New Case 45 yr , F,Maladivian, Developed back pain with severe electric shock like sensation radiating to left lower limb up to the big toe. 20 days ago while walking she developed pain in the left leg. Sudden shooting pain .She took rest the pain subsided .The next day when she got up in the morning developed low back pain more towards the left side. Sneezing , coughing & flexing the spine she has severe pain . On exam intact peripheral pulsations. weak EHL left . DTRs elicitable .Dulling of sensation left L45 Whst is the diagnosis ? what is the line of management?



Case update. Thanks CUROFY & all others who answered the case.Dessicated disc atL4-5 with severe compression of L5 root. Disectomy done by the Neurosurgeon . Pt became better. All of you are given appropriate answers &once again thank you all

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Severe L4-L5 protusion hence needs immediate ortho surgeon's opinion, following successful surgery needs physiotherapy for at least 4-6 months followed by MRs and GABA pain relievers.

Dessicated discs L4. 5 and L5 S1 Disc bulge and ligamentum flavum hypertrophy Together product severe spinal canal stenosis Will benefit from Laminectomy /discectomy

Disc protrusion at l4 -l5 level and narrowing of neural foramina. According to mri finding mam this case is going to be surgery. But before going to surgery it can be hold by physiotherapy. In physiotherapy basically focus on biomechanical correction like release hip flexors muscle and paraspinal muscle and strengthen glutei muscle. And neural mobilization help to reduce radiating pain. For inflammation cryotherapy is best option and kinsiotaping help to reduce excessive load. ( this protocol is basically advice only according to mri findings) for better results postural analysis is must.

PID L4/ L5 with weakness o EHL lt Initially supportive t/t with continuous pelvic traction for 10 days If no improvement Surgical intervention If improvement consider physiotherapy and other supportive t/t

L4 L5 level extra dural cord compression with root pains ...Intial bed rest to avoid aggravation of sensitisation.motor deficit.. Laminectomy is the treatment of option

L4-L5 disc protrusion with narrowing of the left lateral neural foramina Disectomy is to be done Spine surgeon consultation

Thanks Dr Suma for the appropriate answer.Already referred, this pt needs surgery

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L4/5 PIVD , as there is ehl weakness, it's urgent operative.

its compression of neural canal & disc protrusion at L4-L5 level due to this the subjects from acute electrifying shock in the leg needs complete bed rest,neurotrophic drug,Physiotherapy treatment include LT,Laser treatment to increase the nitric oxide level to defuse the prostaglandin secretion which decrease at the level , by laser treatment and followed by moist hot pack will increase the blood supply level and conductivity of electric impulse will increase this impulse reduces the pain severity.

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