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Neurology (Expert Forum)
Lower Back and Leg Pain - Sciatica?
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Lower Back and Leg Pain - Sciatica?
by Jasper W, Aug 31, 2003 12:00AM
My father has experienced severe pain in his left leg (only) and more recently lower back for a number of years - say 7 - that is steadily getting worse. He has seen numerous specialists and had MRI scans etc., but no one seems to know what the probelm is. He is of the opinion that the problem is Sciatica. In the early days the problem would only happen at night when he was horizontal. Now, seven or so years later the problem appears to be worse during the daytime. It is affecting him so badly that his left leg has 'given way' and he has fallen over a couple of times. He has been given some fairly powerful pain killers so that he can get to sleep but only uses these ocassionally since he does not want to become dependent on them. The pain is occassional (and becoming more frequent) and can happen 'anywhere' form his big toe to his hip and he describes the pain as being stabbed with a red hot needle - he stresses that the pain is 'internal' in his leg, not an external pain. He is 73 years old and otherwise fit and strong mentally and physically. He thinks there may be a connection to a skiing accident he had in his thirties in which he broke his left leg. If anyone has any ideas about what route he might take I would appreciate hearing about it. He has tried acupuncture, physio, etc, all to no avail...
Doctor's Answer
by CCF-Neuro-M.D.-CS, Sep 02, 2003 12:00AM
The pain you have described sounds like nerve pain. The problem can be anywhere from the lower back to the individual nerves which enter the leg. Since the pain is unilateral it may be indicative of nerve entrapment either by a bulging disc, boney enlargements, or narrowing of the exit from the spinal cord. These disorders can typically be seen on MRI scans of the spine, but occasionally a CT scan after the placement of a contrast agent into the spinal fluid is required. If the spine itself is normal then the nerve may be irritated within the leg itself.
Your father should see a neurologist who can evaluate this disorder. Your father could be examined and it can be determined if a specific nerve or nerve root is involved. The imaging can be reviewed and a decision regarding further imaging could be made. An EMG may also be of help. This test will evaluate the function of the nerves and muscles within the leg to assess for dysfunction.
Based on what is found it may be possible that there is a surgical procedure which would help. Your fathers age does not necessarily exclude him from surgery. Also, if he has seen a local neurologist, a second opinion with an academic doctor would be recommended. Good luck
Your father should see a neurologist who can evaluate this disorder. Your father could be examined and it can be determined if a specific nerve or nerve root is involved. The imaging can be reviewed and a decision regarding further imaging could be made. An EMG may also be of help. This test will evaluate the function of the nerves and muscles within the leg to assess for dysfunction.
Based on what is found it may be possible that there is a surgical procedure which would help. Your fathers age does not necessarily exclude him from surgery. Also, if he has seen a local neurologist, a second opinion with an academic doctor would be recommended. Good luck
Let me tell about the nature of my leg pain.
The pain is intense! I felt it often follows the path of my nerve - down the back of my legs and thighs, ankle, foot and toes, very few times it enters in to my back. The pain is pulsating. Some times I cannot even move my leg from one position to another. I can't tell it is happening periodically, but once or twice in two months , it is happening. Some times within a month 3 or 4 times. It may last for 2 or 3 days max.
The pain is not happening to both of my legs same time. if one day it is in my left leg, the next day it will be in my right leg.
Presently I am taking pain killer "Voveran-SR". This will reducethe pain for 20-24 hours, but I need a permanent solution.
I will be greatfull to you if you could suggest a solution to this
Diagnosis: Lumbar Radiculopathy. I have been to a Neurologist; had an MRI; EMG (painful kinda); NCV motor with F-wave; NCV sensory nerve; H-reflex soleus; had 2 epidural procedures with Fluoroscopy in lower spine. These "treatments" after great expense and time had zero results. I am in as much pain as ever. Saw a Chiropractor who thinks problem may be in the L2/3 area (Radiologist and hence Neurologist was treating the L4/5 region). After 8 chiropractic treatments including Accupuncture....still no improvement. I continue to take Ultracet pain killers, in spite of the severe side effects, since this painkiller is the ONLY think that provides a small measure of relief so I can sleep. I'm a mess like you.Thinking of seeing another Neurologist at a teaching hospital.