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drphophalia
drphophalia, Other
Category: Neurology
Satisfied Customers: 32156
Experience:  Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.
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Excruciating lower back pain from left hip through back of

Customer Question

Excruciating lower back pain from left hip through back of leg into foot. Feels like something is pinched. Impossible to raise myself from a lying position without searing, electrifying shots of pain.
JA: Have you had any recent injuries? What seems to make the pain better or worse?
Customer: Not that I am aware of, but x-ray following an accident 5 years ago showed arthritis in that L5 area. Physio over the years has helped but this pain has never made me scream when I try to get out of bed.
JA: Anything else in your medical history you think the doctor should know?
Customer: My GP knows everything I know, but he is on vacation and has not responded to our panic calls to voicemail. I am thinking chiropractic, but am not confident going that route - desperate right now.
Submitted: 1 month ago.
Category: Neurology
Expert:  drphophalia replied 1 month ago.

Hello! My name is***** to JustAnswer. I'm reviewing your question now, and will post back with the reply momentarily.

Expert:  drphophalia replied 1 month ago.

These symptoms of back pain from left hip through back of leg in to foot are likely due to the pinched nerves in the back. This can be due to;

1) Herniated/degenerated disc in back

2) Lumbar spondylosis; bone spurs in the back vertebrae pressing on the nerves. Arthritis of the back which you had been diagnosed already aggravates both of these.

Following investigations would be required;

1) X-ray of the lower back

2) MRI of the spine

3) Nerve conduction velocity (NCV) study

4) Electromyography (EMG).

Chiropractor may not be helpful at this point of time and may aggravate the issue.

Following measures would be helpful;

1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:

a) Avoid activities which increases the pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided till pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on floor

2) Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants

3) Local analgesic gels or sprays / ointment

4) Hot fomentation

5) Electrotherapy like trans cutaneous electrical nerve stimulation: done by physical therapist. Other thing are ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.

6) Good supervised physiotherapy: The exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.

7) Lumbosacral corset or support or brace

8) If obese or over weight, reduce weight for long term benefit.

9) Epidural steroid shots

10) You can start the following exercises;

1) Straight leg raising: Lie on the bed with your back and remain in a relaxed position. Slowly raise one of your legs upward and keep it as straight as possible. Count up to ten, and slowly bring down the leg. Do the same with the other leg. Repeat this exercise ten times.

2) Curl ups; lie on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back, and curl-up lifting the head and shoulders from the bed / couch. Hold for ten seconds, then slowly lower to starting position. As strength builds, aim to complete one sets of ten curls. The exercise should be done twice a day (both the sets).

This is a slide show for the exercises (you can pick up your own set, which suits you);

http://www.mayoclinic.com/health/back-pain/LB00001_D

You can consult following specialists (apart from your GP);

a) Orthopedist

b) Neurologist

c) MD in Physical medicine and rehabilitation

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  drphophalia replied 1 month ago.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

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Thank you.

Wishing you all the very best in life.