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Suffering From Lower Back Pain, Numbness In Neck. Full Body X Ray Report Showed No Abnormalities. Reason?

Posted on Mon, 19 Nov 2012

Question: Hi Doctor,
This is regarding the pain which my wife is going through, the pain started with the lower back, then in the Knee (Left) with the numbness, there is sometime numbness in the neck as well which is intermittent but the numbness in the neck is always when she wakes up in the morning. She went for the full body X-Rays 5 months ago which were normal Please suggest,

Answered by Dr. Divya Agarwal (3 hours later)

Hi XXXXXXX
Thanks for your query.
To be able to help you better, I need a little more information from you:

Does she get pain also which is worse in the morning?

Does she get any stiffness in the back?

Was there any swelling in the knee?

Does she get good relief with painkillers?

Lastly does she or anyone in her family suffer from psoriasis?

Has she got her ESR or her HLA B27 (lab tests) done?

Let me know and we can take this ahead properly
Thanks

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Divya Agarwal (24 hours later)

Hi Doc,
Thanks for replying back, below are the answers:

Does she get pain also which is worse in the morning?

Yes

Does she get any stiffness in the back?

No stiffness but Numbness is there

Was there any swelling in the knee?

No

Does she get good relief with painkillers?

Yes
Lastly does she or anyone in her family suffer from psoriasis?

No

Has she got her ESR or her HLA B27 (lab tests) done?
No

Answered by Dr. Divya Agarwal (24 hours later)

Hi XXXXXXX
Thanks for writing back.
Your wife may be suffering from a condition called ankylosing spondylitis. She needs to get her complete blood count, ESR, HLA B27 and CRP.

She should start taking an anti-inflammatory medicine like Etoricoxib. Since this is a prescription drug, I would suggest that she sees her local physician for the same. We can then see how much relief she gets with it.
Let me know if you have any more questions.
Regards

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Divya Agarwal (23 minutes later)

Thanks a lot doc for answering my query, i was reading about ankylosing spondylitis that it is associated with an inflammation of the eye (iritis and uveitis), causing redness, eye pain, vision loss, floaters and photophobia. This is thought to be due to the association these two conditions have with inheritance of HLA-B27. Other common symptoms are generalized fatigue and sometimes nausea. Less commonly, aortitis, apical lung fibrosis and ectasia of the sacral nerve root sheaths may occur. but these symptoms are not there with her its just the pain and numbness which i have mentioned earlier. Moreover ankylosing spondylitis is hereditary and in her family no one has it. Please suggest.

Regards,
XXXXXXX

Answered by Dr. Divya Agarwal (16 hours later)

Hi XXXXXXX
I agree with you.

However, every disease has a spectrum, it is not essential that every patient should suffer from all the symptoms.

Secondly, considering some of her symptoms, it is essential that we rule out ankylosing by doing the tests so that we do not miss a treatable disease.

The hallmark of this disease is sacroillitis and a positive HLA b27.

Therefore, I suggest we go ahead with this and take it from the results.

Regards,

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Above answer was peer-reviewed by : Dr. Shanthi.E