Low Back Pain: Lumbar Radiculopathy

Patient

Q: March last year i woke up with back pain that affected everything i did also had four spots on my back similar to a rash. went to doctor and she said i had shingles, but other doctors said it wasn't because i had no sensitivity and it didn't spread. rash lasted about 3 days but the back pain keeps getting worse. had mri's and drs. say nothing should be causing that much pain, do have a bulging disc, marrow edema,numbness in buttocks,big toes and if i push to much numbness in one leg. pain at the top of buttocks from walking and sitting to long. since they can't figure out what is wrong they said it is my fibromyalgia. do think that this possible since it showed up so suddenally and is getting worse? please help me i can't even take care of my personal needs without help. any ideas would be appreciated. tired of being pushed from dr to dr. thank you

Doctor

A:   Depending of the level that the bulging disc is located, we expect to have specific symptoms caused by compression of a nerve at that level. The compression also can be caused by a Lumbar Spinal Stenosis which is a narrowing of the spinal canal, causing nerve compression as well and producing symptoms like: numbness, weakness and pain at different levels in the lower limbs.
Fibromyalgia is a widespread or global pain, it can start in one site but becomes generalized pain for more than 3 months of duration, it can affect individuals of any age, and more women than men, but just the 2% of the general population in US meet the criteria to be diagnosed of Fibromyalgia.
In the view of your past medical history of a bulging disc and the symptoms that you described, the suggested strategy would be: a physical therapy program emphasizing flexion exercises for the lumbar region, they decrease the stress on the spine and increase the size of the spinal canal reducing the nerve compression. Stretching of gluteal and hamstring muscles are of great benefit. Abdominal muscles strengthening and cycling can be also practiced. Other very important recommendations are: keep your weight under control and avoid activities that place additional stress on the lumbar spine

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