Doctors Lounge - Orthopedics Answers
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Forum Name: Spinal problems and back pain
|catsealpan - Tue Nov 04, 2008 3:55 pm||
1. Diagnosed with Sciatica 1 week ago severe lower back pain, going into left hip, down left leg. Xrays were taken in ER. Went to to see family physician.
2. Given steroid pack of 6 days finished yesterday. Pain meds also given.
3. Still in the same pain. I am feeling more pressure in the lower back. I also feel nauseous now.
4. I work 3 X 12 shifts which is mostly all set down work. This pain hurts significantly worse when setting. No previous back injuries. No previous back pains and/or surgeries. The only regular medications that I am on is Topamax 25mg (4 a day). (additional information, if needed) Female, early 30's, overweight.
I called my doctor to tell him that I am not feeling any better. He is sending me to physical therapy and calling me in additional medicine of anti-inflammatory and muscle relaxant. How will physical therapy help me? I do not understand why we are not doing an MRI being that will help find the root cause of the pain. Can you provide me a professional 2nd opinion?
|John Kenyon, CNA - Thu Dec 11, 2008 12:29 am||
Hi there -
The diagnosis of sciatica fits perfectly, assuming the pain is traveling down the back of the affected leg. The prolonged sitting, being overweight, the lower back origination, all are typical factors involved in sciatica originating at the nerve outlet in the low back.
An MRI would not be out of order, but PT may show early results, if appropriate manipulations and exercises are used (the sort which will place traction on the lumbosacral spine). I'd personally want an MRI first, to rule out any displacement which could potentially be worsened by PT. You'd be within your rights to request this, certainly. If the treating doctor refuses, you'd also be within your rights to ask for a second opinion before starting PT.
Anti-inflammatory meds may help, but the muscle relaxant med could really make or break the doctor's case. I'm inclined to agree with you that an MRI should probably be done prior to PT. Also, muscle relaxants are usually effective in direct proportion to their sedating side effects, which could make work and other tasks difficult.
I hope this is helpful. Best of luck to you.
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