How To Get Rid Of Sharp Pain In Lower Spine Due Bulging In L4 And L5 And Cramps In Legs While On Amitriptyline And Panadol?

Posted on Thu, 9 Jan 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 9 Jan 2014 Answered on

Sat, 25 Jan 2014 Last reviewed on

Question : sharp pains in lower spine and cramp in legs I have bugling discs in L4and 5 , but in the last week the sharp pains are gerring worse At night the sharp pains radiating from the base of the spine and down my legs causing broken sleep During the day the pain gets worse after sitting for awhile or bending over My doctor said it was nerve pain and gave me 25 Amitriptyline each night but this not helping I take 2 panadol twice daily Have you any suggestions about helping me to get rid of the pain I am 77 years old Helen

Answered by Dr. K. Naga Ravi Prasad (28 minutes later)

Brief Answer: Initial management is by conservative means. Detailed Answer: Hi, thanks for writing to XXXXXXX The initial method of management for Lumbar disc disease with radiculopathy is always by conservative (nonsurgical) methods, which is as follows - - Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though. - Maintain optimum body weight,if you are obese - Avoid lifting heavy weights as it imparts more strain on your back - Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed. - Use a lumbosacral back support to stabilize your spinal muscles - Intermittent pelvic traction might be helpful to cause a regression of the protruded disc - After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery. - Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain. If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management. If all these measures fail to provide significant pain relief, then surgical decompression may be an option. Hope I have addressed your query. Happy to help further Regards

Above answer was peer-reviewed by : Dr. Shanthi.E