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Back pain, disc problem, worse after physiotherapy, taking medication for seizure

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General & Family Physician
Practicing since : 2005
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Hi Doctor,

My wife got lower back pain during sevent month of her pregnancy.
After the delivery it reduced, not fully though(used pain killers as well).
Two years later (2008) when in US and consulted a doctor, it was advised for an MRI
There was some problem between L4 and L5 discs. Physiotherapy and Accupunture was done.
In the meantime we came back to India in the end of 2009.
She recovered well till Sep 2010, though some pain was still there.
She started Yoga in October and from November end pain worsened a lot.
We again got some tests done (MRIs, X-rays, Thyrois tests, TB tests, etc).
All tests were fine. There were no issues. Even the problem between L4 and L5 is not there as per doctors.
Doctors have suggested swimming and physiotherapy.
We did both. But after physiotherapy, it even worsened further and she currently not able to walk properly as well.

She got seizures problem also from delivery and is under medication for that as well.

Please suggest.

Thanks in Advance
Sat, 19 May 2012 in Back Pain
Answered by Dr. Prasad 5 hours later

Thanks for your query.

Pregnancy is known to produce back pain. Hormones, growing fetus, physiological changes of pelvis (hip bone) as well as changes in spine can be responsible for the pain. Pain gradually disappears after delivery in almost all women, though a few continue to have such pain for a long time.

Persisting back aches are often associated with many factors. They include increased body weight, bad posture, disc protrusion, bone degeneration, sacroilitis and so on. A few individuals such constant back aches are attributed to functional causes.

It is interesting and also unfortunate that MRI scans did not reveal a significant problem that could explain the back pain. But it is not uncommon to see patients with no medical cause suffering from chronic back ache. Since your wife reports difficulty in walking, perhaps a neurological examination and or EMG studies can pick the missing puzzle and finding the cause. If found, treating it is essential in alleviating pain.

In the mean time, following can be used to help her:

1. Ample rest with reduced activity and continued physiotherapy under the guidance of a trained physiatrist.
2. Lumbar support application
3. Physiotherapy techniques such as ultrasound/infrared diathermy, local dry/moist heat application and so on.
4. Prescription anti inflammatory analgesics such as NSAID's could be tried for a while.
5. Alternative medicine therapies such as homeopathy/ayurveda churans, accuputure, yoga therapy, etc have helped some people with chronic back ache. You may continue with them, if they have been helped her in the past.
6. Some group of anticonvulsant drugs (seizure medications) such as carbamazepine, gabapentine, topiramate and to a less extent even phenytoin are known to reduce pain. You can discuss about these with your neurologist.
7. Apart from this, certain other medications such as tricyclic antidepressants have been used by neurologist in treating non-inflammatory chronic pains in the past. They may be started if needed.

I guess you might have known most of these, but I hope I have helped a bit with some details.

If you have any other query, I am available to answer them.


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