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My Mother Who Is 63 Years Old Is Suffering From

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Posted on Fri, 24 Jul 2020
Question: My Mother who is 63 years old is suffering from pain in the thigh and waist area since last few days. The pain gets worse during the late evening/night and also while walking on stairs which makes walking even for essential activities very difficult.
The pain seems specifically in the right thigh area and left knee along with spreading on the waist. Also, the left knee was operated after relocation 35years ago.
She is diabetic and consumes the following medication:
Amaryl 1mg - 1 tab in Morning and 1 tab in Evening
Glycomet 500mg - 1 tab in Morning and 1 tab in Evening

The recent readings of sugar level is:
Before meal: 103
After meal: 142

Kindly suggest.
doctor
Answered by Dr. Sudhir Kumar (50 minutes later)
Brief Answer:
The pain seems to be neuralgic in nature.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted the clinical details of your mother. Based on the symptoms, it seems to be neurogenic pain. There are two possibilities:

1. Diabetic lumbosacral plexopathy (Bruns XXXXXXX syndrome)- where the nerves in thigh region gets affected due to diabetes- either due to less blood flow or damage due to high sugars. In any case, treatment is with medications and sugar control. Nerve conduction studies may be done to confirm the diagnosis.

2. Lumbar disc disease- In this condition, the nerves in lumbar region (lower back) get compressed due to prolapse of inter-vertebral discs. The diagnosis can be confirmed by MRI lumbo-sacral spine. Treatment is with medications and physiotherapy in most cases.

As of now, I would suggest to start medications such as GABAPENTIN CAPSULES for pain relief.

I hope it helps, please get back if you have any follow-up queries.

Dr Sudhir Kumar MD DM (Neurology)
Consultant Neurologist





Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Sudhir Kumar (4 hours later)
Hi sir,
Thanks for the advice!
As suggested, we have purchased Gabapin 300mg (Intas Pharmaceuticals) capsules. However, we were unsure of the mg.

Kindly suggest whether it's fine or we need to change it.

Also it will be great if you can please suggest the dosage(timings) of consumption of the medicine.
doctor
Answered by Dr. Sudhir Kumar (6 minutes later)
Brief Answer:
GABAPIN 300 mg is fine.

Detailed Answer:
Thank you for getting back.

To start with, I normally advise GABAPIN 300 mg once daily at nights. After a week, if the response (relief from nerve pain) is inadequate, we can make it two times daily. GABAPIN can be continued for a month, or until improvement is noted.

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Sudhir Kumar (2 days later)
Hi Sir,

Thanks for the suggestion!
She is taking GEBAPIN 300 once daily at night. The pain in the legs seems better during the day but gets worse towards the late evening and night before sleeping. It gets very difficult to even take each small steps.

Kindly advice whether it may help if she can takes GEBAPIN twice daily.
Please feel free to suggest.
Thank you for your support.
doctor
Answered by Dr. Sudhir Kumar (2 hours later)
Brief Answer:
Yes, it can be increased to twice daily.

Detailed Answer:
GABAPIN dose may be increased to twice daily. Watch for 7-10 days before making any further changes.

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6232 Questions

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My Mother Who Is 63 Years Old Is Suffering From

Brief Answer: The pain seems to be neuralgic in nature. Detailed Answer: Hi, Thank you for posting your query. I have noted the clinical details of your mother. Based on the symptoms, it seems to be neurogenic pain. There are two possibilities: 1. Diabetic lumbosacral plexopathy (Bruns XXXXXXX syndrome)- where the nerves in thigh region gets affected due to diabetes- either due to less blood flow or damage due to high sugars. In any case, treatment is with medications and sugar control. Nerve conduction studies may be done to confirm the diagnosis. 2. Lumbar disc disease- In this condition, the nerves in lumbar region (lower back) get compressed due to prolapse of inter-vertebral discs. The diagnosis can be confirmed by MRI lumbo-sacral spine. Treatment is with medications and physiotherapy in most cases. As of now, I would suggest to start medications such as GABAPENTIN CAPSULES for pain relief. I hope it helps, please get back if you have any follow-up queries. Dr Sudhir Kumar MD DM (Neurology) Consultant Neurologist