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Suggest Treatment For Nerve Pain In The Leg
Question: I have a nerve paid in the back of my upper left leg. It started as a slight pain several months ago, but recently it has become really painful. It is worse when I change positions (getting in/out of bed or car, putting on shoes/socks).
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from your description the most probable cause of the pain would be a spinal issue such herniated discs or arthritic changes of the vertebrae (both part of the degenerative changes of the spine with age and physical work). They can lead to local inflammation and muscle spasms as well as nerve root compression which can cause pain to radiate along the lower limb supplied by that nerve. However it would be advisable to have it seen by your primary physician to differentiate it from other potential causes such as pelvic girdle joint issues which can produce similar symptoms.
In terms of management (whether spinal or pelvic origin) initially it consists always in physical therapy, which comprises specific exercises to stretch and strengthen your back muscles in order to ease the load on the spine. In the meanwhile anti-inflammatory pain killers such as Ibuprofen may be used to alleviate the pain.
If the symptoms persist then an imaging exam is needed (MRI is the best, CT may be done if MRI is not easily available) in order to confirm the diagnosis and consider further therapeutic strategies such as local injections at the compressed site or (shouldn't be your case, over 80% do not need it) surgery.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from your description the most probable cause of the pain would be a spinal issue such herniated discs or arthritic changes of the vertebrae (both part of the degenerative changes of the spine with age and physical work). They can lead to local inflammation and muscle spasms as well as nerve root compression which can cause pain to radiate along the lower limb supplied by that nerve. However it would be advisable to have it seen by your primary physician to differentiate it from other potential causes such as pelvic girdle joint issues which can produce similar symptoms.
In terms of management (whether spinal or pelvic origin) initially it consists always in physical therapy, which comprises specific exercises to stretch and strengthen your back muscles in order to ease the load on the spine. In the meanwhile anti-inflammatory pain killers such as Ibuprofen may be used to alleviate the pain.
If the symptoms persist then an imaging exam is needed (MRI is the best, CT may be done if MRI is not easily available) in order to confirm the diagnosis and consider further therapeutic strategies such as local injections at the compressed site or (shouldn't be your case, over 80% do not need it) surgery.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Taka,
Thank you for your reply.
My research on WebMD also suggests a Lumbar Herniated Disc.
So far, I'm not having any muscle spasms, but sometimes the pain will cause some numbness and extend downward to my lower leg.
Standing and walking is the most pain-free. Sitting with the back support is relatively pain-free.
Laying down and getting out of bed is painful. Getting in/out of a car is painful.
Q1: Is this self-treatable? Doing the right exercises, maintain the correct postures, etc. Or, do I need to get examined? The pain has been quite intense for about a week after 3 months of relatively slight pain where I would still do my normal jogging, swimming, and sports.
I am currently living in China, and I try to avoid going to local doctors.
I will travel to the US from Dec 9 - 29th. What type of doctor or physical therapist should I visit?
Thanks,
XXXX
Thank you for your reply.
My research on WebMD also suggests a Lumbar Herniated Disc.
So far, I'm not having any muscle spasms, but sometimes the pain will cause some numbness and extend downward to my lower leg.
Standing and walking is the most pain-free. Sitting with the back support is relatively pain-free.
Laying down and getting out of bed is painful. Getting in/out of a car is painful.
Q1: Is this self-treatable? Doing the right exercises, maintain the correct postures, etc. Or, do I need to get examined? The pain has been quite intense for about a week after 3 months of relatively slight pain where I would still do my normal jogging, swimming, and sports.
I am currently living in China, and I try to avoid going to local doctors.
I will travel to the US from Dec 9 - 29th. What type of doctor or physical therapist should I visit?
Thanks,
XXXX
Brief Answer:
Read below.
Detailed Answer:
Thank you for the additional information.
The fact that it is more pronounced when getting out of bed and you feel better when you're active is more in favor of an articular (joint) issue rather than pinched nerve as the compression on the nerve is augmented when standing.
As for being self treatable, exercises can be done by yourself. But it is advisable that one has a couple of first sessions with a physical therapist to make sure you're using the correct technique. The other reason why I recommend a visit and imaging to confirm the diagnosis is to make sure there are no signs you might have missed, indicating another cause such as a tumor. It is very rare, do not want you to panic, but when symptoms persist one wants to make sure it is not one of those rare cases. You can perhaps have imaging in China and have it reviewed by the doctor you'll consult in the US. Also have some routine blood tests for inflammation as the doctor in the US might want to see those as well.
As for thee most appropriate doctor, I would say the specialists dealing most often with these issues are rheumatologists, neurologists and physiatrists (a specialist in physical rehabilitation and pain), any of these would be fine, if I had to pick one I might go with the last.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Thank you for the additional information.
