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What Do My Lab Test Reports Indicate?
Question: I had CT scans and X-rays on my lumbar area. I have been in moderate to severe pain for 3 to 4 months. The doctor called last night and said my problem is between L4 and five and I have to go for an injection I do not understand what is happening.
Brief Answer:
Get examined by a neurologist and take medications
Detailed Answer:
Hello,
I have gone through your question and understand your concern.
Probably you are having L4-5 disc prolapse.
For neuropathic pain pregabalin, gabapentin or amitriptyline can be used.
Mri of lumbosacral spine is required.
Injection of steroids can be used too.
In severe non responsive cases, operation is required.
Hope you found the answer helpful.
Regards
Dr N Kumar
Neurologist
Get examined by a neurologist and take medications
Detailed Answer:
Hello,
I have gone through your question and understand your concern.
Probably you are having L4-5 disc prolapse.
For neuropathic pain pregabalin, gabapentin or amitriptyline can be used.
Mri of lumbosacral spine is required.
Injection of steroids can be used too.
In severe non responsive cases, operation is required.
Hope you found the answer helpful.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I have been taking 2 300mg of gabapentin at bedtime which has not helped. Also I have A defibrillator so I cannot have an MRI.
Brief Answer:
Take treatment as advised and upload reports
Detailed Answer:
Hello,
You are probably having disc prolapse between L4 and L5 region which is compressing nerve roots supplying the lower limbs.
The best modality to diagnose nerve root compression is MRI but is not possible in your case due to cardiac disease and implant.
CT scan can help in assessing vertebrae and space between adjacent vertebrae. Some displacement of bone can be seen too. You can upload images for review.
For treatment precautions like stooping forward, sitting crossed leg, squatting should be avoided.
Physiotherapy under guidance should be done once pain decreases.
For management of pain, pain killers and muscle relaxant like aceclofenac or diclofenac with tizanidine or thiocholchicoside can be taken for 1-2 weeks.
Neuropathic pain responds to gabapentin, pregabalin, Amitriptyline or nortriptyline.
The dose of gabapentin can be increased and additionally amitriptyline can be added.
Steroids or anesthetic agents can be given intrathecal for relief.
Provide the name of injection advised by your treating doctor.
Surgical options are available for non responsive pain and increasing neurodeficits.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Neurologist
Take treatment as advised and upload reports
Detailed Answer:
Hello,
You are probably having disc prolapse between L4 and L5 region which is compressing nerve roots supplying the lower limbs.
The best modality to diagnose nerve root compression is MRI but is not possible in your case due to cardiac disease and implant.
CT scan can help in assessing vertebrae and space between adjacent vertebrae. Some displacement of bone can be seen too. You can upload images for review.
For treatment precautions like stooping forward, sitting crossed leg, squatting should be avoided.
Physiotherapy under guidance should be done once pain decreases.
For management of pain, pain killers and muscle relaxant like aceclofenac or diclofenac with tizanidine or thiocholchicoside can be taken for 1-2 weeks.
Neuropathic pain responds to gabapentin, pregabalin, Amitriptyline or nortriptyline.
The dose of gabapentin can be increased and additionally amitriptyline can be added.
Steroids or anesthetic agents can be given intrathecal for relief.
Provide the name of injection advised by your treating doctor.
Surgical options are available for non responsive pain and increasing neurodeficits.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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