Brief Answer: Consult orthopaedic surgeon. Detailed Answer: Hi, I have gone through your query. You have mentioned that you suffer from Constant low back pain, pain in both legs burning sensation in legs and feet wake up with pins and needles every morning occasional numbness and muscle twitches, all these symptoms may occur due to many reason e.g disc problem in lumber area, spinal cord neoplasms, acute disseminated encephalomyelitis (ADEM) etc. Many of my patients who come with these symptoms usually have lumber disc prolapse or vitamin B12 deficiency. But as you have specially ask for multiple sclerosis I want to explain you that though, these symptoms may occur in multiple sclerosis but addition to blurred or double vision, thinking problem, loss of balance etc there is a long list. So you should not be worried about that, but you should consult orthopedic surgeon, who will do your physical examination and advise you x-ray lumbo-sacral spine in AP and Lateral view, and if needed MRI scan of spinal cord. He may further advise you some blood tests also. Till you see your doctor my advise for you is- Avoid heavy weight lifting pushing and pulling heavy objects, because it will further increase back pain. You can take medicine like painkillers + muscle relaxants by discussing it with your doctor. You may need stronger pain-killers which are available on prescription only. You can try ibuprofen or naproxen, gabapentin, vitaminB12 till you see your doctor. Apply hot packs for 30 min in morning and evening . I hope it helps. If you are satisfied, you may close the discussion and if possible you may rate the answer 5 points for me, so that I get a good feedback. Thanks. Dr.Singh.

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Brief Answer: Good. Detailed Answer: Hi, Thanks for writing back. If blood work is negative, then it is good. But you still need orthopedic consultation for your physical examination as already explained, you may also consult your doctor for vitamin D. It generally seen that people who have low levels of vitamin D intake or low blood levels of vitamin D have a higher risk for MS. This suggests that vitamin D is related to the disease, but it’s unclear whether low vitamin D levels are a cause or a consequence of MS. After doing physical examination and vitamin d and x-rays and if needed MRI scan, your doctor will tally all the reports and act accordingly. I hope you have got your answer. Thanks. Dr.Singh.

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