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Does Pain Radiating From Back To Legs And Feet Indicate Disc Herniation?

Posted on Sat, 12 Dec 2015

Question: following a laminectomy on L2/L3 last year a current MRI detects a new right paramedian disc herniation/fragment at L3/L4. what does this new finding mean other than it explains the enormous pain and suffering i have experienced in lower back which radiates down legs and feet.

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
Yes.This well explains the low back pain radiating down to legs.

Detailed Answer:
Hi xxxxxx,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

New paramedian disk herniation now at L3/L4 can well be the reason for the lower back pain which is radiating down the legs.It is possibly causing foraminal stenosis thus compressing nerve radicles at the corresponding spinal level,which is the probable cause of the pain.I suggest you to please upload the MRI image here or MRI CD on google drive and share the link in the follow up question so that I can read your MRI and answer it well further.

As far as,development of a new herniation is concerned after surgery,it is no XXXXXXX because a fair percentage of patients who undergo surgery for a disk herniation are predisposed to herniations in the future as well.

I shall be glad to have you in follow-up with your MRI image/CD and welcome your further queries.

Regards
Dr.Ajay Panwar
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (54 minutes later)

I appreciate your response - since the pain I am experiencing now is worse than the pain I had prior to the surgery last August '14, I believe surgery to treat the cause of the pain is vital. Treating the symptoms with injections is not what I want.

Answered by Dr. Ajay Panwar (9 hours later)

Brief Answer:
Surgery should be the last option.

Detailed Answer:
Hi xxxxxxx,
Thanks for being in follow-up.

Medical decisions should not go by 'What you want'?They should be based on medical reasoning and guidelines.
Surgery in disk herniation should be done only if conservative measures have failed.Medicines and Physiotherapy exercises should be tried first.Dedicated spinal exercises have a great importance.

Further, its not that once you get a surgery done,you are cured forever.I mentioned that disk surgeries have a fair chance of recurrent disk herniations in future as well.

What is more important is lifestyle,posture and exercises-even after surgery.If you don't follow these,you'll may again have herniation in future.

If you have any further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (10 hours later)

Thanks you for your very clear response. I have tried physical therapy and it made the problem worse. I am not able to tolerate pain medication. Also, the pain has caused so much pain that it is affecting my mood in a very negative direction.

Answered by Dr. Ajay Panwar (15 minutes later)

Brief Answer:
Physiotherapist's guidance.

Detailed Answer:
Hi xxxxxxx,
Thanks for being in follow-up.

You must not do the exercises which worsen your pain.

Please tell that since when you are having this severe pain?I am interested in knowing whether it's severity has increased just from past few days or from a longer duration?Is it this much severe since the time of last surgery itself?

The reason I am asking these questions is that exercises need to be avoided in acute symptoms, and they may worsen pain in that phase.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (16 minutes later)

approximately two-three months after August 8. 2014 surgery the pain began to appear. The pain steadily intensified since this time last year and has rapidly intensified since July-August this year. As of this month he symptoms now include numbness in my feet, especially the right foot. In short it has been excessively painful to cope with this pain in last few months.

Answered by Dr. Ajay Panwar (12 minutes later)

Brief Answer:
Physiotherapist's guidance.

Detailed Answer:
Hi xxxxxx,
Thanks for being in follow-up and providing further details.

So,the symptoms have been there for few months now.In this scenario,if exercises are causing pain-then you need to abolish those exercises.Instead, you must consult a physiotherapist with some real good knowledge and take lessons from him regarding which exercises to do and which to avoid.I am sure,this will help you a lot.Please let me know the progress.

Hope that I have answered your query.If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.

If that's for the day,please get back to me in case you have any query in future.

You can also put up a query directly to me on my HCM address- http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69273

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar