How to manage severe back pain?
Honorary Professor of Neurology,
BJ Medical College, Pune
Q: I am a 34 years old male facing severe back pain for the last 2 years together with burning sensation and hot flatulence all over the body. Sometime its appeared in lower back and some times in shoulder, neck, chest and back of chest & behind head. I feel some burning pain in these areas. As per the advice of a neurologist, I had undergone X-Ray & MRI. In MRI, it shows nerve root stenosis and disk impinging on the thecal sac and the final impression of report was Lumbar Spondylosis (LS1 and S2). The doctor mentioned in the prescription that PIVD (Prolapsed Inter-vertebral Disc) at lumbar region. Nerve routes of other discs except lumbar region of spinal cord found normal. I feel pain & burning in lower as well as upper back when I do any sitting work. As advised by Neurologist, I have undergone lumbar traction for 5 days. If I walk a distance of 1 km, I feel shoulder and neck pain. Then the pain is moving to chest and upper back and moving to lower back. From the beginning, along with the back pain I am also having chest pain like anginal pain (burning and crushing pain like muscle ache in chest) for which I have undergone TMT, 2-D Echo, ECG, etc. but all tests were normal. I can't also do any continuous sitting jobs due to this problem. Kindly let me know the course of further treatment in this regard? Whether the prolapsed Intervertebral Disc at the lumbar region can cause discomfort or pain in chest?
A:The lumbar disc cannot cause pain in upper back chest and neck. Fromlistening to your complaints, this appears myalgic pain due to muscle tensiondue to psychological stress. To make sure there is no other neuromuscularproblem I would advise ESR by Westergren, RF Test, CPK, Serum Ca,Phosphorous and Alkaline Phosphatase. I would recommend something like tablet Tryptomer and tablet Emsulide P. If any of the tests mentioned above comes abnormal please consult your doctor.