The fact that it is more pronounced when getting out of bed and you feel better when you're active is more in favor of an articular (joint) issue rather than pinched nerve as the compression on the nerve is augmented when standing.
As for being self treatable, exercises can be done by yourself. But it is advisable that one has a couple of first sessions with a physical therapist to make sure you're using the correct technique. The other reason why I recommend a visit and imaging to confirm the diagnosis is to make sure there are no signs you might have missed, indicating another cause such as a tumor. It is very rare, do not want you to panic, but when symptoms persist one wants to make sure it is not one of those rare cases. You can perhaps have imaging in China and have it reviewed by the doctor you'll consult in the US. Also have some routine blood tests for inflammation as the doctor in the US might want to see those as well.
As for thee most appropriate doctor, I would say the specialists dealing most often with these issues are rheumatologists, neurologists and physiatrists (a specialist in physical rehabilitation and pain), any of these would be fine, if I had to pick one I might go with the last.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Taka,
The slight pain in my leg began 3 months ago after playing tennis during which I had a fall. At the time, I didn't notice anything major and kept playing. Afterwards, I started to notice the slight pain. At that time, I could stretch thru the minor pain and keep exercising.
Q: Would you advise for or against the following?
- Massage
- Heating pads
Q: If I use heating pads, should I apply to the paid area in the leg, or the spine area?
Q: What is your opinion about the 3M FUTURO Stabilizing Back Support? When I first starting using it, the pain seemed to lessen during the first couple of days, but the actions that cause pain (laying down, getting in a car, putting on shoes/socks) seem to have worsen the pain recently.
Q: Do you recommend against normal exercising (jogging, swimming)?
The activity limiting pain started about 10 days ago. It is activity limiting, but it has not gotten any better or worse. Moving around and standing instead of sitting helps.
I want to try to survive until I return to the US on Dec 9 before seeing a doctor/specialist for MRI.
Thanks,
XXXX
The slight pain in my leg began 3 months ago after playing tennis during which I had a fall. At the time, I didn't notice anything major and kept playing. Afterwards, I started to notice the slight pain. At that time, I could stretch thru the minor pain and keep exercising.
Q: Would you advise for or against the following?
- Massage
- Heating pads
Q: If I use heating pads, should I apply to the paid area in the leg, or the spine area?
Q: What is your opinion about the 3M FUTURO Stabilizing Back Support? When I first starting using it, the pain seemed to lessen during the first couple of days, but the actions that cause pain (laying down, getting in a car, putting on shoes/socks) seem to have worsen the pain recently.
Q: Do you recommend against normal exercising (jogging, swimming)?
The activity limiting pain started about 10 days ago. It is activity limiting, but it has not gotten any better or worse. Moving around and standing instead of sitting helps.
I want to try to survive until I return to the US on Dec 9 before seeing a doctor/specialist for MRI.
Thanks,
XXXX
Brief Answer:
Read below.
Detailed Answer:
Hello again.
Heating pads are helpful for some patients so while they do not help in all patients I do recommend them since there is no harm. Regarding where to apply them, when the origin is due to the spine they should be applied to in the lumbar spine area. However now that you confirm again that the pain is not exacerbated by standing or sitting, on the contrary improved, I believe the source is further down, so I would apply them on the painful site.
Massage shouldn't offer much benefit.
I would recommend to stop exercising for a few weeks in order to allow the inflammation to subside. I am not recommending bed rest, continue daily activity, but limit exertions.
I haven't tried the FUTURO support specifically, not marketed in my country, but 3M is a well renowned company which is trustworthy. Generally speaking back supports are useful for back related pain, if the source is in the pelvic joints though benefit would be limited.
Read below.
Detailed Answer:
Hello again.
Heating pads are helpful for some patients so while they do not help in all patients I do recommend them since there is no harm. Regarding where to apply them, when the origin is due to the spine they should be applied to in the lumbar spine area. However now that you confirm again that the pain is not exacerbated by standing or sitting, on the contrary improved, I believe the source is further down, so I would apply them on the painful site.
Massage shouldn't offer much benefit.
I would recommend to stop exercising for a few weeks in order to allow the inflammation to subside. I am not recommending bed rest, continue daily activity, but limit exertions.
I haven't tried the FUTURO support specifically, not marketed in my country, but 3M is a well renowned company which is trustworthy. Generally speaking back supports are useful for back related pain, if the source is in the pelvic joints though benefit would be limited.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
After 10 days of more serious pain (following 3 months of minor pain), I know the exact activities that cause the most pain.
Getting out of bed in the morning by far causes the most excruciating pain. I can barely stand without assistance. After walking around for about 5 minutes, the pain normalizes and eventually subsides.
