Neurological Inflammation: Managing Symptoms and Home Care

Suspected neuroinflammation

Hello, doctor.
My father is 70 years old.
Two months ago, he caught a cold, which led to nightly coughing and lower back pain.
After recovering from the cold, the back pain worsened instead of improving.
About a week later, he developed severe pain in his lower back and thighs, accompanied by cold sweats, and his right leg became weak and numb, making it difficult for him to walk.
Initially, we suspected a herniated disc causing nerve pain.
After visiting an orthopedic specialist and undergoing X-rays and an MRI, the orthopedic doctor determined that the bones were normal and the disc only had a mild protrusion that did not require treatment.
They suspected a metabolic issue and recommended a referral to a neurologist.

We have scheduled an appointment with the neurologist, but the wait time is one month.
Due to the long wait and uncertainty about the source of the pain, we are unsure how to manage his health to prevent further deterioration.
During this time, my father has been trying to do home rehabilitation exercises, taking pain relievers, supplementing with B vitamins, and doing leg lifts and walking daily.
Currently, his pain has decreased to the point where he no longer needs pain medication, but he experiences unexplained body heat and thirst at night, which disrupts his sleep.
He can walk steadily on flat ground, but sometimes his legs feel weak when going up and down stairs.
Given my father's current condition, is his approach to home rehabilitation correct and effective? Are there any other considerations we should be aware of while we await a diagnosis?

A-Wan, 30~39 year old female. Ask Date: 2024/07/15

Dr. Jiang Junyi reply Neurology

Dear Ms.
Awan,
You mentioned that your father is suspected to have a metabolic issue, and it is recommended that he be referred to a neurologist.
I suggest that he first consult with an internist or a rehabilitation physician at the same hospital for blood tests and peripheral nerve examinations.
Regarding self-rehabilitation, it would be beneficial to discuss this with a physical therapist before making any arrangements based on their recommendations.
This is important because after seeing a neurologist, there will be a waiting period for tests and results, which could delay his medical care.
You noted that he experiences severe pain in the lower back and thighs, accompanied by cold sweats, and that his right leg feels weak and numb, making it difficult to walk.
These symptoms may indicate peripheral nerve compression.
The nature of the pain can be described as burning or electric, with symptoms exhibiting a specific dermatomal distribution that can be triggered by touch or pressure, along with muscle weakness and soreness.
Examinations for peripheral nerve issues typically include electrophysiological studies to assist in diagnosis.
Nerve conduction studies assess the transmission speed and waveform of large fiber nerves, while electromyography evaluates the muscle response in the affected nerve distribution area.
I recommend that you follow up with a neurologist for further evaluation, preferably one who specializes in peripheral nerves, as they may have more experience with electromyography.
Additionally, it would be advisable to supplement with B vitamins and ensure adequate hydration, along with sufficient rest to enhance the body's healing capacity.
Thank you for your inquiry, and feel free to discuss any related questions further! Wishing you good health and peace.
Dr.
Jiang Junyi, Neurology Department, Taoyuan Hospital/Hualien Hospital

Reply Date: 2024/07/15

More Info

Managing neurological inflammation and related symptoms can be a complex process, especially when the underlying cause is not yet identified. Your father's situation, where he experienced significant pain and discomfort following a respiratory illness, raises several considerations that we can explore.

Firstly, it is important to understand that neurological symptoms such as pain, numbness, and weakness can arise from various conditions, including nerve compression, inflammation, or even metabolic issues. Given that your father's imaging studies did not reveal significant structural problems, it is plausible that his symptoms may be related to inflammation or irritation of the nerves, possibly exacerbated by his previous illness.

The self-management strategies your father is currently employing—such as taking pain medication, supplementing with B vitamins, and engaging in gentle exercises like leg lifts and walking—are generally positive steps. Physical activity can help maintain mobility and reduce stiffness, which is crucial for overall well-being. However, it is essential to ensure that these activities are not causing additional strain or discomfort. If he experiences increased pain during or after exercises, it may be wise to adjust the intensity or type of activity.

Regarding the symptoms of night sweats, thirst, and difficulty sleeping, these could be indicative of several issues, including anxiety, metabolic changes, or even side effects from medications. It is crucial to monitor these symptoms closely. If they persist or worsen, it may warrant a discussion with a healthcare provider, even before the scheduled appointment with the neurologist. Sleep disturbances can significantly impact recovery and overall health, so finding ways to improve sleep hygiene—such as maintaining a regular sleep schedule, creating a comfortable sleep environment, and avoiding stimulants before bedtime—can be beneficial.

In the absence of a definitive diagnosis, there are several additional considerations and precautions to keep in mind:
1. Hydration and Nutrition: Ensure that your father is adequately hydrated and consuming a balanced diet rich in vitamins and minerals. This can support overall health and potentially aid in recovery.

2. Pain Management: While over-the-counter pain medications can be helpful, it is essential to use them judiciously and under the guidance of a healthcare provider. If pain persists, a more comprehensive pain management plan may be necessary.

3. Physical Therapy: If possible, consider consulting with a physical therapist. They can provide tailored exercises that focus on strengthening and improving flexibility without exacerbating pain.

4. Mental Health Support: Chronic pain and uncertainty about health can lead to anxiety and depression. Encourage your father to engage in activities that promote mental well-being, such as mindfulness, meditation, or gentle yoga.

5. Monitoring Symptoms: Keep a detailed log of your father's symptoms, including when they occur, their intensity, and any potential triggers. This information can be invaluable for healthcare providers when determining the next steps in diagnosis and treatment.

6. Follow-Up Care: While waiting for the neurologist appointment, consider reaching out to the primary care physician for interim advice or to discuss the possibility of earlier intervention if symptoms worsen.

In conclusion, while your father's current self-care strategies are a good start, it is essential to remain vigilant and proactive in managing his symptoms. Encourage open communication with healthcare providers and consider exploring additional support options to ensure he receives comprehensive care. The journey to understanding and managing neurological symptoms can be challenging, but with the right approach, it is possible to improve quality of life and promote recovery.

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