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Suggest Treatment For Back Ache Radiating To Leg

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Posted on Fri, 4 Jul 2014
Question: I am suffering from back ach since 10 years.last 2 years radiating to right leg.can not walk small distance. sitting more pain. hot pack at back relief yor 2 hours.neurologiccal o/e slr is restricted in both lower limb 45 degrees hypoesthesia in rll in l5 s1 dermatome. diagnosis lumbar PIVD L5 S1.TAKEN CAP LYRICA 75 DAILY ONE FOR THE LAST 2 MONTHS. ATTACHED MRI REPORT. IS MINIMALLY INVASIVE SINE SURGERY( ENDOSCOPIC DISECTOMY) WILL HEALP? AT WHAT LEVEL. MY AGE 73 YEARS NO OTHER HEALTH PROBLEM.
doctor
Answered by Dr. Sudhir Kumar (20 minutes later)
Brief Answer:
Surgery may help.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your symptoms, MRI reports and the treatment received so far.

As per the MRI report, there is moderate compression of the nerve at L4-5 level (lower back region). This is responsible for your back pain and leg pain.

Surgery would definitely help at L4-5 level, and MISS (minimally invasive spine surgery) done at this level would relieve the leg pain.

However, prior to the surgery, a good trial of medical treatment should be done. The correct dose of lyrica (pregabalin) is upto 300 mg daily. So, I would recommend you to increase its dose slowly to the desired level.

Physiotherapy should also be done.

If above measures fail, surgery may be attempted.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar (18 minutes later)
dear doctor will minimally invasive surgery at l4 5 l5 s1 will healp. after this surgery can i travel to usa in 30 days? can Itake steps 12 to 15 daily 3 times after 30 days? what exercices i have to do? medicine lyrica tobe taken even after surgery and dosage pl.
doctor
Answered by Dr. Sudhir Kumar (9 hours later)
Brief Answer:
Yes, surgery would help.

Detailed Answer:
Thank you for getting back.

Yes, minimally invasive surgery would be helpful and you would be able to travel in a month's time to USA.

Also, you would be able to climb steps.

After surgery, you would need physiotherapy. Physiotherapist would teach you back extension exercises.

If pain persists, you can take lyrica after surgery also. If you were my patient, I usually prescribe 75 mg twice daily.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (2 hours later)
DEAR DOCTOR THANK YOU FOR YOUR KINDNESS.LAST QUESTION IS THERE ANY RISK INVOLVED IN MINIMALLY INVASIVE SURGERY? CAN IMANAGE WITH MEDICATION AND PHYSIO OR YOGA? IS THERE ANY MEDICINE BETTER THAN LYRICA OR COURSE OF INJECTIONS? FEW YEARS BACK EPIDURAL INJECTION FAILED WITH REGARDS A XXXXXXX
doctor
Answered by Dr. Sudhir Kumar (4 hours later)
Brief Answer:
Surgery is safe.

Detailed Answer:
Thank you for getting back.

Minimally invasive surgery is fairly safe and there is no risk.

If pain is less, you can manage with lyrica. Other alternative medications include gabapentin and duloxetine.

Physiotherapy should be continued.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sudhir Kumar

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Suggest Treatment For Back Ache Radiating To Leg

Brief Answer: Surgery may help. Detailed Answer: Hi, Thank you for posting your query. I have noted your symptoms, MRI reports and the treatment received so far. As per the MRI report, there is moderate compression of the nerve at L4-5 level (lower back region). This is responsible for your back pain and leg pain. Surgery would definitely help at L4-5 level, and MISS (minimally invasive spine surgery) done at this level would relieve the leg pain. However, prior to the surgery, a good trial of medical treatment should be done. The correct dose of lyrica (pregabalin) is upto 300 mg daily. So, I would recommend you to increase its dose slowly to the desired level. Physiotherapy should also be done. If above measures fail, surgery may be attempted. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, XXXXXXX XXXXXXX Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in