How can I get relief off my low back pain and associated neuro problem? Few details are given below.

by K

I am a 35 years old man. In March 2009 I received an injury in my low back due to lifting weight in awkward position. Then I went for medical treatment and some exercises. Injury was minor as per X-ray report, and it seemed to me that it was cured. I had no pain in my low back and I was leading a normal life.

Then in December 2011 the pain started again with slight sensation problem in my left leg. Again I am going through medical treatment and exercises but still it is not helping. What should I do?

Please suggest something for me!!...

Well Mr. K, it certainly sounds like you are having a difficult time. But fortunately, there are some things that can be done to help you. You should not have to live in constant pain.

If your first episode of back pain was healed and completely resolved for nearly three years it seems unlikely that this is related to that episode. Especially considering that you are having lower extremity symptoms that you did not have before.

Your note says that you are going through medical treatment and exercises; I am unsure exactly what that means. Has your doctor started you on an anti-inflammatory such as ibuprofen or naproxen? Anti-inflammatory drugs or acetaminophen can help to relieve minor pain and make you more comfortable.

Gabapentin or Lyrica are non-narcotic nerve pain medicines that may be helpful if you are having pain radiating into your left leg. You can discuss these medications with your doctor, but at this point, I do not think any stronger narcotic pain medications or muscle relaxers would be a good idea.

You also mentioned that you are doing exercises. Have you been seen by a physical therapist since this most recent episode started? As I said, because of the symptoms in your left leg it appears that what is going on now is different, or at least more severe, than your first episode of back pain. So the exercises you were doing before may not be the correct program for the problem you have now.

If you have recently been evaluated by the physical therapist and 6 to 8 weeks of therapy is not helping, and if anti-inflammatories are not effective for controlling your pain, you should return to your doctor for further evaluation.

X-rays of a lumbar spine will most likely not show anything significant, but they can be helpful to rule out fractures, dislocations, and problems with alignment.

Because of the pain or other symptoms radiating into your left leg you need to be concerned about nerves being squeezed or otherwise irritated. You may need an MRI for a more complete evaluation. X-rays are best to look at bones. An MRI is more helpful to look at soft tissue, such as discs, nerves, and muscles.

So Mr. K, I think you need to return to your doctor for further evaluation. You should not have to live in pain. If you have tried at least 6 to 8 weeks of physical therapy along with anti-inflammatory medications, and your symptoms are not improving, you need to have in x-rays of your lumbar spine. If that is negative and you're having symptoms radiating into your legs you need to have an MRI to find out why.

After having more imaging studies to determine a more exact diagnosis your doctor can consider more aggressive treatments that may be helpful. Things that you may consider depending on what the x-rays and MRI show would be epidural steroid injections, facet joint steroid injections, and lumbar traction.

I hope this information helps. Please keep in touch and let us know how you are doing.

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