Possible lumbar radiculopathy getting worse

Patient

Q: I have been having severe pain with my scaitic nerve since sept of 2010, but I have yet to recieve an MRI or CT scan of my lower back. The pain can be almost debilitating and brings me tears at times. I have been taking muscle relaxers and 800 mg ib broufrin for months now and to no avail. What I am scared of is long time nerve damage in my back. Now the pain had spread to the front of my body. What does this sound like?

Doctor

A:   The type of pain that you described might be due to a nerve compression, caused by a degenerative process or a bulging disk at lumbar spine level, and you can feel it worst in some positions because in certain positions the intervertebral space gets smaller and compress the correspondent nerve. The pain can radiate to the upper thigh, leg or even to the foot depending of the lumbar segment involved. In order to confirm this diagnostic impression, the best imaging study is the MRI. Basically the conservative treatment is Physical Therapy aimed to recondition and stabilize the lumbar spine by re-educating you, by teaching you a daily stretching routine for the lumbar area, strengthening of abdominal muscles, and other important general recommendations as follows: sleeping with a pillow between the knees lying on the side, avoid activities that place additional strain on the lumbar spine (example: weight lifting). All of the above, with the objective to keep you as far as possible from episodes of acute low back pain, and also to preserve your quality of life. If the conservative measures do not seem to work, the local corticosteroid injection may be considered.

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