Dr. Sumit Chawla
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My mother is 80 years old. She has been suffering from arthritis or spondylolysis for more than 30 years. She is receiving treatment from a local orthopedician. She has been taking NSAIDs and other general medicines for five years. Her ESR level suddenly rose. For the last few months, she felt an extreme burning sensation in her lower legs, especially after lunch. Since she cannot walk properly due to her disease and severe pain, we face a problem taking her to a doctor like before. I would like to know which medicine will be helpful to control the burning sensation. I am attaching the MRI report for your reference. Please guide.
Hello,
Welcome to icliniq.com.
I have gone through the MRI report (attachment removed to protect patient identity).
Your mother has nerve compression at two levels. Grade I spondylolisthesis is mild and an osteoporotic compression fracture D12 vertebra. Burning pain is due to ischemia of the nerve; it can be due to the involvement of small blood vessels supplying nerve in diabetes or compression of the nerve. Burning pain is a symptom of neurological involvement. Neurological examination is required to look for neurological impairment; if present, she might require disc decompression surgery to relieve the pressure of the nerve roots. Vitamin B12 deficiency is also a cause for peripheral neuropathy, and some patients may get some relief with vitamin B12 injection. Caudal injection of corticosteroid is also helpful to alleviate edema around the nerves. In prolonged cases, degeneration occurs, and no relief with medication is observed.
Patient's Query
Hello doctor,
Can you advise some specific medicine to buy from the medical store as I am away from my mother and there is a problem taking her to the hospital and for several tests? The medicine may help her in reducing the burning feeling in her leg.
Hello,
Welcome back to icliniq.com.
I suggest your mother should take the following medication (provided there is no renal abnormality or other coexisting diseases)
1. Tablet Shelcal (Calcium and Vitamin D3) HD 1 tablet once a day.
2. Calcirol (Vitamin D3) sachet with milk- one sachet per day for ten days followed by one sachet every 15 days (if she is not on Vit D3 therapy, if she is on Vitamin D3, then the dosage will be changed).
3. Tablet Osteofos (Alendronic acid) 70 mg - One tablet once a week.
4. Tab Ultracet semi (Paracetamol or Acetaminophen and Tramadol) - one tablet sos (when severe pain).
5. Tab Pregaba M (Methylcobalamin and Pregabalin) one tablet before dinner (for relief of burning pain, might cause some giddiness and excessive sleepiness during daytime, patients usually get used to this medicine in seven to ten days).
The first three drugs are to be used for a longer duration to improve the quality of bone, the fourth is an analgesic for pain relief, and the fifth medicine is for the burning sensation.
Follow up after fifteen days regarding her condition. Medication should be stopped immediately and reported to me or a local physician in case of adverse effects.
Patient's Query
Hello doctor,
Thanks for the reply. But when I tried to buy the medicines, they asked prescription to sell the drug as you advised. It is requested to provide a prescription in JPG or JPEG format with your registration number to buy the medicines.
Hello,
Welcome back to icliniq.com.
Sorry for the inconvenience. The required prescription will be provided tomorrow during the office hours through the icliniq support team.
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Orthopedician and Traumatology
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