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What Causes Lower Back Pain, Irritation In Bowel Area And Numb Legs

Posted on Thu, 13 Aug 2015

Question: Hi Doctor, I'm 60 year old female. For the past 6 years, Have been experiencing severe lower back pain with symptoms of irritation in bowel area and twitching pain and numbness in both my legs. Unable to walk or sit even for few minutes which aggravates the pain. Some times the irritation could be felt on my lower back even with the touch of clothing. Have consulted all specialists like Gastro, Rheumetologist, Ortho, Neuro apart from general physician. However no reason or findings could be ascertained. Few doctors reported menopause associated spinal degradation and thyroid associated problems as the reason, but the medications have failed. Have been on constant medication and bed rest.
Recently MRI scan results revealed Tarlov cyst at the nerve root near the tail bone but doctors are divided in opinion. Neuro surgeon recommends for removal of cysts while Neuro physician does not recommend for surgery as in his view the cyst has nothing to do with the pain. The irony is I'm left in dark about the cause of my lower back pain. Now that the presence of the cysts which measures about 15 mm being confirmed, I want to try the surgical procedure. Before that need to know if there is a quick and permanent remedy for the above stated problem. Appreciate your advice on this ASAP.

Regards, XXXXXXX

Answered by Dr. Sudhir Kumar (12 minutes later)

Brief Answer:
Multi-modal treatment is required.

Detailed Answer:
Hi Ms XXXX,

I have noted your symptoms and MRI findings. It is unfortunate that you continue to suffer from pain and other symptoms even after six years.

The cause of your symptoms is likely to be multiple factors- Tarlov cyst is one of them; other reasons are degenerative disc disease, osteoporosis, spasm of back muscles, etc.

So, the treatment should focus on all these things. Surgery to remove the cyst would help you get better, but not completely.

Additional treatment would include physiotherapy, neuropathic pain medications (pregabalin, gabapentin or duloxetine) and medications for osteoporosis.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://XXXXdoctor.blogXXXX.in

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Sudhir Kumar (2 days later)

Dear Dr. XXXXXXX

Thanks for your reply to my query. In general, the neurologists whole I have been consulting have the same opinion. I'm already on Pregabalin 75mg 3 times a day.

In addition to the information provided earlier, I would like to provide the following information as well
1. Vitamin D deficiency
2. Vitamin B-12 deficiency.
3. Depression

Kindly review and provide your valuable advice related to diet and medications.

Thanks & Regards,
XXXX.

Dear Dr. XXXXXXX

I have uploaded the discharge summary of my recent hospitalization for your review.

Regards,

XXXX

Answered by Dr. Sudhir Kumar (45 minutes later)

Brief Answer:
Current medications are fine.

Detailed Answer:
Thank you for getting back.

I have reviewed the prescription and the medicines are correct. Please continue your present medications.

Normal diet should be continued.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar