
Suggest Treatment For Severe Lower Back Pain

My age 31. I 've a civier low back & back ache pain.I've this pain last 10 years. Whenever I go to doctor, they r taking scan & x-ray and saying that all r normal and its happening because of stress/strain and giving physio therapy for 10 days and some excersises..After 3 months the pain arises again with similar frequency especially spinal guard tail end in low back and top in back head and slowly transferring to buttocks and neck area..I don't know wats going wrong..I've this pain even in sleeping position also...always I'm feeling this pain..(note- initially it starts from spine tail end, waist, buttocks & neck part) .Please guide me..what can I do now and what could be the reason?
Possible diagnosis after few questions
Detailed Answer:
Hi Mum, thanks for asking from HCM.
I can understand your concern. Before reaching upto some conclusion, we should first know few points
: Were your scans totally normal or any abnormality was found? Can you please send me the reports
: What is your age?
: Do you have any history of injury at tail end/back?
: Any history of per vaginal discharge, irregular periods?
: Any history of anal fissure, piles or anal surgery?
: Did anyone tell you about "Fibromyalgia"?
: Is your pain sharp shooting, current like or burning type or dull aching type?
: Are there any aggravating or relieving factors?
If possible, please answer my questions. After getting into your symptoms and reports, we can make some differential diagnosis of illness and then we can manage it accordingly.
Hope you got my point. If any doubt, do let me know.
Thanks. take care


Differential diagnosis - Lumbalgia and management
Detailed Answer:
Hi Mum, thanks for responding.
I got your point. You are young. At such age, usually disc does not occur. But in your report, MRI is suggestive of some compression at L4-5 level which is one of the commonest area of compression. I think it might be due to your work or occupation which has resulted in disc at such young age.
If your job is continuous sitting, computer job, then you must follow few steps to relieve the pain of Lumbalgia (Lumbar pain due to disc compressing over dura and nerves)
: Kindly sit with straight back
: Use lower back support to maintain lumbar curve or lordosis
: Use lumbar corset while travelling
: If you get some relief, start lower back strengthening exercise along with stretching. It will relieve the load over disc and thus decrease the pain automatically.
: You can apply hot compresses over pain site, thrice daily
: Use Diclofenac gel local application to relieve pain
If still no relief, you can take few medication after proper prescription from doctor
like
: Tablet pregabaline 75 mg twice a day
: Tablet Gabapentine with nortriptyline
: To relieve back pain, take tablet Diclofenac sodium 100mg sustained release tablet
Try to take these medication in minimal dose and give more focus towards changing your lifestyle and habits.
Also take few nerve regenerating medication like
: S-Adenosyl methionine after proper prescription
: Nerve specific vitamin like Pyridoxine, Thiamine, Folic acid, B12 etc.
You will get gradually relief, not within days. Try to follow these tips and check for the relief. If still in doubt, do let me know.
Thanks. Take care.

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