[34M] With throbbing spinal pain radiating to leg

Patient Description

A 34-year-old male roofer reports experiencing throbbing pain at the bottom of his spine that radiates to his hip and down to his calf, accompanied by a dull numb pain in the leg. This pain has persisted for about a week and a half and began suddenly upon waking. The patient describes a sensation akin to stretched rubber bands connecting his thigh to his calf at the knee. The pain is constant, varying in intensity, and worsens with walking, sitting on the opposite side, and using stairs. No specific injury or event triggered the pain, and no treatments or medications have provided relief. The patient denies any history of back problems, spine-related issues, or changes in bladder or bowel control. There is no family history of back problems, and the patient engages in heavy lifting due to his occupation. No use of tobacco, alcohol, or recreational drugs was reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Sciatica: This condition occurs when the sciatic nerve, which runs from your lower back through your hips and buttocks and down each leg, is compressed or irritated. This can cause pain that radiates from your lower back to your hip and down your leg, often accompanied by numbness or a tingling sensation. Sciatica can be caused by a herniated disc, bone spur, or spinal stenosis.

    • Typical treatments include physical therapy, pain relief medications, and in some cases, corticosteroid injections. In severe cases, surgery might be considered.
  • Herniated Disc: A herniated disc in your lower spine can press on the nerves that lead to your leg, causing pain, numbness, or weakness. This often results in symptoms similar to sciatica.

    • Treatment often involves rest, physical therapy, pain medications, and sometimes surgery if conservative treatments do not help.
  • Piriformis Syndrome: This occurs when the piriformis muscle in the buttock region spasms and causes buttock pain. It can also irritate the nearby sciatic nerve and cause pain, numbness, and tingling along the back of the leg and into the foot.

    • Treatment typically includes physical therapy, stretching exercises, and anti-inflammatory medications.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Rest and Avoid Aggravating Activities: Try to avoid activities that worsen your pain, such as heavy lifting or prolonged sitting.
  2. Apply Heat or Cold: Use a heating pad or ice pack on the affected area to help reduce pain and inflammation.
  3. Gentle Stretching and Exercise: Engage in gentle stretching exercises to help relieve tension in the muscles around your spine and legs. A physical therapist can guide you on the best exercises for your condition.
  4. Pain Relief: Over-the-counter pain relievers like ibuprofen or acetaminophen may help reduce pain and inflammation.
  5. Use MDandMe: Consider using the MDandMe app to journal your symptoms, track your progress, and share your medical notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening pain that does not improve with rest or medication
  • Sudden weakness or numbness in your leg
  • Loss of bladder or bowel control
  • Symptoms that persist or worsen over time

Remember, it's important to consult a healthcare professional for a proper diagnosis and treatment plan. They can provide personalized advice based on your specific situation.

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People Also Ask


What is sciatica and what causes it?

Sciatica is a condition characterized by pain that radiates along the path of the sciatic nerve, which extends from the lower back through the hips and buttocks and down each leg. It is often caused by a herniated disc, bone spur, or spinal stenosis compressing part of the nerve.


How can a herniated disc lead to leg pain?

A herniated disc occurs when the soft center of a spinal disc pushes through a crack in the tougher exterior casing. This can press on the nerves that lead to the leg, causing pain, numbness, or weakness, often resulting in symptoms similar to sciatica.


What are the symptoms of piriformis syndrome?

Piriformis syndrome is characterized by pain in the buttock region, which can also irritate the nearby sciatic nerve, causing pain, numbness, and tingling along the back of the leg and into the foot. It is often due to spasms of the piriformis muscle.


What are some effective home remedies for managing lower back and leg pain?

Effective home remedies for managing lower back and leg pain include resting and avoiding activities that worsen the pain, applying heat or cold to the affected area, engaging in gentle stretching and exercises, and using over-the-counter pain relievers like ibuprofen or acetaminophen.


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