Bulging disc L4-5, L5-S1 - pins and needles in heels, pain in rectum

[vel28]

Dear Doctor,

My mother aged 58 has the following symptoms:
1. severe pins and needles sensation in both heels - last 5 months
2. mild pins and needles sensation in toes - last 5 months
3. rare mild pins and needles sensation in palms - last 5 months
4. burning sensation in both foot
5. jerks hands, legs, and abdomen during sleep
6. burning sensation in left upper back - occasionally last 5 months
7. pain in buttocks.
8. pain in rectum - last 3 months mostly in the nights
9. urinary hesitancy - last 3 months occasionally mostly in the nights
10.pain in lower back - last 3 months

We have been consulting with a neurophysician for the past 3 months.

Not a diabetic.
Vitamin D - 11.5 ng/ml
Vitamin B12 - 671 pg/ml
Nerve conduction study report : Mild peripheral Neuropathy, Mild right carpel tunnel syndrome

MRI whole spine report: Mild broad posterior bulge at L4-5 and L5-S1  disc indenting the thecal sac

She is on following medicines for the past 3 months:
1. Maxgalin 75 mg
2. Nervijen
3. Shellcal 500 mg
4. Calcirol - 1 sachet per week in milk
5. MetXL - 50

Conditions that have changed:
We moved from a hot and humid place to a cold place a year ago.
She was lifting weights(groceries, wet clothes) up the stairs regularly from the time we moved to this new place.  Stopped after the above

symptoms started.


Questions:

Doctor says there is no relation between her bulging discs and her symptoms. Can I trust this?
Doctor wants her to be on the above medications for another 2 months and then go for a whole body PET scan.  Is the whole body scan necessary

or something more local has to be investigated?
On the days when she takes Calcirol, the jerks are aggravated. Is there a relation?
Should we consult with an Ortho specialist now?


Thank you so much for your precious time and attention.

Velsankar - Bangalore

[vel28]

Thank you for your care and attention once again.

The pain is severe in heels, rectum and lower back.  Relatively the pain is less in buttocks. It is only local and not radiating from lower back to feet.  Just want to know whether it is possible to have a non-radiating pain at three different locations(lower back, rectum and heels) due to a nerve compression lumbar and sacral area.  

Another bothering symptom is the relatively mild and less frequent pins and needles in palms which can not be due to a nerve compression in lumbar area in my layman understanding of the anatomy.  If the symptoms are in line with any brain related issues, I am ready to spend on the whole body PET scan that the neurologist is suggesting.

Yes, we were consulting with a neurologist for the past 3 months.  But whenever I tried to understand the reason behind the pains specifically at certain locations, he simply rejected saying "she will have pain from head to toe" and wanted to continue with the supplements and pain management drugs.  I am in the process of finding another neurologist who will pay some attention and care and try to understand what is happening with my mother.

[caregiver222]

It is impossible to say for certain without an in-person evaluation, however the symptoms are consistent with classical sciatica. The deterioration of the discs causes compression of the sciatic nerve. This can be exceptionally painful, however generally the pain is episodic, and lasts a for a few days at a time. Sleep with a pillow between one's legs on the side sometimes helps. Severe attacks are often treated with steroidal injections. Surgery ( a procedure called a laminectomy) should be considered as a last resort. The palsy of the hands and feet are another issue. A neurological consult is in order.  Intense pain in "the cheek" of the buttocks is common with sciatica.

[vel28]

Dear Doctor,

Thank you so much for your response.  I am sorry that I an unable to understand the following from your response:

Your response: I do not accept the fact that any M.D. in the world would not misdiagnose "classical" textbook symptoms of sciaticia.

Question: - Does this mean her symptoms are sciatica symptoms?  Is there a relation between her bulging discs and her symptoms?

Your response: That being said, there appear to be other things going on to acount for the urinary hesitancy and the "jerking" of the hands, legs and abdoman.

Question:  Does the above mean we need to perform further diagnostic tests?

Her hba1c blood test resulted in normal values. I do not have access to that report for the moment.

Thank you once again for your care and attention

[caregiver222]

The answer is "yes" and "no". I am going to give the physician the benefit of the doubt.  I suspect there is miscomunication between the physician and your mother and yourself. I do not accept the fact that any M.D. in the world would not misdiagnose "classical" textbook symptoms of sciaticia. That being said, there appear to be other things going on to acount for the urinary hesitancy and the "jerking" of the hands, legs and abdoman. Calcium mediates muscular contractions, so the connection between taking a supplement and increased "jerking" is significant. Immediately, the problem is to reduce the swelling in the vertebra that are causing sciatic nerve compression. Square one in the treatment is to have a consult with an exercise specialist, who will have a copy of the MRI of the lumbar area,  who will recommend special exercises. Lifting heavy objects in the future is a "no-no". She also requires an hba1c blood test to rule out diabetes.