Is low back pain with leg weakness a serious spine issue?
Patient's Query
Hello doctor,
I have had low back pain and weakness in my right leg for the past two years. Please review my attached reports.
Thank you.
Hello,
Welcome to icliniq.com.
Thank you for your query.
I have seen your MRI (attachments removed to protect the patient's identity). Regarding your lumbar MRI, I could not find any gross compression, which explains your right leg weakness. However, I could see there is severe facet joint arthropathy at L5-S1 and also at L4-5. Otherwise, there is nothing grossly abnormal.
So now I suggest you get three things to find the exact cause which are, MRI screening the whole spine, sometimes the compression is above and responsible for symptoms, so get just a screening MRI, and if anything becomes abnormal, then we can go for a detailed MRI, EMG or NCV of lower limbs to look for any peripheral neuropathy, and X-ray of the lumbosacral spine - lateral view in standing position in flexion and extension, to look for any instability in the lumbar spine.
I hope this helps.
Kindly revert in case of further queries.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
We have scheduled the full MRI, and the X-ray was unremarkable. As far as treatment goes, I have tried medications, physical therapy, and now getting injections, which help a bit, but the pain comes back fairly quickly.
As currently shown, would I be a candidate for a nerve ablation or any other more involved procedures? Secondly, is there a chance that these results are from Parkinsonian or other neurological conditions that I should rule out?
Thank you.
Hello,
Welcome back to icliniq.com.
First of all, the diagnosis in your case is not clear. At least, I am not sure your pain is coming from the lumbar spine based on the MRI you sent me. Secondly, there is no point in nerve ablation unless we are unsure of the diagnosis.
So I suggest you get a full MRI as scheduled and EMG or NCV. Parkinson's does not present with such symptoms. So it is unlikely.
I hope this has helped you.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
I recently completed the next series of MRIs for my thoracic and cervical spine. Can you please review them? I have attached the file.
Thank you.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
I have seen your cervical spine MRI (magnetic resonance imaging). There are myelomalacia changes in your cervical spinal cord. There is a high possibility that the symptoms are due to that. Kindly tell me, have you recently noticed any change in your handwriting, or signature or any difficulty in eating food from your hands or buttoning or unbuttoning your shirt?
I hope this has helped you.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
The handwriting, hand-eye coordination, and overall clumsiness have been a lesser issue, but one I have noticed. I do have to follow up, but could you point me in the direction of some potential causes - would something like MS or ALS be a concern?
Thank you.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern. It does not seem to be MS (multiple sclerosis). ALS (amyotrophic lateral sclerosis) can only be diagnosed after clinical examination.
Anyway, at least the cause is now known. The problem is in the cervical spine. I think you should take steroids and look at how you behave with that. I think your doctor will suggest the same.
I hope this helps.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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.