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Have Pain In Leg After Standing For A Long Time. Have Big Medical History. All Tests Done. What To Do?
Dear Doctor,
After standing for more than 10 minutes I feel pain in my left leg starting starting from my lower muscular portion spreading upwards & need immediate sitting. The same thing happens after I walk for say 20 minutes.
I am 67 years old, type-II diabetic & on oral medicine. Latest Hb1c reading being 7.2 (Daily Dose being :Metforminhydrochl 1.850, Glimperide 7mg, Pioglitazone 15, Sitagliptine 100)
My MRI report is as under:
Grade I anterolisthesis of L4 over L5 with L4-5 diffuse annular disc pseudo-bulge extending into bilateral neural foramen causing moderate impression on thecal sac & bilateral traversing nerve roots(Lt>Rt).
Diffuse annular disc bulge with partial extension into left neural foramen at L3-4 level causing mild to moderate impression on thecal sac & left traversing nerve roots.
Diffuse central disc bulge at C3-4, C4-5, C5-6 & C6-7 levels with mild impression on thecal sac.
Grateful for your considered opinion on:
1. is it necessary to undergo surgery?
2. Is the surgery safe without any threat of being cripled after surgery?
3. Can I pull on with exercise & oral medication without surgery?
4. your suggestion
After standing for more than 10 minutes I feel pain in my left leg starting starting from my lower muscular portion spreading upwards & need immediate sitting. The same thing happens after I walk for say 20 minutes.
I am 67 years old, type-II diabetic & on oral medicine. Latest Hb1c reading being 7.2 (Daily Dose being :Metforminhydrochl 1.850, Glimperide 7mg, Pioglitazone 15, Sitagliptine 100)
My MRI report is as under:
Grade I anterolisthesis of L4 over L5 with L4-5 diffuse annular disc pseudo-bulge extending into bilateral neural foramen causing moderate impression on thecal sac & bilateral traversing nerve roots(Lt>Rt).
Diffuse annular disc bulge with partial extension into left neural foramen at L3-4 level causing mild to moderate impression on thecal sac & left traversing nerve roots.
Diffuse central disc bulge at C3-4, C4-5, C5-6 & C6-7 levels with mild impression on thecal sac.
Grateful for your considered opinion on:
1. is it necessary to undergo surgery?
2. Is the surgery safe without any threat of being cripled after surgery?
3. Can I pull on with exercise & oral medication without surgery?
4. your suggestion
Tue, 30 Apr 2013
Hi, thanks for writing to HCM. The description suggests that you have Lumbar disc disease with radiculopathy and neurogenic claudication. The initial management for this problem would be :
- Bed rest
- Pain medications
- Oral / I.M. Methylcobalamine preparations
- Lumbar back support
- Avoiding forward bending
If all the above measures fail to provide relief for you within 6 weeks, then undergoing surgery would be an option.
Considering your age and medical comorbidities ( Diabetes ), the chances of getting complications will be higher than a normal person. The only feared complication would be wound infection leading to Post operative "Discitis" which is really troublesome to treat. Consult a good spine surgeon with a good track record and follow his advise. Hope this helps
- Bed rest
- Pain medications
- Oral / I.M. Methylcobalamine preparations
- Lumbar back support
- Avoiding forward bending
If all the above measures fail to provide relief for you within 6 weeks, then undergoing surgery would be an option.
Considering your age and medical comorbidities ( Diabetes ), the chances of getting complications will be higher than a normal person. The only feared complication would be wound infection leading to Post operative "Discitis" which is really troublesome to treat. Consult a good spine surgeon with a good track record and follow his advise. Hope this helps
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Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
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