other visual images done from the MRI scan for your visual inspection and review (dated Dec. 18,2014).I forgot to fully upload them before.
This is already the 10th day into this leg pain and numbness (left buttock and left side of the genital area).
I have not done any physical therapy as of yet as I am following your advice of bed rest.
My symptoms so far are:
Pain on the tailbone (L5-S1) sometimes when waking up.
Stiffness on the tailbone.
Legs are still somewhat stiff.
No major leg pain at the moment,but I am really having a hard time finding the best sleeping position.My legs hurt more when I am in bed.Could depend on the quality of the bed and mattress.
I am still able to get an erection and have an ejaculation,but it's just hard to achieve one because of the numbness.It just feels weird.
I am still able to have bowel and bladder movements so far.No straining on the bowel,but urine would just dribble (pass somewhat slowly out compared to before I had these issues).
I can still stand up and walk with no major pain aside from the numbness and stiffness.I have not tried walking long distances as of the moment.
What do you overall think doctor?
Do you think I am improving or worsening?
Do you think my nerves would suffer permanent damage/numbness while being compressed for too long?
I also plan on losing more weight so it would lessen the compression on my nerves.
I just hope that I don't have Cauda Equina Syndrome.
Please let me know what you think doctor,please do not hesitate at all to let me know.
Kind Regards
Brief Answer:
You have moderate disc prolapse at L5,S1
Detailed Answer:
Hi
Welcome back
I have studied your query, follow up queries ,MRI report and all MRI films in detail.
After going through these I concluded that you are having moderate disc prolapse at level of L5,S1 and mild disc prolapse at L4,L5. I think you are improving. I think you are not having Cauda Equina Syndrome.Your nerves are likely to gradually improve as it is due to pressure by disc which is likely to improve once pressure is relieved. 10 days is not a longer time as far as disc prolapse is concerned as it takes long time to recover. You can start some exercises once you nearly recover from backache(means only there is little back pain). Best position of relief in resting (sleeping) period is lateral position with both hip and knee bend. I think your overall recovery is good. You are planning to lose weight, it will help you to prevent recurrence and improving general health if you are overweight.
I just wanted to know whether your sensations in genitals and bowel and bladder condition are improving from previous condition(9 days back) or not. If it is improving as compared to previous condition then no need to worry.
Rest already discussed.
You can discuss with your Doctor about it.
Hope your query gets answered.
If you have any clarification then I will be happy to help you.
If you have no clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
You have moderate disc prolapse at L5,S1
Detailed Answer:
Hi
Welcome back
I have studied your query, follow up queries ,MRI report and all MRI films in detail.
After going through these I concluded that you are having moderate disc prolapse at level of L5,S1 and mild disc prolapse at L4,L5. I think you are improving. I think you are not having Cauda Equina Syndrome.Your nerves are likely to gradually improve as it is due to pressure by disc which is likely to improve once pressure is relieved. 10 days is not a longer time as far as disc prolapse is concerned as it takes long time to recover. You can start some exercises once you nearly recover from backache(means only there is little back pain). Best position of relief in resting (sleeping) period is lateral position with both hip and knee bend. I think your overall recovery is good. You are planning to lose weight, it will help you to prevent recurrence and improving general health if you are overweight.
I just wanted to know whether your sensations in genitals and bowel and bladder condition are improving from previous condition(9 days back) or not. If it is improving as compared to previous condition then no need to worry.
Rest already discussed.
You can discuss with your Doctor about it.
Hope your query gets answered.
If you have any clarification then I will be happy to help you.
If you have no clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Dear Doctor,
My bladder and bowel movements seem to be improving so far.
The flow of my urine is stronger now compared to the previous days.
Just a few moments ago,I noticed a strong ITCHING sensation on my left buttock (where most of the numbness is).Is the itching sensation a good sign doctor?I guess it's safe to say that the sensations now feel a bit better too.
I also noticed on the left side (where the numbness is) of my genital area some sharp/shooting pain.
The itchiness and sharp pains have subsided as of now.
When I walk up the stairs,the pain on my tail bone while using the left leg has also subsided.
Please let me know what you honestly think doctor.
Kindest Regards
My bladder and bowel movements seem to be improving so far.
The flow of my urine is stronger now compared to the previous days.
Just a few moments ago,I noticed a strong ITCHING sensation on my left buttock (where most of the numbness is).Is the itching sensation a good sign doctor?I guess it's safe to say that the sensations now feel a bit better too.
I also noticed on the left side (where the numbness is) of my genital area some sharp/shooting pain.
