Question :

Cervical and Lumbar Radiculopathy

Dear Ask The Doctor:
I am experiecing severe leg cramps in the back thigh down to the knees. I am also experiecing shoulder and upper arm pain very severe. My legs only cramp when i am standing or walking. Once I sit daow i get relieve and then they just burn and feel really warm almost like i have fever in them. My shoulder keep me up at night. I can't sleep on it and it seem to worsen when my neck hurts. I have had 3 MRI's of the back, neck and shoulder, and they show some bugling disc and heriniated disc My doctor seem to think that my shoulder will not get better until I get my neck problem looked at and that it is possible that my back is causing my leg pain. I am wondering if it is sciatic nerve and what can i do about it?


Answer :

Dear Patient: 
The leg pain caused by a herniated disk is due to a nerve compression that can produce an inflammatory process affecting nerve roots (neuritis). The bulging of the content of the disk is more common in the lumbar region than in the cervical region, but can occur in both indeed. The bulging may or may not be clinically significant. Some patients with bulges are symptomatic and have a lot of pain, while others remain totally asymptomatic.
The treatment strategy would be as follows: try to keep a proper posture, avoiding repetitive cervical and lumbosacral stress (example weight lifting), adhering to a healthy lifestyle and proper nutrition, physical activity, losing excess of weight, smoking cessation, seeking medical advice in a timely manner when indicated. During the pain crisis a physical therapy program should be followed and aimed to reduce pain and inflammation. For patients that show poor response to these measures the surgical option may be considered.


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