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What Causes Pain In The Lower Back Radiating Down The Leg?
Question: I have had pain in my lower back down the back of my legs in my knees and hips which gets progressively worse overtime. It has been there for at least two months. A physiatrist has said it is my back. The doctor who did a fusion about two years ago says it is not connected to my back and my internal medicine doctor says its is a pinched nerve. It is always an excruciating pain and I am taking three pain medications three times a day and they do not help. I can sleep in no position at all and I have gone through every avenue to try to tell them that I know how I feel and am now so depressed that I do not know what to tell anyone at Mayo Clinic that I cannot keep going the way I am. I am only 63 years old and have had no life for 23 years because of health problems and surgeries and would like to be able to live again. Please let me know what you would give me as advice as to what you think I should do.
Brief Answer:
Consultation
Detailed Answer:
Hi XXXXX, thanks for asking from HCM.
I can understand your concern. You have been having lots of spine complaints. It is sad that you have undergone surgery of spine two times. Because in spine, repeat surgery is very difficult and increases chances of complication. Thats why you are now experiencing "Failed back syndrome".
Now coming to your complaints, there is back pain, pain in posterior part of leg/knees/hips which might be radiation of pain. This type of sharp, radiating pain is due to nerve pain (Neuropathic pain). You mentioned that the fusion which was done 2 years back, was not connected yet. If it is so, it can cause
: spine instability
: nerve compression and
: increased chances of disc prolapse above/below
You are having neuropathic pain which means your nerve is compressed. You need to send me
: MRI or CT reports to find the status of spine.
Only after it, I can comment to the actual pathology.
But still for your pain relief, you can follow few tips
: Avoid forward bending
: Avoid lifting any kind of weight
: Continue physiotherapy and occupational therapy to strengthen back
: If you have weight issues (Obesity), reduce weight to decrease load on spine.
: Use spine support like dos-lumbar corset to stabilise spine while walking/travelling
: Get your Vitamin D level checked. If it is low, start Vitamin D tablets 60,000 IU once a week under supervision.
: Use hot fomentation and painkiller gel like Diclofenac gel over pain site.
: I am mentioning good neuropathic painkillers. If you are taking any of them, it is good and if not, ask your doctor to prescribe one - Pregabaline/Gabapentine/Nortriptyline/Amitrityline/Duloxetine.
: If there is confusion regarding nerve damage, it can be confirmed by NCV (nerve conduction velocity) and EMG (electromyography).
Hope it will help you. If still in doubt, do let me know.
Thanks. Take care
Consultation
Detailed Answer:
Hi XXXXX, thanks for asking from HCM.
I can understand your concern. You have been having lots of spine complaints. It is sad that you have undergone surgery of spine two times. Because in spine, repeat surgery is very difficult and increases chances of complication. Thats why you are now experiencing "Failed back syndrome".
Now coming to your complaints, there is back pain, pain in posterior part of leg/knees/hips which might be radiation of pain. This type of sharp, radiating pain is due to nerve pain (Neuropathic pain). You mentioned that the fusion which was done 2 years back, was not connected yet. If it is so, it can cause
: spine instability
: nerve compression and
: increased chances of disc prolapse above/below
You are having neuropathic pain which means your nerve is compressed. You need to send me
: MRI or CT reports to find the status of spine.
Only after it, I can comment to the actual pathology.
But still for your pain relief, you can follow few tips
: Avoid forward bending
: Avoid lifting any kind of weight
: Continue physiotherapy and occupational therapy to strengthen back
: If you have weight issues (Obesity), reduce weight to decrease load on spine.
: Use spine support like dos-lumbar corset to stabilise spine while walking/travelling
: Get your Vitamin D level checked. If it is low, start Vitamin D tablets 60,000 IU once a week under supervision.
: Use hot fomentation and painkiller gel like Diclofenac gel over pain site.
: I am mentioning good neuropathic painkillers. If you are taking any of them, it is good and if not, ask your doctor to prescribe one - Pregabaline/Gabapentine/Nortriptyline/Amitrityline/Duloxetine.
: If there is confusion regarding nerve damage, it can be confirmed by NCV (nerve conduction velocity) and EMG (electromyography).
Hope it will help you. If still in doubt, do let me know.
Thanks. Take care
Above answer was peer-reviewed by :
Dr. Yogesh D
I am wondering if I can print what you sent as a response. I am seeing a doctor tomorrow and would like to bring a copy of what you said to the doctor and see what there response would be to what you said. I am also starting therapy tomorrow which is with a therapist for water aerobics because I also have fibromyalgia and they feel that it is a good exercise for that and also would be a good exercise for this problem too. The first session would just be talking to the therapist but after that it would be working in the pool on ways to strengthen my back and making the fibromyalgia less painful. I was not blessed with good health as you can tell. I am also going through botox injections at this time for headaches so you can imagine some days how bad my depression can get. If you can please respond right away to let me know if it is possible to print what you sent as a response so I can take it with me tomorrow.
Brief Answer:
Consultation
Detailed Answer:
Hi XXXXX, thanks for asking from HCM.
I got your point. You can take a snapshot on your laptop or take a picture of this answer and show it to doctor.
It is good that you are going to start water aerobics. It is a safe and effective therapy. Do not worry, you will be alright. It is sad that you are going through so much.
Hope it will help. If still in doubt, send me your mail-id, I can mail the answer to you. I don't know whether your doctor take it into consideration. Hope he/she will.
Thanks. Take care.
Consultation
Detailed Answer:
Hi XXXXX, thanks for asking from HCM.
I got your point. You can take a snapshot on your laptop or take a picture of this answer and show it to doctor.
It is good that you are going to start water aerobics. It is a safe and effective therapy. Do not worry, you will be alright. It is sad that you are going through so much.
Hope it will help. If still in doubt, send me your mail-id, I can mail the answer to you. I don't know whether your doctor take it into consideration. Hope he/she will.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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