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Recurring lower back pain, foot numbness, X-ray showed no sign of slip disc, taken Efetran, ultracet, V12. Cause?

I am aged 48 suffering from lower back pain . I cloud not get up from where I was sitting on the floor. Nerve catch and I was taken to Ortho. Dr.Ortho gave pain killer injection & V12. Took x-ray and no sign seen on slip disc but said not to rule out. Advised for MRI in case of SOS. Medicine taken Efetran, Ultracet, Benzaday15, PAN D for 10 day. I was quite comfort and do my regular work/travel etc. After a month the pain developed. The pain from lower back to foot , numbness at the foot etc. Pl advise.
Asked On : Wed, 13 Jun 2012
Answers:  3 Views:  650
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Internal Medicine Specialist 's  Response
Hello.Thanks for the question.This is most probably because of a pinched nerve or lower limb radiculopathy (Sciatica ).
Common cause is bulging intervertebral discs in the vertebral column that compress on the nerves as they come out of the spinal cord. Symptoms are experienced along the area of distribution/path of that particular nerve.

Xrays cannot be ideal to evaluate this so go ahead with MRI.
Conservative treatment include anti-inflammatory medications, physical therapy or chiropractic treatment, and avoiding activity that strains the neck or back. The majority of radiculopathy patients respond well to this conservative treatment, and symptoms often improve within six weeks to three months. I guess conservative treatment are not proving helpful in your case.

If patients do not improve with the treatments listed above they may benefit from an epidural steroid injection. With the help of an X-ray machine, a physician injects steroid medication between the bones of the spine adjacent to the involved nerves. This can help to rapidly reduce the inflammation and irritation of the nerve and help reduce the symptoms of radiculopathy.

In some cases the symptoms continue despite all of the above treatment options. If this occurs and the symptoms are severe, surgery may be an option. The goal of the surgery is to remove the compression from the affected nerve. Depending on the cause of the radiculopathy, this can be done by a laminectomy or a discectomy. A laminectomy removes a small portion of the bone covering the nerve to allow it to have additional space. A discectomy removes the portion of the disk that has herniated out and is compressing a nerve.

I would suggest you to see a spine specialist who will take into account severity of your symptoms and MRI findings to guide about the treatment.

Thank you.

Answered: Wed, 13 Jun 2012
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General & Family Physician Dr. Akif Abbas Zaidi's  Response
Dear sir

How are you? Your pain as it is radiating to your foot looks very much like a nerve compression. You do need to further investigate this and confirm it. You can initially try to loose some weight and being over weight can cause back pain which is mechanical back ache and resolves with weight loss. There are a range of exercises to strenghten your back muscles and relieve the pain.
I would also like to caution you as to the use of pain killers as they can cause complications.

Avoid sitting or sleeping on the floor and it puts excessive pressure on your back when you are getting up from the floor.

If none of these works and the pain is too much of a interference in your daily activities you can discuss surgical methods with your orthopedic surgeon.

Take good care of your self.

Answered: Wed, 13 Jun 2012
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Pulmonologist Dr. Arnab Maji's  Response
thanks for ur query
see its now an emergency
u need to have a MRI SPINE to prperly evaluate ur most of the cases x-ray fail to reveal it clearly
now u have developped root pain ,, nerve compression
probably there is slipped disc
so go for an MRI spine immediately
because if u r late the disease may be fatal
u may develop paraplegia, compressive myelopathy etc etc
better to have surgery if needed at its earliest b/c prognosis will be better in early stages
so do have MRI SPINE and consult ur doctor
thank u
Answered: Wed, 13 Jun 2012
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