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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pain Resonating From The Top Of Left Buttocks All The Way Down The Back Of Left Leg, Constant Pins And Needles. Sciatic Nerve ?

Brian H. , 45 Male, Workout 3-5 times a week. This past Saturday took a spin class for 50 min and then did a shoulder workout with free weights. After leaving the gym I found I had a pain resonating from the top of my left buttocks all the way down the back of my left leg to about the bottom of my calf muscle . Also my left foot has constant pins and needles. Since Saturday I am unable to stand longer then 2-3 minutes at a time. Feels better when I bend my knees and stretch on the floor. After reading up it appears this is the Sciatic nerve , but I don t know what to do, I have never been diagnosed with any spinal problems so Im not sure if I have a bulging disc or not. What do I do to relieve the pain and how long will this last. Oh by the way got to get on a plane tomorrow for 2 hour ride to columbus, Oh from Washington, DC.
Sat, 10 Aug 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

Based on the description, you could have suffered a lumbar disc prolapse causing compression over the nerve root producing pain in the entire leg.

The initial management of your problem will be as follows -

* avoid lifting heavy weights as it imparts more strain on your back
* avoid forward bending activities as it will worsen the disc protrusion
* Use a lumbosacral back support to augment your spinal muscles
* Intermittent pelvic traction to cause a regression of disc
* Maintain optimum body weight,if you are obese
* Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.
* Judicious use of analgesics and muscle relaxants.

If your symptoms are not resolving with the above measures, an MRI scan is needed to know the exact problem in the lumbar spine.

Hope this information is helpful. Good day
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Orthopaedic Surgeon Dr. Brijendra Gupta's  Response
It seems that this is prolapsed disc with impingment over Sciatic Nerve root at some point. It needs Stirct bed rest.
- MRI Lumbo sacral region.
- No Forward bending
- No heavy weight lifting
- No prolong standing
- Take NSAID with Muscle relaxant combination( Dicolofenac + Chlorzoxazone 500mg ) Twice a Day after meals
- Take Pregabalin and Methylcobalamine Combinatio twice a day
Physitherapy- Ultrasonic and Hot foamentaion with help.
- While on Plane pls sit straight most of the times with out bending at lower back.
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Orthopaedic Surgeon, Joint Replacement Dr. Saurabh Gupta's  Response
Hi and welcome to HCM

From description it seems you might be suffering from siatica.
MRI is needed to establish the cause of sciatica, so that appropriate treatment can be prescribed. Sciatica do respond well to bed rest and analgesics (pain killer) and is right mode of treatment.
The definitive treatment depends upon the cause of sciatica. I would suggest you to consult an orthopediac surgeon who may order MRI to determine cause of sciatica (level and degree in case of disc herniation) and may suggest other mode of treatment. After initial few days of bed rest, you needs physiotherapy (exercises).

Hope this will helps you. Take care.
You can consult me again directly through my profile http://www.healthcaremagic.com/doctors/dr-saurabh-gupta/64132
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Pain Resonating From The Top Of Left Buttocks All The Way Down The Back Of Left Leg, Constant Pins And Needles. Sciatic Nerve ?

Hi, thanks for writing to HCM. Based on the description, you could have suffered a lumbar disc prolapse causing compression over the nerve root producing pain in the entire leg. The initial management of your problem will be as follows - * avoid lifting heavy weights as it imparts more strain on your back * avoid forward bending activities as it will worsen the disc protrusion * Use a lumbosacral back support to augment your spinal muscles * Intermittent pelvic traction to cause a regression of disc * Maintain optimum body weight,if you are obese * Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided. * Judicious use of analgesics and muscle relaxants. If your symptoms are not resolving with the above measures, an MRI scan is needed to know the exact problem in the lumbar spine. Hope this information is helpful. Good day