patient 32 yr male, c/o rt gluteal region pain radiating to thigh & calf. since 2-3month. no comorbities. chronic smoker, alcohol+ ,what should be the management.



bed rest for a maximum of 3-4 days. prolonged bed rest is of not much value as per current literature. start on analgesic, muscle relaxant, neurotropics. physiotherapy aimed at back strengthening. lumbar belt can be given. check neurology in detail. periodic documentation will help in ascertaining progression. osteophyte is at age of 32 is not a regular occurrence. there can be disc degeneration or facet instability. MRI should be done to find exact pathology and treatment directed appropriately.

thanks for guiding, sir. just want to ask about prognosis .

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Right sided lower limb neuropathic pain probably due to nerve compression due to lumbar spondylitis. Management 1 Tab Gabapentin + Amitrytaline (300mg + 10mg) 2.Tab Etoricoxib 90 mg O.D 3Inj neurobion forte alt . days 5 injections 4 Complete bed rest for 15 days. Treatment for 1 month

Get Blood sugar done,the pain seems to be from S1and L5 nerve root,start with Aceclofenac+Thiocochacide4mg,benfotamine+methylcobalamine,gabapentine, avoid forward/backward bending,sleeping on hard surface/or lateral decubetius psition with pillow between legs,physiotherapy,SWD,coorect posture,if not getting proper response Adv MRI and treat accordingly.

stop alcohol and smoking as it ll additionally cause neuropathy

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Complete bed rest ,rest on hard bed For 21 days Use LS Belt Cap Indomethacin 75 SR OD Tab Gabapentin 300 OD Tab Methylcobalamine 1500 OD Tab Sachets Cholecalciferol weekly for 8 week then monthly Tab Calcium pantothenate OD. all for 6 week Physiotherapy .

Kindly don't think of surgery now. Please check distal pulse to rule out vascular compromise. Structure Physio which includes Mulligan technique manipulation will do wonders. Remind him to take care of his back in terms of posture correction and back care techniques to prevent recurrence.

At 32 years of age the prognosis is excellent with conservative line of management provided he follows instructions in self Physio at home, follows back care and posture correction techniques properly. In short if he gets hold of a good Physio therapist then he will do very well.

First diagnosis will be Rt sciatica. I will proceed with an M R I and follow the pt. Very difficult condition to cure. Life long recurring Disease. Treatment is rest painkillers varies according to stage of the condition. It is debatable conditions all Over the world. In india there are so many unorthodox treatment is beyond imagination.

This is most discussed topic all over world so many things hrs.of work lost due this condition is difficult to is billion dollars lose making is recurring problem.if it caused by a disc bulge there different opinions. conservative rest pain killers ,physiotherapy,exercise,long walks,go to a neuro surgeon

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Suggestive of disc prolapse between L5 and S1 causing nerve compression. and root pain.Treatment would be spine extension exercise, rest and

can b the lordosis due to osteophytes and reduction in space in L5 and S1? requires? mri??

can b the lordosis due to osteophytes and reduction in space in L5 and S1? requires? mri??

Do mri whole spine lumbar spondylosis pressing nerve root causing pain

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