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Dr. Andrew Rynne

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Getting premenstrual symptoms, burning sensation on lower back. Not getting enough sleep at night. Suggestion?

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Dr. Saurabh Gupta

Orthopaedic Surgeon, Joint Replacement

Practicing since :2004

Answered : 5930 Questions

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Posted on Tue, 29 Jan 2013 in Women's Health
Question: hi I'm 34 and in last 6 months had 2 periods. Each month I get all the PMT symptoms and no period. My weight is creeping up and I'm tired all the time. I notice when I walk more than 5 minutes at a time, I get a horrid burning sensation and tightening and cramping in lower back and hips - its so bad I have to stop and bend over. I get relief when I sit. My right leg goes numb a lot, and last few weeks I've noticed swelling in my legs which I never had before. I have terrible neck pain where my head feels too heavy for my neck and the only relief is pushing shoulder blades back and pushing head bak and looking at ceiling. Even turning head to right is killing me and my neck always throbs and buzzes and I get the sensation it is bleeding :( My hands are always numb when I wake due to CTS, but last few weeks its very bad, hands and fingers burning and now I get swelling which I never had. I'm not sleeping at all as I can't get comfortable. No matter how I lie or which position I lie in, neck and arms hurt, leg goes numb and I can't sleep. I'm currently getting between 2-4 hours sleep a night and I'm 34. I feel so frustrated that I cry a Lot now as I just dont know what to do. Sick of Dr giving me painkillers and sending me home. I took 2 ibuprofen and 2 aspirin today and just 5 mins walking I couldnt stand the pain was so bad I thought my lower back would snap.
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Answered by Dr. Saurabh Gupta 2 hours later
Hello,
Thanks for writing to us.

I can understand your pain. Your symptoms of lower back and lower limb suggestive of lumbar canal stenosis .
Narrowing of the lumbar spinal canal pinches the nerves that control muscle power and sensation in the legs.

I would suggest getting this evaluated by an orthopedician for an accurate diagnosis and appropriate management. You may get the MRI of the area affected under his/her guidance.

There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks.Discuss these with your orthopaedic.

Hope this will help you. I will be available for further guidance if you needed

Wishing you good health...
Regards.
Dr Saurabh Gupta
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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MRI OF LUMBOSACRAL SPINE: -

PROTOCOL:

-     SE T1W & TSE T2W SEQUENCES IN SAGITTAL PLANE.
-     TSE T2 W SEQUENCE IN AXIAL PLANE.
-     STIR SEQUENCE IN CORONAL PLANE.
-     MR MYELOGRAPHY USING HEAVILY T2W SEQUENCE IN SAGITTAL AND CORONAL PLANES ON A 1.5 TESLA SCANNER.

There is some degree of straightening of lumbar lordotic curvature. Vertebrae are normal in height, alignment and marrow signal intensity.
Dessicative disc changes and anterior osteophytes are noted at multiple levels. Disc height is reduced at L4-5 with degenerative endplate changes at this level.

There is diffuse disc bulge, thickened ligamentum flavum & facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R). The mid sagittal diameter and area of spinal canal are 0.8cm and 0.75cm² (lower normal limits are 1.0cm and 1.5cm² respectively. Effusion is detected in the facet joints.
Annular tear, diffuse disc bulge and facet joint arthropathy are visualized at L3-4 indenting the thecal sac.
Diffuse disc bulge is observed at L5-S1 mildly compromising the neural canals bilaterally.

Cord ends at L1 vertebral level and shows normal signal intensity. No abnormal pre or paraspinal soft tissue mass is seen. MR myelography confirms the above findings.

Impression      :     MR findings reveal lumbar spondylotic changes with
     -     Diffuse disc bulge, thickened ligamentum flavum and facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R).
     -     Annular tear, diffuse disc bulge and facet joint arthropathy at L3-4 indenting the thecal sac.
     -     Diffuse disc bulge at L5-S1 mildly compromising the neural canals bilaterally.

-     To be correlated clinically.

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