 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / General / April 2007severe back/leg pain
I recently started having severe back pain after shoveling snow/ice (about 4 weeks ago). Since Saturday, the pain has gone into my left leg -- pretty severe. P/T seems to think it might well be nerve root pain and so far P/T is not helping. Question: once back pain also turns into leg pain, does this mean it won't go away via therapy?? Am I doomed to surgery (which I probably am not a candidate for due to degenrative disk disease at a variety of levels) or injections or stronger stuff. Or are exerises still possible to relieve the back/leg pain. In the past, I've had lots of back pain problems but usually found the key to overcoming it (extra walking and/or exercise). I've never had the leg pain. A final question: is there a newsgroup dedicated to back pain??? I can't seem to find one on my server. What about some kind of back pain forum on the internet? Mel >I recently started having severe back pain after shoveling snow/ice (about 4 >weeks ago). [quoted text clipped - 17 lines] > >Mel See a good neurosurgeon who has a reputation for being conservative with such cases. It sounds as if you have a localized disc herniation and there is good nonsurgical therapy which has an 85% chance of relieving your symptoms. Surgery should be reserved for those who do not get adequate relief from nonsurgical measures. Best, Bob Robert A. Fink, M. D. Neurological Surgery 2500 Milvia Street Suite 222 Berkeley, CA 94704-2636 USA 510-849-2555 ********************************** NOTE: The material above is not "medical advice". Medical advice can only be given after an in-person contact between doctor and patient. ********************************** Thanks Bob. It's encouraging to hear that. I am currently seeing a P/T but I am just not confident with her. She always seems unsure as to what to try. Can you give me a clue regarding therapy (just general-- I understand you can't give specific advice). Are you referring to NSAIDS, P/T, and other stuff?? The leg pain seems to be the most intransigent; it has been 6 days so I guess its still early Mel >>I recently started having severe back pain after shoveling snow/ice (about >>4 [quoted text clipped - 43 lines] > doctor and patient. > ********************************** > Thanks Bob. It's encouraging to hear that. > I am currently seeing a P/T but I am just not confident with her. She [quoted text clipped - 41 lines] >> relieving your symptoms. Surgery should be reserved for those who do >> not get adequate relief from nonsurgical measures. I'm not a neurosurgeon, but I beleive that "non-surgical therapy" in this case means doing everything possible (therapy, traction, NSAID, pain medication, maybe some steroids) to keep you as comfortable as possible, or at least functional, until the protruding disk dessicates or otherwise stops pressing on the nerve root. HMc >Thanks Bob. It's encouraging to hear that. >I am currently seeing a P/T but I am just not confident with her. She always [quoted text clipped - 8 lines] > >Mel Dr. McCollister is correct: >>I'm not a neurosurgeon, but I beleive that "non-surgical therapy" in this case means doing everything possible (therapy, traction, NSAID, pain medication, maybe some steroids) to keep you as comfortable as possible, or at least functional, until the protruding disk dessicates or otherwise stops pressing on the nerve root. HMc<< BUT, I have a few additional suggestions. Generally, Physical Therapy is NOT a good idea during the acute phase (other than massage, heat, ultrasound, which are modalities designed to reduce pain and muscle spasm). "Exercise" activity should be avoided until the pain has gone away. Pain medication and NSAIDs are good treatment, and muscle relaxants (I prefer Methocarbamol, or Robaxin, in sufficient dosage). Traction (pelvic traction), in my opinion, is relatively ineffective, as one cannot get enough "pull" on the spine to make much difference. Steroids (by pill) are, to me, a two-edged sword, as they can increase the complication rate if surgery has to be done, and unless there are other strong reasons why surgery cannot be done (heart disease, etc.), I usually try to avoid systemic (internal) steroids. The most important treatment in the acute phase is bed rest, as rigorous as is possible. For most people, that means in bed continuously except for bathroom privileges. There are also some back braces (like the Raney Flexion Jacket) which can help a disc patient return to activity somewhat sooner than without bracing, but the brace will not work until the acute symptoms have settled down. If the above is followed, about 85% of patients will avoid the need for surgery with the current episode. If during the above treatment, there is either no improvement or worsening (or muscle weakness of the feet and/or bladder), then surgery is indicated. Good luck, Bob Robert A. Fink, M. D. Neurological Surgery 2500 Milvia Street Suite 222 Berkeley, CA 94704-2636 USA 510-849-2555 ********************************** NOTE: The material above is not "medical advice". Medical advice can only be given after an in-person contact between doctor and patient. ********************************** Bob: The main problem is the leg pain. I know you said complete bed rest but that is really difficult with my life situation. I am a college professor. I am going in now, teaching 2 consecutive 2-hour classes (plus 1 office hour) and then going home and pretty much resting. This is 4 days a week. This week, my last workday will be Wednesday, so I will have 4 days to rest and I am resting this weekend. I gather, then, that walking is contraindicated at this time. I guess I am asking, when you say bed rest, how much bed rest are you talking about?? What I am finding is the back pain has improved 70% from its most acute phase but the leg pain is worse. It is horrible. Yesterday, it started out okay and no problems teaching my first class but it just really deteriorated during the second class. We also had a family get-together/birthday celebration last night. It included dinner at