Concluded Case

21 year old male in severe left leg pain

21 year old male came with c/o severe left leg pain,no associated claudication.Non smoker,non diabetic with normal vitamin B 12 levels.Already managed on pregabalin and gabapentin but no response.MRI attached,please help with the management.

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Concluded answer

Its PIVD , early stage , give muscle relaxant like Flexura, with analgesic , gabapin 100mg HS , ask him to avoid lifting heavy weights and avoid bending forward for lifting objects, light activities, hot fomentation over tender area, local analgesic cream, after a week start spinal extension exercises and physiotherapy with TENS therapy.

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MRI can justify the symptoms But rule out vascular element Arterial and venous doppler

Thank you doctor
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As there is disc protrusion,adv lumbar belt and refer pt to neurosurgeon

Thank you doctor
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Desication and prolapsed disc indentation of thecal sac Adv decompression

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Its PIVD , early stage , give muscle relaxant like Flexura, with analgesic , gabapin 100mg HS , ask him to avoid lifting heavy weights and avoid bending forward for lifting objects, light activities, hot fomentation over tender area, local analgesic cream, after a week start spinal extension exercises and physiotherapy with TENS therapy.

Thank you doctor
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MRI correlates with symptoms. Is there any history of trauma on low back? Looks like radiculopathy. Check for vascular involvement by bluish discoloration or with vascular tests. Can try with McKenzie protocol and to go ahead with clinical correlation.

No doctor,no history of trauma.Should go for a arterial and venous doppler?
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May be case of std, so take history of patient some type of virus develop blockge and swelling in vains.

So doctor should go for a doppler?please suggest further
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Diseases Related to Discussion

Radiculopathy