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Having low back pain with S1nerve compression

Dear Doctor: I am 50 years old man weighing 96kg working as an emergency physician transfered reently to the G surgery dept.with no H/O chronic illness ,complaining of occasional low back pain for the last 3 months which is increased on long standing an hard work . I took 3 injections of voltarin for my back pain last year but unfortunatly not eliviate the pain for the last attack that lasted 1 week . Tje pain is spasm like increased on movement and decreased on lying down and after rest, I have tingling sensation at the right 2nd toe that coms and goes during walking or standing 3 months duration and I noticed that specially when I had weared a theatre shoes . I did an MRI to exclud disc prolaps but unfortunatly it reveals a paracentral focal disc protrusion causing S1 nerve root compression with nural oedema .and incidental sacral meningeal cyst at S2 level compressing right S2 nerve, I wander how my symptoms and signs are not applicable or corelate the MRI findings.and I want to know the problem exactly and the managment of such case .,may be I have 2 pathology one at the foot and the other at the disc. Thanks. I look forward to hearing from you soon. Yours Faithfully Dr,Mohammed Alabd
Asked On : Thu, 5 Jan 2012
Answers:  1 Views:  195
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Orthopaedic Surgeon 's  Response
dear doctor,
your low back pain may be due to lumbar spondylosis where the typical pain is when u do repeated activities and subsides on taking analgesics, ice massage and bed rest. since you are overweight , which also contributes to the symptoms, u should try to reduce your weight. back stengthening exercises should be started once the pain comes down.tingling sensation of your little toe correlates with the MRI finding of S1 nerve root compression. but if your symptoms are not severe and your SLR is > 70 there may not be an inflammation / irritation of the nerve roots.
get well soon,
Dr Jijo
Answered: Fri, 13 Apr 2012
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