Desperate for Relief: Chronic Back Pain and Nerve Issues Explained

Poor young lady, suffering from腰痛 (lower back pain), leg soreness, tightness, numbness, and weakness for a year. Please help me!

Hello D.R.: About ten years ago, I fell while taking a shower and have had a few accidental falls since then, resulting in back injuries.
However, after receiving chiropractic treatment, I recovered quickly.
In recent years, whenever I feel tired, my lower back becomes uncomfortable and sore, but it usually improves after resting.
Until last November, when I suddenly experienced a stiff neck, and a few days later, I noticed numbness in my right index finger.
One morning, after shaking out my blanket, I felt severe pain in my lower back, which has persisted for a year.
During this time, I have consulted various specialists, including rehabilitation medicine, neurology, surgery, orthopedics, internal medicine, and family medicine.
My symptoms fluctuate; currently, my lower back aches after standing for a long time, and there is tenderness in the indented area of my right buttock.
My right leg sometimes feels slightly numb, and at times, I experience significant pain, weakness, and fatigue in my right leg, while my left leg remains completely normal.
Occasionally, I feel better when moving, but when sitting, my leg becomes tight, painful, and slightly numb within three minutes.
Previously, I underwent an examination at Cathay General Hospital's neurology department, where I had an electromyography (EMG) test and nerve conduction studies that returned normal results.
The straight leg raise test was also not very painful.
I have been taking Sertraline and Solaxin, but there hasn't been much improvement.
I took Chilon, Gascon, and MgO for over two months, which resulted in my tonsils becoming enlarged.
The doctor at Shudian said this was normal and that these medications could cause such effects.
Eventually, I couldn't tolerate it anymore and stopped the medication.
I didn't take antibiotics, which led to chronic tonsillitis, and I had surgery at National Taiwan University Hospital in July.
I am at a loss about how to seek further medical help.
The doctors have not identified any obvious clinical symptoms, but I am truly uncomfortable, and it has severely affected my life.
I requested an MRI, but it was denied.
It is disheartening to feel that I must be incapacitated to receive proper attention.
I apologize for writing so much and taking up your valuable time! Please, can you help me?

Xiao Yang, 30~39 year old female. Ask Date: 2004/10/25

Dr. Xiao Furen reply Neurosurgery

So many experts are unable to solve your problem, and just hearing your question, it is certainly impossible for me to make an accurate diagnosis.
Generally speaking, if a physician believes that you do not need an MRI, then undergoing the procedure would likely be unnecessary.
However, if you really want to proceed with it, you may consider paying for it out of pocket.

Reply Date: 2004/10/25

More Info

Dear Patient,
I understand that you are experiencing significant discomfort and frustration due to your chronic back pain and associated nerve issues. Your history of falls and subsequent treatments indicates that you have been proactive in seeking help, but it seems that the resolution of your symptoms has been elusive. Let's break down your situation and explore potential avenues for relief.

From your description, it appears that your back pain has evolved over the years, initially responding well to treatments like massage therapy. However, the onset of new symptoms, such as numbness in your right hand and severe pain after certain movements, suggests that there may be underlying nerve involvement or spinal issues that need to be addressed more thoroughly.

Chronic back pain can stem from various causes, including muscle strain, disc degeneration, or nerve compression. Given your history of falls and the recent development of symptoms, it is possible that you may be experiencing a condition such as a herniated disc or spinal stenosis, which can lead to nerve root compression. This could explain the numbness and weakness in your right leg and hand.

You mentioned that you have undergone various evaluations, including electromyography (EMG) and nerve conduction studies, which returned normal results. While these tests are helpful in assessing nerve function, they may not always detect subtle issues related to the spine or surrounding structures. An MRI of the lumbar spine could provide valuable insights into the condition of your discs, vertebrae, and any potential nerve compression. If your request for an MRI was denied, it may be beneficial to seek a second opinion from a specialist who can evaluate your symptoms in the context of your medical history and physical examination.

In the meantime, there are several strategies you can consider to manage your pain and improve your quality of life:
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles supporting your spine, improve flexibility, and reduce pain. A physical therapist can tailor exercises to your specific needs and monitor your progress.

2. Pain Management: If over-the-counter medications are not providing sufficient relief, you may want to discuss alternative pain management options with your physician. This could include prescription medications, nerve blocks, or other interventional procedures.

3. Lifestyle Modifications: Incorporating low-impact activities such as swimming or walking can help maintain mobility without exacerbating your pain. Additionally, practicing good posture and ergonomics, especially during prolonged sitting or standing, can alleviate strain on your back.

4. Mind-Body Techniques: Techniques such as mindfulness, yoga, or tai chi can help manage pain and improve mental well-being. These practices can also enhance your ability to cope with chronic pain.

5. Support Groups: Connecting with others who are experiencing similar challenges can provide emotional support and practical advice. Consider seeking out local or online support groups for individuals with chronic pain.

It is crucial to advocate for your health and communicate your concerns clearly with your healthcare providers. If you feel that your symptoms are not being taken seriously, do not hesitate to seek a second opinion or consult a pain management specialist. Your well-being is paramount, and you deserve a comprehensive approach to your treatment.

In summary, while your journey has been challenging, there are still options available to help you find relief. I encourage you to continue seeking answers and exploring different avenues for treatment. Remember, you are not alone in this, and there are healthcare professionals dedicated to helping you navigate your pain management journey.

Wishing you strength and relief,
Doctor Q&A Teams

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