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What Do These Lab Reports Indicate?

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Posted on Sat, 29 Jul 2017
Question: I've suffered from back pain for 10 years. Primary cause is disc deg disease (I think). Had a MRI on my lumbar in 2010. It showed disc deg disease (ddd). I also had two disc herniation in my L4-L5, L5-s1 in 2010. Fast forward to January 2016 I started having pain in my mid back region that radiated to my ribs in my liver area. It also radiated into my lower abdomen occasionally. This went on for several months until may of 2016. I went to the ER and they did a catscan of my abdomen. That catscan showed I had a enlarged liver and spleen. I went to a gastroenterologist who performed a ton of blood work as well as a endoscopy. Everything was normal. He told me to come back in January of 2017 to recheck. Went back and he ordered a ultrasound as well as a liver and spleen nuclear scan. Everything came back normal as well as the liver was normal size. I was still having this pain and it was getting worse. I even went to urgent care several times because I thought I had kidney infections. I ended going to my gp who said maybe your back has gotten worse. He sent me to PT for 2 months and the PT discontinued PT because it was not working. She requested a MRI from my doctor for my thoracic and lumbar. I've known my lumbar has been bad for some time but the thoracic is what is really hurting bad. I mean bad. He ordered both thoracic and lumbar and I will post results. If u want to see pictures as well I can post the pictures. I have the DVD of my MRI. The pain now radiates on my left side as well but not near as bad as my right side. I have to wake up at 3 am to stretch every night and I have a desk job and it's excruciating to sit at a desk. I can't get into a pain clinic, which is what they recommended, for a month. My GP doesn't really know what they will do other than injections. I want to get your thoughts on this. I'm really young and it's very frustrating. I also called a surgeon but can't see me for over a month. I don't even want to think surgery and I'm hoping other things work. I can't sit straight up because it feels like I may break my back it hurts in these problem disc areas. That's the best way I can describe the pain.


I know thoracic disc issues are rare. At least that's what the doctor told me. At first he would even write me the script for my thoracic MRI because he said I can't injure that unless I was in a auto wreck or fell 5 stories from a building. I domt know what the spurs mean and if any of this is fixable. Put didn't work, I've lost 50 pounds trying this past year, so I've tried different things. I can always send more images if needed.
doctor
Answered by Dr. Neeraj Kumar (1 hour later)
Brief Answer:
Follow instructions and take treatment as advised

Detailed Answer:
Hello,
I have gone through your question and reports.
The overall status is not so bad.
Lumbar region is not having any significant root compression.
T5-6 disc prolapse is mild and may be the cause of radicular pain over thoracic region.
The best treatment plan will be good physiotherapy for back muscles strengthening.
Strict postural care. Avoid stooping forward, lifting heavy objects, sitting crossed leg, sitting or standing for more than an hour in a stretch.
Pain killers and muscle relaxant like aceclofenac or etoricoxib with thiocholchicoside or tizanidine can be taken for 2-3 weeks.
Drugs for neuropathic pain like pregabalin or amitriptyline or gabapentin can be used and increased gradually.
Local pain reliever ointment can also be used.
No need of surgery at present.
Get vitamin D 3 tested and if deficient then supplement it.
Hope you found the answer helpful.
Do get back to me for further information.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Neeraj Kumar (15 hours later)
is it normal to have Thoracic issues at my age (37)? This pain has been here for 7 months non-stop and I get no break from it. Physical Therapy did not help at all so they are sending me to a pain clinic for shots. I am in no way exagerating the pain. I cant sit up straight with out my mid back feeling like it might snap. Could the bone spurs be causing these issues?
doctor
Answered by Dr. Neeraj Kumar (16 hours later)
Brief Answer:
Take treatment as advised and visit to pain clinic

Detailed Answer:
Hello,
Bony spurs are unlikely to be so painful until compressing a nerve root.
Pain clinic advice will be helpful as sometimes injection can be beneficial.
The involvement of thoracic region and disc prolapse in this region is uncommon at this age. It can occur if there is trauma or fall from height.
Continue treatment as discussed previously.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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What Do These Lab Reports Indicate?

Brief Answer: Follow instructions and take treatment as advised Detailed Answer: Hello, I have gone through your question and reports. The overall status is not so bad. Lumbar region is not having any significant root compression. T5-6 disc prolapse is mild and may be the cause of radicular pain over thoracic region. The best treatment plan will be good physiotherapy for back muscles strengthening. Strict postural care. Avoid stooping forward, lifting heavy objects, sitting crossed leg, sitting or standing for more than an hour in a stretch. Pain killers and muscle relaxant like aceclofenac or etoricoxib with thiocholchicoside or tizanidine can be taken for 2-3 weeks. Drugs for neuropathic pain like pregabalin or amitriptyline or gabapentin can be used and increased gradually. Local pain reliever ointment can also be used. No need of surgery at present. Get vitamin D 3 tested and if deficient then supplement it. Hope you found the answer helpful. Do get back to me for further information. Regards Dr N Kumar Neurologist