Hello Doctor-DD here and am 50 years old. I had lower back pain on left hand side along with radiating pain in left groin area since end of March 2023. After initial local pain management, the pain did not go, so my GP asked me to do LS Spine MRI. The report suggested some nerve root issue in L4 and L5, so I was asked to refer it to spine specialist. I tried to connect with Dr. Bapat at Nanavati Hospital, but could not see him as his assistant reviewed the reports and said its mild and suggested medicines – Ultracet 1-0-1 for 10 days, Vitencial – 0-1-0 for 30 days and Calciman K10 – 0-1-0 for 30 days. However, the pain persisted with bit of increase in pain in groin area. So the assistant suggested that for pain in groin area better to check with general surgeon about hernia and / or prostate. Since my regular GP is out of town and I had to take my mother to see Dr. Pande, Urologist at Kokilanben Hospital for Urinary Tract problems. So I checked with him about my problem. So he first did Uroflow test and then physically examined the prostate also and later said it’s all fine. He said due to L4-L5 nerve issue, there is pain in groin area and suggested medication – Synaptol 50mg 1-0-1 for 3 weeks, Pregablin (50mg) 0-0-1 for 6 weeks and Etoshine 90mg – 1-0-0 for 10 days and said to do USG of Groin, PSA (total) test and HBA1C after 6 weeks and then again see him. I have started his medication from 20.5.23. He said this type of pain is due to L4-L5 nerve falls under his area and now there is no need to again see Dr. Bapat (I am scheduled for his appointment on 29.5.23). I had also done MRI for hip joints in Nov 22 and the reports were normal.
Please note all through last 2-3 months, most of the time the pain is dull and mild specially when in sitting position and at times in sleeping position. If I stand, walk, there is as good as no pain or very very minimal pain. But the pain still continues but in less intensity. Since yesterday, I have also started getting pain on right hand side also, but it pains only while getting up and / or twisting the body a bit here and there. Also, today morning I was having some burning sensation in pelvic area in sleeping position but no pain at that time.
I am worried about all this and do not understand what the problem could be and why it is taking so long to become normal and whether all these pains is only due to L4-L5 nerve root issue or is it due to some other complications. I had done CBC test, LFT, KFT, Routine Urine and stool test around one month back and the reports were all normal.
Ans: This would need a thorough examination in addition to the tests that were done. The possibilities are nerve root pain both in the lumbosacral and cervical areas accounting for the arms pain and pelvis and leg pain, vitamin B12 deficiency, folic acid deficiency, or a kind of nerve inflammation. Please do keep your appointment with Dr Bapat on 29th and in fact you may please come meet me as well on the same day.