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Dr Ashit

Dr Ashit Hegde  |180 Answers  |Ask -

Consultant Physician, Internal Medicine and Critical Care Expert - Answered on Jul 09, 2023

Dr Ashit Hegde specialises in internal medicine and intensive care. He has nearly 40 years of experience and is consultant physician, intensivist and head of the critical care section at the PD Hinduja Hospital and Medical Research Centre.
He is actively involved in teaching and training residents for post graduate programmes in internal medicine and critical care.
He holds an MD degree in general medicine and therapeutics from the Lokmanya Tilak Municipal Medical College, Mumbai, and an MRCP from the Royal College of Physicians, Edinburgh.... more
PADMAKUMAR Question by PADMAKUMAR on Jul 09, 2023Hindi
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Dear sir, I was operated for spine in 2016 and post operative status was PIVD L5-S1. After a period of two years, again back pain and weakness in left leg was felt. On taking treatment, improvement was seen. The same occurred in 2018, 2020 and now in 2022 I was diagnosed with ACUTE LUMBOSACRAL PAIN AND PIVD L5-S1 as was finding it difficult to walk, weakness in both the legs (extreme weakness in left leg and other complications. I was administered with EPIDURAL INJECTION. Thought at present relief is felt but still finding it difficult to climb the stairs, continuous walking etc and severe back pack is sometimes felt. Doctor had advised for second surgery but I am not open to the surgery. Can you please guide for further medical process.

Ans: I don't think I am qualified to answer your question. You can take a second opinion from another spine surgeon.
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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.

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Nidhi

Nidhi Gupta  |161 Answers  |Ask -

Physiotherapist - Answered on Feb 20, 2024

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Hello Coach, Arun from delhi, 43 years old (weight 81 Kg, Height 5 ft 8 inch), sedentary job style. I was very health conscious about diet, fitness. But during workout for abdominal strength, there was some pain in my back & doctor suggest for MRI and found there was slip disc / disc herniation issue of L4-L5. During last 2.6 years, does several physiotherapy with renowned physio center, yoga & focusing on my diet plan. After 1.6 years also comparing MRI report, shows almost same situation. Need your guidance in this matter, how to recover from pain. Because my current situation is, while standing 5-6 minutes, or walking 5-10 minutes, pain increase from buttock to left side feet. Then I have to take rest for 3-4 minutes, to start again. So, please guide me or suggest me as per your experience. Thanks Arun kumar
Ans: Hello Arun,
Please do let me know more details about the physiotherapy done. Did they give you a Mckenzie program for slipped disc as that is one of the best treatment for disc issues. It includes systematic exercises like wall side glides, road kill position, back extensions. If you are having pain on left side of leg/feet it seems to be a posterolateral disc protrusion for which the wall side glides are very important.
Have you been working on your core? Are your Vitamin D3 and B12 levels ok? How much is your weight now?
If not already please goto a Mckenzie certified physiotherapist and it can make a lot of difference.
If not ok after that also then you may need to go to an orthopedic doctor and consider a minor surgery for the disc.
All the best!

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Nidhi

Nidhi Gupta  |161 Answers  |Ask -

Physiotherapist - Answered on Oct 16, 2023

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i am 55 years old. Retired defense pilot. Have lots of sports injury which is showing up at this age. Body biochemistry is all with in limits, only fasting sugar is 108. For last few months i am having pain in outer left thigh muscles which increases during sleep as well as while lying down resulting in sleepless nights hence general body fatigue due lack of sleep. My exercise includes 5-6 km walk in the morning and occasionally thrice a week cycling. Orthopedic , General surgeon, neurologist as well as ayurvedic doctor has been consulted with MRI report. FINDINGS: Dorsal and lumbar vertebrae are normal in attenuation and alignment. Straightening of lumbar lordosis. Desiccation of lumbar intervertebral disc from L2-L3 to L5-S1 levels. Mild diffuse disc bulges at L2-L3, L3-L4 and L4-L5 intervertebral discs indenting anterior thecal sac with mild narrowing of lateral recesses and neural foramina. No significant compression of the cauda equina. Mild disc bulge at L5-S1 level indenting anterior thecal sac. Bilateral facet arthropathy is seen at L4-L5 level. Dorsal spinal cord, conus medullaris and cauda equine are normal. Para spinal soft tissues are normal. IMPRESSION: Mild lumbar spondylosis with mild diffuse disc bulges from L2-L3 to L5-S1 levels. Kindly help me and advice
Ans: Hello Partha,
You need to consult a physiotherapist who knows the Mckenzie treatment for slipped disc. At times pain in outer thigh can be due to slipped disc.
Or you may have a hip bursitis which will not come up in lumbar spine MRI, only hip MRI will show it. Outer thigh pain while sleeping on left side can cause pain if it is a left hip bursitis.
Or this could be a Iliotibial band tightness which is a band of muscles on the outer thigh.
A good sports physiotherapist who also knows the Mckenzie treatment needs to evaluate you, understand the root cause and accordingly give you the treatment and you should be fine.
All the best!

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