What is the treatment for thigh and testicular pain despite taking medications and physiotherapy?
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Explanation and history 1. I had pain in my right lower limb Since April’06. 2. I had taken Acupuncture, Acupressure & root Compression (Trackation), route block therapy in same 2006 but not found any proper relief. 3. I went to CIIMS Nagpur 14th Nov’06 for the routine check up to Dr. Lokendra Singh--MS( Neuro). He planned for surgery & operation performed : L 4 – L5 lumber cord compression with L4-L5 disc Prolapse. Procedure & Findings : Under GA prone position given, cleaning and drapping done. Vertical midline incision from L 2 to S 1 level lamina is exposed L 4 – l 5 laminectomy done. L 4 - L 5 disc gone under the antligament. Disc removed. Adequate decompression done. Complete haemostasis achieved. w/c in layers, no drain kept. 4. After few days (7-8 days) unbearable pain started & after a 10 days Dr. XXXXXXX Sahni- MS (Ortho) found discitis developed in operated area ( Attached MRI Report name as “2007”) & again I was admitted at CIIMS Nagpur for 20- 25 days & course of antibiotics given in these period & also given ozone therapy. After a month period pain reduced substantially. 5. With slow movements I restarted my life but every year I had flow of pain & after the bed rest of week period along with NSAIDs I came to normal life. 6. Every year same problem of pain is repeating. 7. But in the mid of Oct’13 a sudden pain started in my right thai . It started from testicular & moved till thai area. I had taken NSAIDs along with course of Steroids ( Two – three times in 3 month period). Now I have severe pain while getting up after sleep, coughing, sitting on driving seat, sitting on comodde. 8. I consult to Surgeon ( regarding testicular pain ), MS(Ortho) & Neuro surgeon also. They asked me to get MRI again. Report is attached (name as 2013). 9. Now I am taking physio therapy & bed rest. Because of it I lost my job (as my job was of travelling mostly). Please advice me what to do now. Few doctors are suggesting for re-operation, Few are suggesting to search office job & avoid travelling.
Posted Thu, 9 Jan 2014 in Brain and Spine
Answered by Dr. Sudhir Kumar 2 days later
Brief Answer: My reply is below. Detailed Answer: Hi Mr XXXXXXX XXXXXXX Thank you for posting your query. I have noted your symptoms over the past seven years, the treatment received so far, and also the details of the surgery done in 2006. I have also seen the three MRI reports attached with this query. It is unfortunate that your pain is persisting despite surgery, medications and physiotherapy. I would like to point out that now as per the latest MRI report, there is a nerve compression at L3-4 level, which is different from the L4-5 level, where the original surgery was done. So, in a practical sense, we are dealing with a new disease. The treatment would initially consist of medications such as gabapentin and pregabalin, physiotherapy, etc. Epidural injections may be given if the above does not help relieve the pain. If both the above fail, then surgery would be needed. However, I would agree that second surgery is more challenging, and it should be done by an experienced spine surgeon. 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, Hyderabad, India Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in