Q. Is it possible to treat pain while walking through physiotherapy or medicines?

Answered by
Dr. Shivam Om Mittal
and medically reviewed by iCliniq medical review team.
Published on Jun 23, 2018 and last reviewed on: Oct 09, 2018

Hello doctor,

I am 65 years old with weight 88 kg and height 5'10". I suffer from moderate hypertension and diabetes since last eight years but always in control of medicines. Last year I had undergone angiography as an age-based test and symptom of pain on starting walking short distance a few meters. Many times it does not, in a mid-thoracic area of the upper back and epi-gastro area. But things were seen normal except for a small branch which was 100 % clogged but the cardiologists said it does not matter. This problem of feeling pain when walk some meters started four years back. It is surprising that if I jog stationary position for even two minutes no pain. Now since a few days when I lie down on the bed also the pain starts but not in sitting position. So an MRI was recommended and I underwent MRI of the spine with contrast. The report is in brief here:

  1. Under report one MRI dorsal spine, spine curvature straightened. Generalized spondylotic changes were seen in form of osteophytes and disc desiccation at multiple levels seen in the form of loss of hyperintense signal on T2W images. Rest normal.
  2. Report 2 MRI cervical spine with contrast: spine curvature straightened. Generalized spondylotic changes were seen in form of osteophytes and disc desiccation at multiple levels see I in the form of loss of hyperintense signal on T2W images. Diffuse broad-based posterior and bilateral foraminal disco-osteophyte protrusion seen at C4/5, 5/6, and 6/7 levels having left propensity and causing compression of bilateral exiting C5,6,7 nerves root in their respective foramina. Rest normal.
  3. Report 3 MRI thorax with contrast: fibrotic band seen in left basal lung parenchyma. Rest all normal.
  4. Report 4 MRI lumbosacral with contrast: spinal curvature is straightened. Generalized spondylotic changes were seen in form of osteophytes and disc desiccation at multiple levels seen in the form of loss of hyperintense signal on T2W images. Diffuse broad-based posterior and bilateral foraminal disc bulge with posterocentral disc protrusion seen at L5/S1 level indenting the thecal sac and compressing bilateral traversing S1 nerve roots.

12 years back, I had L4/L5 disc bulge problem stenosis and sciatic nerve type pain in leg left and burning sensation and pinpricks in feet of both legs. I was about to go for surgery but an osteopath corrected this with manipulations for 5 to 6 days and signs abated. Till then this part is fine. But now there is some pain or mild sensation sometimes in legs. I sit long hours on the computer and am academician so have a sedentarylife. I also have GERD type problem. It is also noted by me that if I continue walking for a few days by stopping frequently then after a few days pain does not occur or come after long walks. Now my worry is in light of all the history and records. Questions:

  1. Is it possible to treat this pain by physiotherapy or medicine or both or any other method?
  2. What is prognosis for the type of MRI pictures reported? And how spine health can be restored or brought near normal?
  3. The line of action suggested so I do not have pain in back and epigastric region when start walking.

Currently, I am taking medications for diabetes, acidity, and hypertension.

#

Hi,

Welcome to icliniq.com.

I appreciate your detailed history. The symptoms you have described are suggestive of neurogenic claudication due to the neuro-foraminal stenosis and disc bulges in the spine. If the pain is the prominent symptom, then conservative therapy should be done first. But if you have any weakness or sensory loss or urinary symptoms, then I would recommend consulting a spine surgeon. Conservative management includes the following:

  1. Medications for pain: pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) may provide symptomatic relief of mild to moderate pain. In more serious cases, steroidal nerve root blocks, which are injections of medications directly on or near the affected nerve are used.
  2. Physiotherapy- strengthening of supporting muscles for flexion exercises can help take pressure off the spine. This helps in relieving the pain.
  3. Alternative treatments like Yoga, massage therapy, and other alternative treatments can relax the muscles and relieve the pain symptoms.

For more information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

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