Severe lumbar pain radiated to the leg

Patient

Q: Can i have back pain with pain down leg on march 8th and still be okay to work and do daily living ,then the next month on apil 4th be at work and feel a pull in my lower back and not even be able to tolaret the pain,filed for comp sense i felt the pull at work and now there is a problem cause i was seen the month before for a back ache with pain down the leg.

Doctor

A:   According to the description of the pain, a  Lumbosacral nerve root compression should be ruled out. Some of the major causes of acute and chronic low back pain (LBP) are associated with radiculopathy (nerve compression). However, radiculopathy is not a cause of back pain; rather, nerve root impingement, disc herniation, facet arthropathy, and other conditions are causes of back pain. Lumbosacral radiculopathy, like other forms of radiculopathy, results from nerve root impingement and/or inflammation that has progressed enough to cause neurologic symptoms in the areas that are supplied by the affected nerve root, the leg in your case. During the acute phase of the pain, the physical therapy is very important and involves the use of ultrasound, TENS, heat to control pain, teaching you back-protection techniques (e.g., proper lifting, posture awareness). A lumbar stabilization program is also useful in instructing you in various techniques to control back pain, and you also can work on strengthening the stabilizing muscles of the lumbar spine. Here are some ways to ease the pain at home or at work: Do not bend, lift, or sit in a soft, low chair because your pain will get worse. Unless you are allergic or should not take them for other reasons (if you take a blood thinner such as Coumadin, for example), over-the-counter pain medicines such as acetaminophen (Tylenol), or ibuprofen (Advil, Motrin IB) will probably help ease the pain. Try a cold pack to see if it helps to ease the pain. If you don't have a cold pack, use a large bag of frozen vegetables; it makes a good first aid cold pack. Or have someone close to you massage you in a triangular pattern with an ice cube over the sore areas, no more than 15-20 minutes at the time.  After the cold massages, try alternating with heat from an electric heating pad to see if it helps the pain. If you don't have an electric heating pad, put a hand towel under hot water, wring it out, and place it on your back. Sometimes the moist heat penetrates more deeply and gives better relief of pain. You may feel better lying on your back on a firm surface with a pillow under your knees. Another option is lying on your side with a pillow between your knees to keep your back straight. Also, you might find that a recliner chair is helpful. If after follow a physical therapy program, and try every conservative measure the pain and the neurological symptoms do not improve, the surgical possibility should be considered to release the compressed nerve and avoid more damage.

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