Hi ,
Thanks for your query and Welcome to Healthcaremagic. I am Dr Akshay from Fortis Hospital, New Delhi.
You have mentioned pain in your lower back region with
radiation of pain to the Right side , i guess your lower limb.
Anyways since you are certain that there was no injury which could have actually caused a
muscle strain etc, then we will have to work up in your case to actually rule out a discal prolapse or a degeneration etc.
Before i can give you some advise i would like you to send me the following details:
- What was the cause of onset of this pain if you can recall it?
- Duration of the back pain and if present, your leg pain?
- Apart from your back pain do you also have any associated numbness, weakness in limbs, paresthesias etc as well?
- Any aggravating or relieving factors of your symptoms?
- How much distance can you walk and what are your
analgesic requirements on a daily basis?
- What investigations and management has been done till now for your existing problems?
I can tell you that lower back pain could be due to many reasons but at your age it is mainly postural and sometimes Discal in nature in which the Inter
vertebral disc has lost height as a result of which there can be a
mechanical back pain which is very discomforting for the patient.
Rarely there can be a bony instability like pars defect or something which can lead to pain while doing work or activity involving movements at spine region.
But majority of these conditions actually can be managed conservatively with Posture maintenance,
physical therapy and medications.
Although i am sure you have tried a lot of medications and alternate form of treatments, but till the time i can see your details , If you have localized back pain with no other neurological symptoms like numbness, weakness, paresthesias etc, then you can start with following recommendations for initial period of 2-3 weeks:
- To maintain proper posture of your back while working and sleeping, try maintaining an erect posture as much as possible
- If pain is more then you can take a short course of an anti-inflammatory medications which suits you
- Physical therapy initially under supervision of a trained physiotherapist, initially concentrating on SWD/IFT or
LASER therapy for back pain and TENS for your radiating leg pain
- Adequate calcium & vitamin d intake if levels are low in body
- Hot fomentation can be done at home 3-4 times in a day, if possible
- Analgesic spray or ointment for local application can be used after fomentation
- Avoid lifting heavyweight/ acute forward bending in mornings and take adequate precautions till pain completely subsides.etc
We will observe you for next 2-3 weeks how you respond to this conservative management protocol.
If there is no clinical improvement , then we will plan for your investigations including blood tests, X Rays and if your back pain is a long standing one, then MRI of lower back region.
Do not hesitate to contact me if you need any further assistance/SOS with more clinical details and test reports
Thanks & Regards
Dr Akshay Kumar Saxena
Consultant Orthopaedics
Fortis Hospital, New Delhi