a restaurant. I just did that part and went home. It just gets so fatiguing. Should the leg pain go away as the back pain diminishes? So far, that's not the case at all. I have an aversion to medications, but I do have flexeril and OTC ibuprofin. In the past it just seemed to mask the pain and the pain seemed to get worse than ever when the drugs wore off. I will have to take that again, I guess. Bob, years ago, an MRI revealed I guess what you would call degenerative disk disease. That is, the disk space was pretty much non-existent at 4 or 5 levels. But there was no leg pain and they said no evidence of stenosis or herniation. I eventually recovered fom that episode (back pain and spasms). This is very different the back pain is much lower (tailbone and pelvic area). My question: does this (MRI findings) rule out surgery? Also, I am 60 years old, in decent health. No heart disease that I know of. Thanks for your time in reponding. I appreciate it. Mel >>Thanks Bob. It's encouraging to hear that. >>I am currently seeing a P/T but I am just not confident with her. She [quoted text clipped - 66 lines] > doctor and patient. > ********************************** >Bob: > [quoted text clipped - 29 lines] > >Mel Mel, Optimal bed rest is complete bed rest. That means staying in bed except for the bathroom. It can take several weeks of this routine to settle down some of these flareups. The symptom which is the most serious is the leg pain. It usually means that the nerve root is being significantly compressed. If the compression continues and/or worsens, there can be permanent nerve damage and paralysis (the extent and location depending on which nerve is involved). Bladder and bowel function as well as sexual funcation can also be impaired. Flexeril, in my opinion, is not a good medication for spasm. Ibuprofen is OK for pain and as a NSAID. If you are unable to reduce/eliminate your leg pain, then you may well require surgery. I cannot comment on your MRI because I have not seen the images (nor have I examined you). I would strongly recommend that you see a good neurosurgeon for an evaluation, both of you, physically, and for review of the scans. If the MRI you are speaking of dates back to before the onset of the leg pain, then you will need a new MRI. Where are you located? Perhaps I can suggest someone for you to see. Best, Bob Robert A. Fink, M. D. Neurological Surgery 2500 Milvia Street Suite 222 Berkeley, CA 94704-2636 USA 510-849-2555 ********************************** NOTE: The material above is not "medical advice". Medical advice can only be given after an in-person contact between doctor and patient. ********************************** I live in the Midland/Saginaw/Bay City area in Michigan. This is so frustrating. So far, no loss of function nor weakness nor numbness but the pain is intense. The back pain does not feel like spasms, but I don't know for sure. It improved 70% from its worst but I've been pretty much doing the bed rest for today. 2-3 weeks of such inactivity sounds debilitating Mel >>Bob: >> [quoted text clipped - 83 lines] > doctor and patient. > ********************************** >I live in the Midland/Saginaw/Bay City area in Michigan. > [quoted text clipped - 8 lines] > >Mel I don't know any of the people listed in those cities (in my Directory of Board-certified neurosurgeons), but I recommend: Ann Arbor: Julian T. Hoff, M. D. (Chief of Neurosurgery at U of Mich) Detroit: Murali Guthikonda, M. D. Mark L. Rosenblum, M. D. Setti S. Rengachary, M. D. Lansing: Christopher J. Abood, M. D. Bed rest can be debilitating, but if it can save you from surgery, it might be worth it. I would recommend that you see one of the above neurosurgeons. Best, Bob Robert A. Fink, M. D. Neurological Surgery 2500 Milvia Street Suite 222 Berkeley, CA 94704-2636 USA 510-849-2555 ********************************** NOTE: The material above is not "medical advice". Medical advice can only be given after an in-person contact between doctor and patient. ********************************** Bob: Thanks for taking the time to write. That is so nice of you. I know I've looked at this newsgroup for many years (15?) and it seems you have been posting here on a semi-regular basis. That's great. I rested completely the entire weekend (2 days). I did teach today and it is still tough, but not as bad as Friday. I did have a lengthy period of no leg pain but it has come back now (about 50% as bad as it was). I'm resting and I'm going to try and work Tues and Wednes. and then I have 4 full days to rest. I know that is not what you recommended, but hopefully it will work out. I have an appointment with my regular doctor on Thursday and we shall wee where things stand then. Obviously, if things are getting better I imagine we will let things ride. Otherwise I know I will need a referral to a neuro person (and certainly some tests like x-ray and MRI either before or after the referral). Mel >>I live in the Midland/Saginaw/Bay City area in Michigan. >> [quoted text clipped - 41 lines] > doctor and patient. > ********************************** > >I recently started having severe back pain after shoveling snow/ice (about 4 > >weeks ago). [quoted text clipped - 23 lines] > relieving your symptoms. Surgery should be reserved for those who do > not get adequate relief from nonsurgical measures. My brother did his own therapy for disc herniation. Chin lifts holding the top of door frames. And lifting, about the head, heavy type things. Several times a day, for months. It was time effective and he remains mostly pain free, as long he continues this regimen. And so has avoided surgery, so far. J > > >I recently started having severe back pain after shoveling snow/ice (about 4 > > >weeks ago). [quoted text clipped - 34 lines] > > - Show quoted text - are currently taking any medications? > A final question: is there a newsgroup dedicated to back pain??? I can't > seem to find one on my server. What about some kind of back pain forum on > the internet? > > Mel There's a board about back pain at healthboards.com. |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.