Right leg numbness

Please help with the case Chief Complaint A 65-year-old female complains of numbness in her right leg for the past 6-7 months. Management What do you advise. Should she go for NCV test? She is avoiding going out for any test because of COVID. What should be the treatment? History 7 months back, she had moderate back pain and mild leg pain for 2-3 weeks, and then back pain become severe for 2-3 days. Then she was admitted to the hospital and was diagnosed with PIVD. After that, she had physiotherapy treatment for one month. The back pain was relieved but her leg numbness was not relieved. Now she has mild back pain sometimes and the main complaint is right leg numbness. Patient also has raised uric acid and she is on Febuxostat.

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Numbness in right leg - ? Peripheral neuropathy - check for diabetes and vitamin B 12 deficiency, vitamin D deficiency ? Nerve root compression in lumbosacral spine - please do MRI lumbosacral spine Empirical treatment with Vitamin B 12 supplement and Tablet pregabalin 75 mg once daily

Sir patient is not diabetic. She is taking vit B, miltivitamin and ccm tablet for the past 20 days.
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? PIVD .. ? LS..SPINES ARTHROPATHY.. WITH ASSOCIATED COMPLICATIONS.. NEED'S .. LS..SPINES X-RAY STUDY.. MRI..STUDY .. NEUROLOGICAL EVALUATION .. SYMPTOMATIC T/T..WITH CLINICAL.. CORRELATION ..

Tnx Dr Rita Dhandhalya
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Symptoms suggest radiculopathy Gabapentin will help Calcium vitD Lumbosacral corset Xray evaluation CBC esr MRI sos

Thank you sir
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PID causing nerve root pressure leading To numbness Ad physiotherapy MRI Cap Pregabaline 75 mg bd Tab B 12 bd Physiotherapy

Thank you sir
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Any h/o-DM ??? If patient is diabetic then NCV needed ?? diabetic neuropathy start the medicine as per @Dr. Riju N And start the exercise Avoid traction machine Start with isometric exercise -gradually start nerve glide -basic strengthening Later stage - Start with 500gram weight Gradually increase -TENS machine -PEMF -for backache-IFT Ergonomic -- Avoid bending Avoid prolonged standing & sitting

Patient is not diabetic Sir, thank you for your valuable opinion
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Evaluate for blood sugar, B12 level. Arterial Doppler study. MRI LS spine.

Thank you sir
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It's case degenerative changes prolapse of inter vertebral disc (PIVD) as well as osteoarthritic changes. May be useful advice to visit nearest orthopedic surgeon and physiotherapist for better pain management. If any Orthotics management required please suggest to have a visit to Orthotist.

If any x-ray or MRI attachment would be more helpful to suggest treatment Proper assessment is required but till then Tab.PREGABA 75 mg Becosules SHELCAL HD D-RISE 60K weekly once PT management ■ Advise gravitational traction for self administration (if she doesn't want to go clinic as of now) ■ Ice pack application at the site from where the pain is arising for 15 min intermittently - This will really gonna help ■ TENS ■ Hamstrings ,calf stretchs Consult a Neurosurgeon for further evaluation and treatment.

Thank you sir
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Look like Radiculopathy, according current situation patient is not willing to go out for mri, or other...... Investigation or consultation. My suggestion is to give 1.Combination of Pregabalin and gabapentin once per day HS, along with 2.tablet: cip zox once morning and 3.apply ominigel spray on lowe back pain area and start hot compression on the pain site. and 4.avoid work involving weight lifting and bending for more hours.. 5. Start slowly Lower limb and hip exercise

Xray lumbar spine Rediculopathy Pregabalin + nortriptylline HS Hot water compression Rest

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