Lower back and leg pain for 4 months

Patient

Q: I have had lower left back pain for 4 months. Recently it's gotten quite bad. X rays came back normal, my GP thinks it is a pinched nerve. Sometimes the pain is shooting, it goes down my left leg to my ankle at times and it hurts to sit. Her plan is for me to take Tramadol and just deal with it. Would it be advisable for me to see a neurologist to find a better way to relieve the pain? If there is a better way. I'm hoping there is.

Doctor

A:   First of all, after 4 months of having a lower back pain, the cause of your pain should be determined to present you with the right treatment options, and if your x rays came out normal, and you are still in pain and having symptoms that suggest a lumbar nerve compression or a sciatica (inflammation of the sciatic nerve), the next step is to discuss with your doctor two things: first a evaluation by a specialist and second to perform a  more specific imaging study as MRI and possibly a electromyography. In the meantime, you would benefit from a physical therapy program aimed to control pain and recondition and stabilize your lumbar spine by re-educating  and teaching you a daily stretching routine for your back, exercises to strengthening of abdominal muscles, and other important general recommendations as: sleeping with a pillow between the knees lying on the side, avoid activities that place additional strain on the lumbar spine (example: weight lifting). Finally, when the cause of your pain be determined you will be presented with the proper treatment alternatives and not only with an analgesic drug or pain killer that is just providing a temporary relieve without treating the underlying cause.

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