Q. I am on pacemaker with back pain and weakness in left leg. Will nerve root injecion help?

Answered by
Dr. Renjit George Marcus
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 08, 2020

Hello doctor,

I am a 66-year-old male. I am on a pacemaker for the past 18 years (non-MRI-compatible, dual-chamber with full dependence on a pacemaker). I weigh about 78-80 kg. I have back pain for several years, but I have severe back pain for the past month, and my left leg muscles went flaccid. I have a slight weakness in the right leg too.

I consulted a neurologist and an orthopedic surgeon. The pain was reduced in the back by medications (steroids, painkillers, etc.), but the pain near the buttocks pertains, and left leg weakness continues in the selected muscles while a few have started recovering. I am continuing painkillers and some other neuro medicines like Cirrosam, Felicita, Nervemax, and Trigabantin 300. I had to go for a CT myelography to examine the issue after a month. I am attaching the report for reference.

Will epidural or nerve root injections be of any help in reducing pain? Do these injections help heal or reduce compression? Or are used only for pain management? Can this be treated without surgery (traction, physiotherapy, or alternative treatments)? Given age and pacemaker, is it advisable to go for surgery? Are surgeries successful in the level with severe impact (L2/L3)?



Welcome to

I am sorry to hear about what you are going through from the details of your symptoms and your reports (attachment removed to protect patient identity).

In my opinion, the best option would be to undergo a microscopic discectomy or an endoscopic decompression of the spine at L2 L3. The nerves to your left thigh and knee are blocked due to the disc bulge.

Epidural and nerve root injection only reduces the inflammation around the nerve root and does not remove the block. It is just like a high dose of anti-inflammatory at the site of obstruction. So the relief is mostly going to be temporary.

All the symptoms you described can also come due to a knee problem like a meniscal or ACL (anterior cruciate ligament) injury. I suggest you make sure your knee is fine before doing anything else. A nerve root injection, which is a simple procedure, will give you a better idea of how much improvement you will have after surgery. So it can be used in deciding if you need surgery rather than treatment as such.

Microscopic surgeries are relatively safe, and though you have a pacemaker, it should not be a serious problem. Decompression will give good results. With this weakness, physiotherapy is unlikely to give any lasting improvement. Since the muscles are atrophied, it means that the compression had been there for a long time, and a lot of damage has already happened to the nerve. Surgery will decompress the nerve, but the recovery of damaged will take time and need not be complete. But the pain will be relieved. You will need physiotherapy after surgery.

So my final opinion in a nutshell. Go for a nerve root injection. See how you feel. If you are feeling much better and relieved, go for surgery and get well soon. If there is not much improvement with nerve root injection, the results of the surgery is not going to be great.

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
Understanding Low Back Pain

.. commonly found in young and school going individuals these days unlike it was believed as a disease of old age. So this is a small article giving a basic understanding of low back pain in the young hard working generation .. ...   Read full

Experiencing severe back pain following cervical polypectomy. Is it normal?

.. normal to experience reddish brown discharge for 4-5 days post cervical polypectomy, but it should not cause any back pain per se unless there has been a secondary infection or vaginitis or bacterial vaginosis which is quite likely with vinegar sm...   Read full

How can I confirm pelvic muscle weakness?

.. lower back muscle weakness will give you symptoms of back pain and leg pain. You should do blood tests. Check for vitamin D and B12 levels. These blood tests are useful to check the vitamin levels in the blood which co-relates with muscle weakness...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

Tomato Fever - Causes, Symptoms, Diagnosis, Treatment, and Prevention
Tomato fever is an unidentified and fast-spreading type of viral infection seen in young children. Scroll down to know m...  Read more»
Histrionic Personality Disorder - Causes, Signs, Symptoms, Diagnosis and Treatment
Histrionic personality disorder causes variations in the thinking ability of a person. Read this article to know more.  Read more»
Nighttime Skin Routine for Clear Skin
A skin that gets all the attention during the day requires a chance to repair, rejuvenate and replenish from day damage ...  Read more»

Ask your health query to a doctor online?

Ask an Orthopaedician & Traumatologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.