Next is getting in/out of a vehicle, followed by putting on shoes/socks.
Q: Regarding sleep, can you suggest any pre-sleep routine, sleeping posture, sleeping aid, and/or self-administered therapy?
Q: Am I correct to assume that any activity that causes pain is also preventing my injury from healing?
I will return to the US on Dec 9. I plan to get a MRI as you suggested.
Q: Can you refer a specialist/physician in my area code 92637 (Laguna Woods, CA)?
Getting out of bed in the morning by far causes the most excruciating pain. I can barely stand without assistance. After walking around for about 5 minutes, the pain normalizes and eventually subsides.
Next is getting in/out of a vehicle, followed by putting on shoes/socks.
Q: Regarding sleep, can you suggest any pre-sleep routine, sleeping posture, sleeping aid, and/or self-administered therapy?
Q: Am I correct to assume that any activity that causes pain is also preventing my injury from healing?
I will return to the US on Dec 9. I plan to get a MRI as you suggested.
Q: Can you refer a specialist/physician in my area code 92637 (Laguna Woods, CA)?
Brief Answer:
Read below.
Detailed Answer:
Sleep positions depend a little on the precise location of the inflamed joint. In most spinal and sacroiliac issues sleeping on the side is better. Since I am starting to suspect from your description more a case of a sacroiliac joint issue, apart from sleeping on the side inserting a pillow between the knees may be tried as well.
Yes you should avoid activities which exacerbate the pain for the moment.
As for physicians at the area you mention, I might recommend Dr. XXXXXXX R. Strum of the Loma XXXXXXX University Medical Center, although you should look into other options since I exercise in Europe and the little time I've spent in the US was in the East Coast.
Read below.
Detailed Answer:
Sleep positions depend a little on the precise location of the inflamed joint. In most spinal and sacroiliac issues sleeping on the side is better. Since I am starting to suspect from your description more a case of a sacroiliac joint issue, apart from sleeping on the side inserting a pillow between the knees may be tried as well.
Yes you should avoid activities which exacerbate the pain for the moment.
As for physicians at the area you mention, I might recommend Dr. XXXXXXX R. Strum of the Loma XXXXXXX University Medical Center, although you should look into other options since I exercise in Europe and the little time I've spent in the US was in the East Coast.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Last question.
I currently live in China under my wife's employment insurance, which would not cover any treatments in the US.
Q: Assuming my symptoms accurately match my diagnosis, approximately how much would getting all the necessary treatments, MRIs, etc. cost?
Q: If this could be a long-term issue, would you suggest purchasing insurance coverage in the US prior?
I'm an entrepreneur, so I have no company-paid insurance. We are planning to move back to the US in 2017.
Thanks,
XXXX
I currently live in China under my wife's employment insurance, which would not cover any treatments in the US.
Q: Assuming my symptoms accurately match my diagnosis, approximately how much would getting all the necessary treatments, MRIs, etc. cost?
Q: If this could be a long-term issue, would you suggest purchasing insurance coverage in the US prior?
I'm an entrepreneur, so I have no company-paid insurance. We are planning to move back to the US in 2017.
Thanks,
XXXX
Brief Answer:
Read aloud
Detailed Answer:
Hello again!
You are putting me in the spot with these cost issues. While any medical question is welcome, when it comes to financial issues as I said I exercise in Europe where health care organization is completely different from the US. A MRI in the US from what I am reading online may vary from 500 to 5000$ without an insurance, it varies also between different states and medical centers. As for treatment that depends on the results of physical exam and imaging, naturally if long term physical therapy sessions are prescribed the costs differ from when only Ibuprofen and rest is advised.
I believe a patient should be treated where he lives, no matter where it is, especially when it comes to back and joint issues which are often chronic issues and one may need follow up visits, repeat tests changes in therapy etc. So it depends on where you are going to live, if you are to live in the US then definitely you should purchase some insurance since from what I know health care costs there are much higher than most other countries.
Read aloud
Detailed Answer:
Hello again!
You are putting me in the spot with these cost issues. While any medical question is welcome, when it comes to financial issues as I said I exercise in Europe where health care organization is completely different from the US. A MRI in the US from what I am reading online may vary from 500 to 5000$ without an insurance, it varies also between different states and medical centers. As for treatment that depends on the results of physical exam and imaging, naturally if long term physical therapy sessions are prescribed the costs differ from when only Ibuprofen and rest is advised.
I believe a patient should be treated where he lives, no matter where it is, especially when it comes to back and joint issues which are often chronic issues and one may need follow up visits, repeat tests changes in therapy etc. So it depends on where you are going to live, if you are to live in the US then definitely you should purchase some insurance since from what I know health care costs there are much higher than most other countries.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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