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Why do I have pain in my legs ? I have Lumbar osteoarthritis,and have undergone a surgery for disc prolapse 2 years ago.

MRI Report of Lumbo-Sacral Spine: on 8th June , 2011 says that,: I have degenerative disc disease; severe spinal canal stenosis with lateral recess obliteration/ narrowing and neural foraminal narrowing at L4-5 level due to disc extrusion, osteophytosis & facet hypertrophy at the same level stated above. Mild bilateral neural foraminal narrowing at L5-S1 level due to mild posterolateral osteophytosis with abutting disc & facet hypertrophy at this level stated above. What can be the best treatment for me now? I have Lumbar osteoarthritis present, which is mentioned in my recent X-ray report of Lumbo-sacral spine AP & Lateral View. N.B. : I had a surgery for Disc Prolapse 2 years ago. At first I had problems in right leg but now it is in left leg too. I walk & stand like a lame man, Since the foot drop situation in my right leg, I had that surgery, but still it is not well, & less senses are there. Now I have pain in left leg too. I have tried every form of treatment, physiotherapy traction, steroid injections, stimulation & neuro painkillers. what can I do now?
Asked On : Thu, 9 Jun 2011
Answers:  3 Views:  344
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General Surgeon 's  Response
welcome to healthcaremagic
as the mri report goes you need immediate surgery as all other methods like physiotherapy/traction have failed
immediate pressure release operation should be done
you consult your orthopaedic surgeon/neurosurgeon and get earliest treatment
Answered: Mon, 11 Jul 2011
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  User's Response
You can try in Ayurveda treatment specially Panchakarma.
Dr A.K.Panda
Research Officer
Ayurveda Research Inst. Gangtok
Dept of AYUSH,GOI.
Answered: Mon, 20 Jun 2011
  User's Response
Patient Perspective - From the description of the problems in your lower back, it appears that you have had a fall sometime back. This is not part of the history provided. A fall could have been just a small one like slipping and falling on your buttock. There are pain that have similar symptoms and having osteophytes at facet joints as described appears to be that there are pars interarticularis fracture.

This osteophytes are progressed to abut /compress nerves on both sides. So when there are inflammation presence, the abut situation can cause nerve compressions giving leg pain on either side.

If you had a fall, jarring of back, there could be scar tissues and radio-opacities large enough to compress nerves. These too give similar symptoms of tingling and numbness and shock type pain below feet. Almost always MRI neuro-radiologists do not report everything they see, although they know very well that these could produce symptoms.

You say that you have had operation for disc prolapse. This operation itself is a trauma. It fixes the current problem which is clears the nerve compression which is necessary when nothing else works. But cutting open is a trauma. This is called post operating scar tissue and inflammation causing new osteophytes in the are of operation. This develops within 2 months - 6 months after operation. So pain getting worse on right side could be post operation osteophytes/scar tissue or could be from another source such as facet joints progression of bone remodelling. This is because you now would have vertebra scoliosis which gives ongoing loading on the facet joints.

It is best to identify all the areas of deficits and I suggest to take the MRI images and give a neurologist specialist to first report all likely areas that could produce pain symptoms as described. A lot of times degenerating disc at L5/S1 are blamed for all the pain when it may have only 10% likelyhood of producing symptom as described.

Did you have a fall that you can recall, are you overweight, had your family history of back acne from young age? what is your age, height and weight, male or female? All these add to a proper correlation. Are there pars fractures as facet hypertrophy is not clear? Because you are having issues at L4/5 apart from L5/S1, depending on first obtianing answers to all these questions, one can determine the bulge and facet hypertrophy causes as it appears to be from trauma. If not you must be obese or over the age of 60.

So because the source of pain are many, one must identify the history first with all these answered, before any likely correlation of pain is made. Lack of this sometimes causes more back pain then when you go for the surgery.

Take my answer and give that to the neurologist specialist and he may get anothe MRI done to verify for post operative disorder.

As for treatment, try accupuncture as it reduces the inflammations in the joints as the ongoing inflammation from the unbalanced facet joints will keep causing jarring and remodelling of bones/spurs. Apply massaging oil 2 to 3 times daily in the back. This will reduce pain producing inflammation. Wrap stomach strap to help the heat from oil penetrate into the deep joints as this will reduce pain.

You should try getting deep tissue massage say about 10 sessions. The pain and spasms cause muscle stiffness and this needs to be taken care of which help keep elasticity in the muscles and reduce loading on the discs to slow down aging process of discs. It also helps reduce inflammations deep inside when the muscles relax and also you may have developed mild spinal curve as a result of your pain which could also be giving further pain.

When you get massage, you must get full body as some pain may be referred back pain from feet back into the lower back. Referred pain are also understood better by sports massages, reflexology, Chinese Maggage, Shoulder tendon which in the reason for weak stomach produced by injury.

Look around for some home remedy massages that usually massage stomach for women. They do know what I am talking about. The legs, the hands, the side of spine both sides need deep tissue massage. Together the whole body has to tune in and help reduce stress on the L5/S1 and L4/5.

After a few sessions of massage, have a couple of Chiropractor adjustments. But must take your new MRI so that they know how much pressure to apply as there maybe nerve compressions that requires to be gentle. This is why do so after having relaxed the spinal muscles first.

There is no one modelity treatment when it comes to chronic back pain. You must try multiple models as together they give a very good result. If you want you can email me a copy of your MRI from your CD. I will be able to give better understanding as a patient and not as a doctor!

By trying all the options I have suggested you will be able to manage your pain without neuro pain killers which have more harmful effects but necessary to be taken while you can work out the reasons for the pain.

Age, weight, family history of back pain and sighting of MRI image are required for proper diagnosis. email: minchem@xtra.co.nz
Answered: Mon, 13 Jun 2011
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