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- Wed Feb 22, 2006 7:00 pm
Dear Sirs, I had an accident 20 years ago, there is confusion as to what injuries i sustained. I have had back problems on and off for 20 years, however over the past 18 months, my problems have increased walking and standing have become virtually impossible after 5 minutes, pain is constant, varying in intensity, burning, tingling, numbness and spasms in my legs and a varying intensity in pubic discomfort likened to the sensation when one knocks ones funny bone. I have had various scans and physio all with vague results and conflicting diagnosis and advice. Some letters I have had this information. 1988 no evidence of old fractures, some disc space narrowing 1/2 and 2/3 area there was also signs of very early degenerative changes. 1992 sustained significant injuries in 1986 head injury and fractures of the L2,3 and 4 transverse processes, episodes of collapse presumed to be from muscle weakness. The L5/S1 shows minor reduction suggesting early disc dehydration. 1998 CT scan reveals a very minor localised canal stenosis at L4/L5. Apart from slight reduction in signal intensity in the upper mid cervical disc spaces no evidence of disc degeneration. I apologise for lengthy post. I would appreciate an interpretation of the above, unfortunately the original accident report is lost along with various other reports. Many Thanks
| Dr. Safaa Mahmoud
- Fri Aug 11, 2006 5:37 pm
It sounds like Sciatica,
Sciatica occurs due to a nerve root (sciatic nerve) compression in the lower (lumbar) spine. The condition is due to a herniated disk in most of the cases in the low lumber spine.
This compression results in pain along distribution of the muscles innervated by that nerve, so the pain radiates from your lower back to the buttock down to the back of the legs.
This commonly happens in people who sit for prolonged periods. The pain can be in the form of mild ache to a sharp, burning pain, discomfort or electric shock. Prolonged walking may aggravate symptoms in some people.
Muscle spasm alone can cause this pain which can be an unidentified cause but in many cases it is secondary to spinal or bone problems.
In these cases, self care and avoiding the precipitating cause will lead to a gradual but clear improvement in the pain. Home treatment includes the use of analgesics, cold or hot therapy.
Non surgical treatment includes also, physical therapy, certain exercises, weight reduction, Stretching, non-steroidal Anti-inflammatory medications, and decreased daily activities. The pain usually improves faster than the numbness and the weakness if present.
MRI is of choice in the diagnosis. I advise you to do a new one to see how the previous changes look like now.
Surgery for disc herniation is only considered if symptoms are not controlled after at least one month (6 weeks) of medical and conservative treatment, or in very complicated cases with serious symptoms.