Q. Based on my husband's lumbar X-ray, kindly suggest a treatment for his low back ache.

Answered by
Dr. Padmesh Jain
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 14, 2021

Hi doctor,

My husband recently got an X-ray done at his chiropractor, and they told him to get an abnormal-looking spot on his hip checked out. The location on the X-ray corresponds with the hip pain. Kindly suggest if we can proceed with the treatment.

#

Hi,

Welcome to icliniq.com.

I went through the two X-rays you have provided (attachments removed to protect the patient's identity). Adequate evaluation is limited by loads of overlapping intestinal and colonic gases; most likely, they took the X-ray without proper bowel preparation, or the patient is suffering from constipation. From the given images, I can infer a decrease in the intervertebral disk space at L4, L5 level, suggestive of prolapse or protrusion of intervertebral discs at the corresponding level, which must be compressing the nerve roots at that level, thereby leading to pain and weakness. An MRI (magnetic resonance imaging) of the lumbosacral spine is suggested for further evaluation. This finding at such young age is primarily due to heavy weight lifting or sporting activity, or trauma. In addition, I would like to know if he is experiencing a tingling sensation or pain along his lower back radiating to the gluteal (buttock region) and the backside of the thigh. Also, I would like to know if he has any muscle weakness or gait problems while walking and running.


Treatment plan:

Rest, analgesics, skeletal muscle relaxant, lumbar belt support while moving around, and physiotherapy. Posture correction if any.

Preventive measures:

Avoid lifting heavy weights, avoid bike or scooter ride, avoid long car drives, and sleep on a hard mattress.

Regarding follow up:

Follow up with MRI report and images and further detailed history as mentioned above.

Hi doctor,

Thanks for the reply.

My husband said that he sometimes gets a tingling sensation and frequently has pain along his lower back and thighs, specifically at the base of the spine, around the head of the femur, and directly under his buttock. He does not experience any muscle weakness or changes in gait but does experience pain after running.

#

Hi,

Welcome back to icliniq.com.

The symptoms you have described favor radiculopathy, which may happen due to nerve compression by a protruding intervertebral disk. To confirm the same, get an MRI of the lumbosacral spine, as I suggested before. Regarding pain after running, it may be due to insufficient training, stress, vitamin-mineral deficiency, claudication (if he is a heavy smoker). However, before starting any treatment for now or investigating other causes, let us first rule out the diagnosis of prolapse of the intervertebral disk.



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