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Suggest Treatment For Severe Back Spasms After A Fall
Question: dear doctor..i had bike fall 1 month ago and while trying to lift it back...i had a very bad back spasm ...so bad n painfull was barely able to move , stand or sit...however with medications and hot water fermentation my back problem resolved...but the pain started in the my left calf muscle only when walking along with little numbness in a small part of left feet including last 2 fingers...with on & off pain in left hamstring...the problem is only in the left leg...got the mri done...it shows my L5 S1 DISC EXTRUSION COMPRESSING THE THECAL SAC & THE TRAVERSING NERVE ROOT..i underwent traction for 5 days twice daily...total 10 sessions...and my treating doctor told me to give a gap of 10 days and start again ...now 10 days completed of the gap..but sincec2 days my numbness has incresed and spread from left feet back of the calf upto knee..(only left leg)..the numbness is only on the back of the legs from feet upto the below knee...i have been taking nugatrip(combination of amytreplene & pregablumin) once daily along with b12 vitamin tablet...treating doctor is saying my numbness has increasrd ..hence i have to get discectomy surgery done..now my questio are
1.can i avoid surgery by starting back strenghting excersise under the guidance of a good physiotherapist for 2-3 weeks and see
2..if i have to go for surgery..there are 3 types..open discectomy, micro discectomy and laser or endoscopic discceromy..which beneficial for me as my disc herniation is only on left side compressing the nerve.
3.after surgery can i stop taking pregabalumin as i am putting too much weight due to that..( if i m able to stop pregabalumin fairly quickly after surgery then i wud opt for surgery rather than trying physio...becos i am worried about the speed which i amgaining weight due to pegabalumin..i have gained around 6 kilos in 1 month)
4..only plain pregabalumin is sufficient or i need to take tje combo of amytreplene & pregabalumin..as it has the antidepressent)..
5.very important: if surgery...i need to get it done from an ortho surgeon or a nuro or a nuro-spine surgeon..who is the best suited for this..
6.kindly let me know the doctors and the hospitals that have the facility of the minimally invasive or laser endoscopic disctomy in XXXXXXX
kindly advice.
regards
XXXX XXXXXXX
1.can i avoid surgery by starting back strenghting excersise under the guidance of a good physiotherapist for 2-3 weeks and see
2..if i have to go for surgery..there are 3 types..open discectomy, micro discectomy and laser or endoscopic discceromy..which beneficial for me as my disc herniation is only on left side compressing the nerve.
3.after surgery can i stop taking pregabalumin as i am putting too much weight due to that..( if i m able to stop pregabalumin fairly quickly after surgery then i wud opt for surgery rather than trying physio...becos i am worried about the speed which i amgaining weight due to pegabalumin..i have gained around 6 kilos in 1 month)
4..only plain pregabalumin is sufficient or i need to take tje combo of amytreplene & pregabalumin..as it has the antidepressent)..
5.very important: if surgery...i need to get it done from an ortho surgeon or a nuro or a nuro-spine surgeon..who is the best suited for this..
6.kindly let me know the doctors and the hospitals that have the facility of the minimally invasive or laser endoscopic disctomy in XXXXXXX
kindly advice.
regards
XXXX XXXXXXX
Brief Answer:
Conservative treatment for another month.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
I have examined the MRI reports you uploaded too.
It is herniated disc at L-5-S1 level that is causing your symptoms.
Surgery is indicated only when other measures such conservative treatment are exhausted and didn't relieve the pain.
Numbness may persist for months after the surgery.
I think you should get another round of conservative treatment with rest for some days, NSAID drugs ( ibuprofen, or piroxicam, muscles relaxers for example ), and physical therapy.
Periradicular ( or epidural ) injection of steroids and painkillers at L5-S1 level is a possible treatment too, before deciding to get surgical treatment.
If the pain will continue or gets worse after one month with these measures, surgical decompression ( microdiscectomy by a Neurosurgeon or spine Surgeon in my opinion ) should be considered.
Pregabalin and Amitriptyline are too early to be used.
Hope you found the answer helpful.
Let me know if I can assist you further.
Greetings.
Conservative treatment for another month.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
I have examined the MRI reports you uploaded too.
It is herniated disc at L-5-S1 level that is causing your symptoms.
Surgery is indicated only when other measures such conservative treatment are exhausted and didn't relieve the pain.
Numbness may persist for months after the surgery.
I think you should get another round of conservative treatment with rest for some days, NSAID drugs ( ibuprofen, or piroxicam, muscles relaxers for example ), and physical therapy.
Periradicular ( or epidural ) injection of steroids and painkillers at L5-S1 level is a possible treatment too, before deciding to get surgical treatment.
If the pain will continue or gets worse after one month with these measures, surgical decompression ( microdiscectomy by a Neurosurgeon or spine Surgeon in my opinion ) should be considered.
Pregabalin and Amitriptyline are too early to be used.
Hope you found the answer helpful.
Let me know if I can assist you further.
Greetings.
Above answer was peer-reviewed by :
Dr. Remy Koshy
thanks doctor..but here is the confusion...physiothetapist says for core muscle excercises...but doctors say rest...what kind of rest should i give...is it complete bed rest ...and also do the steriod injections is for solving the root problem or just for managing symptoms...if its only for the symptoms...then is it worth to risk tje dangerous side effects..
Brief Answer:
Few days of bed rest.
Detailed Answer:
Welcome back.
In cases such yours, physical therapy is indicated when the pain has settled down, rest (bed rest for few days and restriction from physical activity for few weeks) is the best thing to do at first stages.
Steroid injections locally don't result in dangerous side effects, however I mentioned this procedure as a possible symptomatic treatment.
All these measures aim to relieve your symptoms, if you will become symptoms free after these treatments, there is no need for surgery.
Hope I helped you.
Kind regards.
Few days of bed rest.
Detailed Answer:
Welcome back.
In cases such yours, physical therapy is indicated when the pain has settled down, rest (bed rest for few days and restriction from physical activity for few weeks) is the best thing to do at first stages.
Steroid injections locally don't result in dangerous side effects, however I mentioned this procedure as a possible symptomatic treatment.
All these measures aim to relieve your symptoms, if you will become symptoms free after these treatments, there is no need for surgery.
Hope I helped you.
Kind regards.
Above answer was peer-reviewed by :
Dr. Remy Koshy
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