Q: I had an attack of malaria three years back. Post that I have been having lots of problems. It started with neck pain and headaches along with severe dizziness. Now I suffer from mid and lower back pain with pain travelling to my left leg. The other symptoms continue. I had an MRI of the brain which was normal. All relevant blood tests are normal, except for Vitamin D levels for which I took supplements and now the levels are OK. I had X-rays of my back taken which showed a mild scoliosis and I followed it with an MRI of cervical and dorsal spine. A small centrolateral disc herniation is seen at C4-5 level, indenting the thecal sac. A small posterior disc bulge is seen at C3-4 level, mild reduction in disc spaces at D5-6-7 levels, small uncovertebral osteophytes seen on right side at C2-3 and left side at C4-5 level. I have reached a point where no pain killers work, not even physiotherapy. Present symptoms are mid and low back pain, pain in shoulders, imbalance and dizziness even when sitting. Discomfort while sitting or standing. What could this problem be? Should I take more tests, If so which ones? Or is it just back pain?

A:I do not feel that the malaria has anything to do with your current problem of pain. Imbalance and dizziness may sometimes be related to the treatment for malaria, though this is not a common side effect. There are obviously wear and tear changes in your spine in the scans which explains the pain. This may take quite some time to treat and has a tendency to recur. These problems are best handled by an orthopaedic surgeon or a neurosurgeon.