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Suggest Treatment For Difficulty Sitting For Short Period Of Time
Question: Initial symptoms occurred over 8 wks ago. I have been receiving laser therapy, traction, current and heat, thru physiotherapy. Also acupuncture and massage for pain in hip, thigh, psoas, and knee. My ability to sit is limited. Doing exercise of bending backwards. I am unable to work because my ability to sit for any length of time is limited. Walking is also limited. My GP has not referred me to a specialist and states that there is no indication for surgery.
Brief Answer:
MRI with contrast will be more helpful
Detailed Answer:
Hello,
I have studied your case and CT report.
Your CT scan says lumbar mild disc bulge with mild thecal sac compression. Due to compression of thecal sac there can be tingling numbness in your leg and pain associated with it leading to walking difficulty.
MRI with contrast will be more helpful to see for soft tissue and nerve root compression.
Medication like methylcobalamine with neurotropic like pregabalin will reduce pain; you can take them after consulting your treating doctor.
Continue your physiotherapy.
Epidural steroid injection shot may help if no relief with physiotherapy.
I will advise to check your vit B12 and vit D3 level.
If MRI shows disc compressing on nerve root then surgical decompression is permanent solution. You can send your MRI films or report. So that I can help you better.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Take care.
MRI with contrast will be more helpful
Detailed Answer:
Hello,
I have studied your case and CT report.
Your CT scan says lumbar mild disc bulge with mild thecal sac compression. Due to compression of thecal sac there can be tingling numbness in your leg and pain associated with it leading to walking difficulty.
MRI with contrast will be more helpful to see for soft tissue and nerve root compression.
Medication like methylcobalamine with neurotropic like pregabalin will reduce pain; you can take them after consulting your treating doctor.
Continue your physiotherapy.
Epidural steroid injection shot may help if no relief with physiotherapy.
I will advise to check your vit B12 and vit D3 level.
If MRI shows disc compressing on nerve root then surgical decompression is permanent solution. You can send your MRI films or report. So that I can help you better.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Take care.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you for your response. I will ask my GP to fill out the referral for a MRI with contrast. The form asks if the scan should be for SI joints? L-spine? Sacrum? and it asks to specify spinal levels for L-spine. I assume c-spine, T-spine are not required?
B12 levels have been high in the past. I take 5000 UI D3 daily.
B12 levels have been high in the past. I take 5000 UI D3 daily.
Brief Answer:
L -spine with SI joint screening
Detailed Answer:
Hello
You should do L -spine with SI joint screening. Lumbar spine L1 to L5 S1.
It is good that B12 is normal.
Hope this answers your query.
If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Take care.
L -spine with SI joint screening
Detailed Answer:
Hello
You should do L -spine with SI joint screening. Lumbar spine L1 to L5 S1.
It is good that B12 is normal.
Hope this answers your query.
If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Take care.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
My knee, same side as the radiating pain from my back, is giving me trouble. I had a plateau fracture in 2009. No surgery. It was swelling before the problem with my back started. It is now painful. if I move the wrong way pain shoots into the knee. I have attached a recent xray. It feels as though it is filled with glue at times. Sometimes I can hear it click. It does not feel stable. Is it likely that the current issue is simply nerve pain? as well as the feeling that it is glue like?
Brief Answer:
There is early osteoarthritis of your knee.
Detailed Answer:
Hello,
I have studied your case and x ray report.
There is early osteoarthritis of your knee may be associated with osteoporosis.
You need to take cartilage protecting medication like chondritin sulphate [glucosamine], that you need to take for couple of months.
If required MRI knee can be done and if there is severe destruction of menisci then arthroscopic shaving can be done.
Physiotherapy like ultrasound and tens will help, along with knee exercises
Mild deformity cannot be corrected with just medication, but further progression of deformity can be corrected.
Exercises will help to strengthen muscle and joint.
In lying flat supine on back – move your ankle up and down[plantar flexion dorsiflexion],keeping small towel below knee-press your patella[knee cap ] on towel and hold for 15 sec, lift your leg straight alternately [10-15 times].
Lying on your tummy- flex knee alternately, make knee rotation in flexion.
Sitting on chair- extend your legs alternately [hold in extension for 15 sec]
VISCOSUPPLEMENTATION: Hyaluronic acid injections can be given into the joint
To see weather knee pain is radicular arising due nerve compression you may need to do EMG-NCV nerve conduction study.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Wishing you good health
Take care.
There is early osteoarthritis of your knee.
Detailed Answer:
Hello,
I have studied your case and x ray report.
There is early osteoarthritis of your knee may be associated with osteoporosis.
You need to take cartilage protecting medication like chondritin sulphate [glucosamine], that you need to take for couple of months.
If required MRI knee can be done and if there is severe destruction of menisci then arthroscopic shaving can be done.
Physiotherapy like ultrasound and tens will help, along with knee exercises
Mild deformity cannot be corrected with just medication, but further progression of deformity can be corrected.
Exercises will help to strengthen muscle and joint.
In lying flat supine on back – move your ankle up and down[plantar flexion dorsiflexion],keeping small towel below knee-press your patella[knee cap ] on towel and hold for 15 sec, lift your leg straight alternately [10-15 times].
Lying on your tummy- flex knee alternately, make knee rotation in flexion.
Sitting on chair- extend your legs alternately [hold in extension for 15 sec]
VISCOSUPPLEMENTATION: Hyaluronic acid injections can be given into the joint
To see weather knee pain is radicular arising due nerve compression you may need to do EMG-NCV nerve conduction study.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Wishing you good health
Take care.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you
Brief Answer:
welcome
Detailed Answer:
take care
welcome
Detailed Answer:
take care
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
The knee exercise is ok? considering what is going on with my back? And would the osteoarthritis explain why the knee has been edematous?
