After Having Back Pain For Months I Got An MRI

Brief Answer:
Treatment options should be exhausted before the doctor can assist you with a disability XXXXXXX

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

The symptoms you describe are due to radiculopathy caused by the disc prolapse. In this case, the prolapsed disc presses on the nerves that go out at the side of the spine and cause pain that may go down to the arms and fingers.
This is a common condition with age and around 98% of patients that have these symptoms do improve completely with conservative treatment (non-surgical). This may be a reason why the GP is reluctant to support you on the disability XXXXXXX
You have mentioned that pain killers help with the pain and the doses but you did not mention which are those that help you.

A stepwise approach to radiculopathy is:
- analgesics such as ibuprofen in full dose (800 mg every 6 hours after food, you may take an Omeprazole 40 mg 30 minutes before breakfast to protect your stomach)
- physiotherapy is adjunct to analgesics and it helps to relieve the nerve from being pinched and also to help the muscles relax as sometimes muscles go into spasm and hurt even more. Physiotherapy consists of techniques and exercises in the office and some exercises that you should regularly perform at home. Both of these are important.
- traction can be applied as well to help the nerves release (should be done under the supervision of a medical professional)
- If the above measures do not help enough, oral steroids may be added, In rare cases, opioids are considered, but the pain management doctor has to decide if this is needed in your case.
- a cervical nerve block is the next step- this consists of local anesthesia at the level of the nerve root to gain control of the pain.
- finally, if all these do not work, surgery is the last step. This is seldom needed as the above measures, if followed promptly should bring relief of the pain.

You may need to talk to the doctor on the above steps of treatment and if you need to step up in treatment. Maybe if all the other methods are consumed, surgery is the treatment needed in your case. This is a decision that should be taken in consultation with a neurologist as well.

If all the treatments fail, maybe the GP will agree to assist you with the disability XXXXXXX It is important to consider that decision on disability grants is a complicated process and several criteria should be fulfilled (this depends on the law and requirement of the area). The doctor may not be able to assist in it if these criteria are not fulfilled, especially with radiculopathy which is considered a treatable condition.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician
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Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

The pain you are talking about when one texts a lot, is called "De Quervain Tendonitis". This is also a condition that may affect the thumbs but it generally does not cause numbness. Probably you have both, the radiculopathy and De Quervain tendonitis.

Both these conditions are treated in a similar way: pain killers, physiotherapy, steroids, and tendonitis may benefit by a splint (immobilization) and local steroid injections and very rarely surgery is needed for it as well.

De Quervain tendonitis and radiculopathy can be easily distinguished in a physical examination so the doctor that examines you should be able to make the difference or know if you struggle with both these conditions.

Both of them are considered highly treatable with conservative treatment (non-surgical) and this is why probably the GP is reluctant to assist with the disability XXXXXXX


I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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