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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Noticing Back Pain That Passes Till Leg

I have pain that starts at the top of my back and goes all the way to the lower back down the left leg and right leg, I have has a history of DVT in the left leg and a Pulmonary Embolism on the third strand of the lungs, So I am Coumadin for the rest of my life, have taken Flexeril, Paraforte, Zanaflex, and amerix, and that doesn't work Im just trying to find out why this happening to me, I do wear compession stockings on my left leg. I had been taking Norco 10-325 1-2 QID PP and the doctor thinks that's a big dose, it does work, I just don't want to take anything that will interfere with the Coumadin.
Mon, 10 Mar 2014
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

Your description of symptoms are highly suggestive of LUMBAR DISC DISEASE causing compression over the nerve roots.

The initial mode of management is as follows -

- Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though.
- Take rest breaks throughout the day, but avoid sitting for long periods of time.
- Avoid lifting heavy weights as it imparts more strain on your back
- Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed.
- Intermittent pelvic traction (under the supervision of a physiotherapist) might be helpful to cause a regression of the protruded disc
- After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery.
If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management ( nonsurgical care).

Hope this information is helpful. Good day
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Noticing Back Pain That Passes Till Leg

Hi, thanks for writing to HCM. Your description of symptoms are highly suggestive of LUMBAR DISC DISEASE causing compression over the nerve roots. The initial mode of management is as follows - - Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though. - Take rest breaks throughout the day, but avoid sitting for long periods of time. - Avoid lifting heavy weights as it imparts more strain on your back - Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed. - Intermittent pelvic traction (under the supervision of a physiotherapist) might be helpful to cause a regression of the protruded disc - After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery. If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management ( nonsurgical care). Hope this information is helpful. Good day