I contacted the imaging facility, to ask a few questions. They said that typically they dont do a MRI with contrast for the lumbar spine unless theres been previous surgery. Can u explain why you specified with contrast?
gabapentin is covered here, but not lyrica. Is gabapentin recommended?
I often break out in cold clammy sweats. Is this associated with the back issue?
http://www.costco.ca/webber-naturals%C2%AE-Osteo-Joint-Ease%E2%84%A2-with-InflamEase%E2%84%A2-Twin-Pack.product.0000.html I am taking this....glucosamine.
I saw my gp today. He gave me a script for gabapentin. He orderd a MRI for knee and lumbar spine. He suggested the epidural injection as well, I didn't even mention it.
I contacted the imaging facility, to ask a few questions. They said that typically they dont do a MRI with contrast for the lumbar spine unless theres been previous surgery. Can u explain why you specified with contrast?
gabapentin is covered here, but not lyrica. Is gabapentin recommended?
I often break out in cold clammy sweats. Is this associated with the back issue?
http://www.costco.ca/webber-naturals%C2%AE-Osteo-Joint-Ease%E2%84%A2-with-InflamEase%E2%84%A2-Twin-Pack.product.0000.html I am taking this....glucosamine.
I saw my gp today. He gave me a script for gabapentin. He orderd a MRI for knee and lumbar spine. He suggested the epidural injection as well, I didn't even mention it.
Brief Answer:
Swelling due to synovitis
Detailed Answer:
Hello
Knee swelling can be due to synovitis stage of osteoarthritis.
You can do gradual knee exercises without straining on back muscles.
MRI contrast can better differentiate cord and nerve compression hence I advised, yes you can go for MRI without contrast also.
Gabapentin is good for nerve impaction so you can continue it.
Sweating may not be related to back issue, this can be hormonal or cardiac related.
Continue glucosamine.
Epidural injection will give you relief for long time.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Wishing you good health
Take care.
Swelling due to synovitis
Detailed Answer:
Hello
Knee swelling can be due to synovitis stage of osteoarthritis.
You can do gradual knee exercises without straining on back muscles.
MRI contrast can better differentiate cord and nerve compression hence I advised, yes you can go for MRI without contrast also.
Gabapentin is good for nerve impaction so you can continue it.
Sweating may not be related to back issue, this can be hormonal or cardiac related.
Continue glucosamine.
Epidural injection will give you relief for long time.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
Wishing you good health
Take care.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thanks again.
I've had a lot of nausea, and attributed it to the codeine in the T3's that I was taking. I stopped them, and continue to have nausea unexpectedly. Also possibly nausea was due to constipation issues.
Can any of this nausea be related to the findings of the CT scan.
I should have been more explicit; the swelling in the knee is more towards the side of the knee , including some of the thigh and the upper part of the calf. It feels tight and edematous as compared to the other knee. Is that still synovitis?
Sweating isn't cardiac i dont think. I did pass a stress test. However, I do have sleep apea.
I am glad to hear that the epidural injection is long lasting.
should have mentioned went thru menopause in 2001 .
Should I be wearing my full length compression stockings? Do they contribute to the burning feeling?
should have mentioned went thru menopause in 2001 .
I've had a lot of nausea, and attributed it to the codeine in the T3's that I was taking. I stopped them, and continue to have nausea unexpectedly. Also possibly nausea was due to constipation issues.
Can any of this nausea be related to the findings of the CT scan.
I should have been more explicit; the swelling in the knee is more towards the side of the knee , including some of the thigh and the upper part of the calf. It feels tight and edematous as compared to the other knee. Is that still synovitis?
Sweating isn't cardiac i dont think. I did pass a stress test. However, I do have sleep apea.
I am glad to hear that the epidural injection is long lasting.
should have mentioned went thru menopause in 2001 .
Should I be wearing my full length compression stockings? Do they contribute to the burning feeling?
should have mentioned went thru menopause in 2001 .
Brief Answer:
Explained below
Detailed Answer:
Hello again,
Your CT does not relate anything leading to nausea.
Yes this still can be synovitis.
Thats great that there is no cardiac issue.
Yes you can wear compression stockings they will not contribute to burning feeling.
Wishing you good health
Take care.
Explained below
Detailed Answer:
Hello again,
Your CT does not relate anything leading to nausea.
Yes this still can be synovitis.
Thats great that there is no cardiac issue.
Yes you can wear compression stockings they will not contribute to burning feeling.
Wishing you good health
Take care.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Gabapentin is working well.
Initially I had numbness on the inside of the LT knee(the one that swells up) and into the calf and thigh. This has disappeared.
Tonight for the first time I notice subtle numbness above the knee and on the outside of the thigh. I only notice it by comparing the sensation of touch between the LT and the Rt.
Mri booking date may not be available for a couple weeks. It might be booked 6 months from now. The disability company may attempt to expeditite it.
Thanks for your support.
Initially I had numbness on the inside of the LT knee(the one that swells up) and into the calf and thigh. This has disappeared.
Tonight for the first time I notice subtle numbness above the knee and on the outside of the thigh. I only notice it by comparing the sensation of touch between the LT and the Rt.
Mri booking date may not be available for a couple weeks. It might be booked 6 months from now. The disability company may attempt to expeditite it.
Thanks for your support.
Brief Answer:
Good
Detailed Answer:
It is good that Gabapentin is working well
Welcome
Good
Detailed Answer:
It is good that Gabapentin is working well
Welcome
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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