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Jef Burk
Jef Burk, Doctor
Category: Medical
Satisfied Customers: 2639
Experience:  MBBS. I've been teaching,practicing and learning since 1985.
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My friend is experiencing very severe lower back pain accompanied

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My friend is experiencing very severe lower back pain accompanied by severe pains all down his right leg. It's not sciatic pain (I don't think)- it's in the front of his right shin, his right thigh, and his lower back. He gets some relief (only a little) by being up on hands and knees. He is taking Advil but getting no relief. He is really in bad shape and not sleeping.



Clearly he has a significant problem.


I would agree that the sciatic nerve is not involved but we need to consider involvement of the L3 and L4 nerve roots.


He needs a good physical exam +/- a MRI scan depending upon the findings.


Dr Jef


Please get back to me if you need to.

Customer: replied 6 years ago.
He had this same problem several years back, and it went away after a few weeks of bedrest and he was in great shape then for several years. Now it's recurring. What would an MRI be looking for? When you say nerve routes are you saying it's likely a nerve problem rather than muscular? Thank you so much for your answer and of course I am going to pay, and more than what I first declared. I really appreciate your quick response, it's wonderful.



The symptoms in his legs suggest that he may have a prolapsed intravertebral disc ( a slipped disc).


Hence the need for an exam - a MRI would confirm this as well as the severity of the problem.It would also indicate if the problem were causing pressure on his spinal cord ( cauda equina syndrome).


He may not need a MRI - you can argue that unless there are significant clinical findings it is OK to wait and see ( most slipped discs get better within 6 weeks ).


Dr Jef

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Customer: replied 6 years ago.
Thank you - I sent a payment I hope it went through. Should he be resting on his back on a flat surface? What about using heat/ice?



Nope he needs to be up on his feet as much as possible.


Heat is not a bad idea in addition to ibuprofen and acetaminophen.


This would b be in addition to seeing his own MD.


Dr Jef


PS - yes your payment came through - thank-you