The itchiness and sharp pains have subsided as of now.
When I walk up the stairs,the pain on my tail bone while using the left leg has also subsided.
Please let me know what you honestly think doctor.
Kindest Regards
Brief Answer:
You are improving
Detailed Answer:
Hi
Welcome back
I have gone through your query,follow up queries,MRI report and MRI images.
After going through these I cancluded that you are recovering and improving.
Your bowel and bladder improvements, sensation improvements and feeling of itching all are signs of improvement.
Rest has already been discussed.
You can discuss with your treating Doctor about it.
Hope your query get answered. If you have any clarification then I will be happy to help you. If you have no clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
You are improving
Detailed Answer:
Hi
Welcome back
I have gone through your query,follow up queries,MRI report and MRI images.
After going through these I cancluded that you are recovering and improving.
Your bowel and bladder improvements, sensation improvements and feeling of itching all are signs of improvement.
Rest has already been discussed.
You can discuss with your treating Doctor about it.
Hope your query get answered. If you have any clarification then I will be happy to help you. If you have no clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dear Doctor,
Happy New Year.
Just to follow up,I am having bowel movements everyday (no straining). I am also urinating (improving).
I would like to know,what else must I do to recover faster?
Kindest Regards
Happy New Year.
Just to follow up,I am having bowel movements everyday (no straining). I am also urinating (improving).
I would like to know,what else must I do to recover faster?
Kindest Regards
Brief Answer:
You are improving and recovering
Detailed Answer:
Hi
Welcome back
After going through your query and follow up queries I want to say that rest and Mecobalamine will help you recovering early. After pain subsides you can start excercises. You are improving and recovering.
Rest already discussed. You can discuss with your Doctor about it.
Hope your query get answered. If you have any clarification then please don't hesitate to write to me. If you have no clarification then you can close the query and rate the answer .
Wishing you a good health.
Take care.
You are improving and recovering
Detailed Answer:
Hi
Welcome back
After going through your query and follow up queries I want to say that rest and Mecobalamine will help you recovering early. After pain subsides you can start excercises. You are improving and recovering.
Rest already discussed. You can discuss with your Doctor about it.
Hope your query get answered. If you have any clarification then please don't hesitate to write to me. If you have no clarification then you can close the query and rate the answer .
Wishing you a good health.
Take care.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Dear Doctor,
Just following up.
As of today,the flow of my urine seems to be near normal (about 90%).
My numbness is still there,but I can feel some itching sensation from time to time.
I sill have bowel movement everday with no straining.
Pain on my tailbone on the left side has almost dissapeared while walking up the stairs.
I can now walk with less pain,but I could still feel some stiffness and pain on my tailbone.
Leg pain is now on my right leg (sharp shooting pain).
Doctor,regarding the numbness in my condition,do you think the nerves would recover 100%? I am very concer ed.
What do you overall think of my condition doctor?
This is the 19th day into this numbness and pain.
Kindest Regards
Just following up.
As of today,the flow of my urine seems to be near normal (about 90%).
My numbness is still there,but I can feel some itching sensation from time to time.
I sill have bowel movement everday with no straining.
Pain on my tailbone on the left side has almost dissapeared while walking up the stairs.
I can now walk with less pain,but I could still feel some stiffness and pain on my tailbone.
Leg pain is now on my right leg (sharp shooting pain).
Doctor,regarding the numbness in my condition,do you think the nerves would recover 100%? I am very concer ed.
What do you overall think of my condition doctor?
This is the 19th day into this numbness and pain.
Kindest Regards
Brief Answer:
Your condition is improving.
Detailed Answer:
Hi
Welcome back
After going through your query and follow up query I came to know that your condition is improving. It is not possible to exactly prediction of recovery of nerves but generally recovery is nearly 100 percent. Mecobalamine help in recovery. Your recovery is good. Your overall condition is good. You can start now back exercises.
Rest already discussed .
Hope your query get answered. If you have any clarification then I will be happy to help. If you have no additional clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
Your condition is improving.
Detailed Answer:
Hi
Welcome back
After going through your query and follow up query I came to know that your condition is improving. It is not possible to exactly prediction of recovery of nerves but generally recovery is nearly 100 percent. Mecobalamine help in recovery. Your recovery is good. Your overall condition is good. You can start now back exercises.
Rest already discussed .
Hope your query get answered. If you have any clarification then I will be happy to help. If you have no additional clarification then you can close the query and rate the answer.
Wishing you a good health.
Take care.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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