What Is The Cure For Lumbar Back Pain And Foot Drop?

Posted on Tue, 28 Jan 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 28 Jan 2014 Answered on

Mon, 17 Feb 2014 Last reviewed on

Question : I am 37 yr old female and have had lumber back pain for 3 months, was hospitalised due to doctors querying caudia equine, I had foot drop to r leg. mri showed only bulge to L4,5S1, mri I had 4 years showed same didn't have leg pain then. I have now changed meds from gabapentin to pregablin, upped the dose now on 150mg tds. taking codeine 60mg tds. have been on diazepam and diclofenac for 3 months.and was on oromorph in early stages. Since upping pregablin to 150mg tds my burning pinching pain to lower back and leg pain has intensified along with increased tingling and numbness down to toes. I have light headedness, hot flushes. My ADL are limited. cannot walk for any long periods use crutches or cannot sit for more than 20 mins without my r leg going into spasm intensity of tingling. I find only comfortable position is to lay on l side. Have done heat and ice. Physio have told me to do very minor exercises. they have arranged 4 sessions acupuncture. Have seen osteopath from the beginning. awaiting spinal cons to see me and pain team. What would you suggest is the best treatment to a full recovery? As I have two young children and have been off work for 3 months!!! and want a life back. Anything you can suggest I would be very grateful.

Answered by Dr. K. Naga Ravi Prasad (-5 hours later)

Brief Answer: Epidural steroid injection is one option. Detailed Answer: Hi, thanks for writing to XXXXXXX Based on the description, your symptoms are very much significant and indicate severe compression of the spinal nerves by the protruding intervertebral discs. As your symptoms are unrelenting to medicines severely limiting your ADL's, I personally think that the next option available to you (apart from surgical decompression) is to have EPIDURAL STEROID INJECTIONS. An Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management ( nonsurgical care) with medicines, physiotherapy etc. Hope I have addressed your query. Happy to help further Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. K. Naga Ravi Prasad (3 hours later)

Thank u for your reply. Would surgery be the most effective means of getting back to normal life including being back at work? also reduce the chances of this returning again! On average how long is the recovery period after surgery? Would it also be advisable to reduce the pregablin back down to 100mg tds as increasing them seems to be making symptoms worse? Regards XXXX

Answered by Dr. K. Naga Ravi Prasad (1 hour later)

Brief Answer: Yes, surgery will be the most effective method. Detailed Answer: Hi, Nice to hear from you. Definitely, surgery will be the most effective form of treatment for the management of a severely symptomatic lumbar disc disease. Yes, you can be back to normalcy after a successful surgical decompression. Though the chances of a recurring disc protrusion at the same level of surgery is very very less, it can happen at other levels either above or below the level of an operated disc. In general, the only restriction after surgical decompression of a lumbar disc is to avoid forward bending for 2-3 weeks and avoiding lifting heavy weights. Other than these, there are no real constraints and recovery will be smooth. There is no need to be confined to bed post operatively and you can be on your feet either on 2 or 3 day after surgery and can attend your daily activities with some form of lumbar back support or brace. Regarding the reduction in the dose of Pregabalin, I cannot make a comment, as your treating doctor knows about your ailment better than me. So, don't tend to change the dosing yourself without consulting your doctor. Hope I have justified your queries. I welcome any more clarification Good day

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar