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Burning pain in stump after left leg amputation, sciatic nerve surgery. Lower Lumbar MRI done. What does the report indicate?

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General & Family Physician
Practicing since : 2008
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Hello. I am a 40 year old male. In September of 2006 my left leg was amputated due to a mistake that was made during a normal foot surgery. After the amputation everything seemed to be going quit well. Then here over the last few months I have been getting this crazy creepy, crawling, burning pain in my stump. It was not phantom pain or a phantom sensation. The doctor then went and surgically cut my sciatic nerve above my knee and buried it into my femur. The pain/feeling is still there. The doctor thought that it might be early signs of RSD and sent me to PT. Well the PT said he doesn't think it was RSD, but rather that there is a problem with my back. So, they did a Lower Lumbar MRI. Here is what the "Impression" reads, "Fusion of left transverse process of L5 and Left sacral promontory noted with modest encroachment of the exiting left L5 nerve root." I know you don't know my whole history, but what would you suggest for my next move??? Any and all help would be so appreciated! I am miserable and want to get back to wearing my prosthetic, golfing, and riding my Harley!!! Can you please help me!!!
Posted Mon, 16 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Raju A.T 18 hours later

Thanks for your query. I have noted your details

After having gone through your symptoms, as your symptoms are congruent with the symptoms of RSDS, I too feel that RSDS may be more likely than nerve root compression (Radiculopathy)

But since a defect in the Lumbosacral spine with L5 nerve encroachment is noted, it needs to be explored before an exact diagnosis, thereby the mode of treatment can be suggested.

Perhaps Consulting a neurologist for a detailed neurological examination; Nerve Conduction and EMG tests can help in differentiating amongst these 2 causes.

Having said this, both the causes are treated significantly by physiotherapy techniques and medications. Resistant cases of Radicular pain may need surgical treatment and nerve decompression.

The treatment ( 40mg Oxycotin twice a day and 900mg of Nuerotin 4 times a day ) is the best for now , continue on the same. Consult a neurologist for the above mentioned evaluation.

Hope this was helpful to you. If you have any additional queries, write back to us.

I will be available to answer your follow up query,

Take care , Bye

Dr. Raju
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