Review Topic QID: 3706 1 Equal limb pain and equal functional outcomes 2 Improved limb pain and improved functional outcomes 3 Worsened limb pain and worsened functional outcomes 4 Worsened limb pain but improved functional outcomes 5 Improved limb pain [orthobullets.com]

Review Ohnmeiss DD, Vanharanta H, Ekholm J:Degree of disc disruption and lower extremity pain. Spine. 1997 Jul 15;2214:1600-5. 8.Spencer DL: The anatomical basis of sciatica secondary to herniated lumbar disc: a review. [hss.edu]

(SBQ12SP.42) A 56-year-old man presents with 6 weeks of worsening back and left sided lower extremity pain and weakness. He has severe pain that radiates from the back to the groin and anteromedial thigh. His axial MRI image is shown in Figure 1. [orthobullets.com]

mass within or lateral to the intervertebral foramen. [ncbi.nlm.nih.gov]

Very large disc herniations may result in urinary difficulty and constipation. In cervical disc herniation, the spinal cord as well as the nerve roots may be compressed. [uclahealth.org]

Constipation is a common side-effect from codeine. This may make back pain worse if you need to strain to go to the toilet. To prevent constipation, have lots to drink and eat foods with plenty of fibre. [patient.info]

Side effects include sedation, nausea, and constipation. Epidural steroid medication (injected into the space just outside of the sac of spinal fluid), reduces swelling, inflammation, and pain. [innerbody.com]

If the anal sphincter is not working, fecal incontinence may occur. This means the patient loses the ability to control the passage of stool from the bowels. If the urethral sphincter is not working properly, urine leaks from the bladder. [livestrong.com]

incontinence as well as sexual dysfunction. [physio-pedia.com]

In the right eye multiple, flat, retinal hemorrhages around the optic disk and the posterior pole were observed. The MRI scan for intracranial hemorrhage was unremarkable. [ncbi.nlm.nih.gov]

Ophthalmoscopy revealed a premacular hemorrhage involving the left macula. In the right eye multiple, flat, retinal hemorrhages around the optic disk and the posterior pole were observed. The MRI scan for intracranial hemorrhage was unremarkable. [ncbi.nlm.nih.gov]

The patient initially suffered from unilateral low back pain and nonradicular/nonlancinating referral to the ipsilateral lower extremity. [ncbi.nlm.nih.gov]

“Red flags” for potentially serious underlying causes of low back pain. Adapted from ACR Appropriateness Criteria: Low Back Pain. 3 Figure 3. “Red flags” for potentially serious underlying causes of low back pain. [jaoa.org]

The patient initially suffered from unilateral low back pain and nonradicular/nonlancinating referral to the ipsilateral lower extremity. [ncbi.nlm.nih.gov]

“Red flags” for potentially serious underlying causes of low back pain. Adapted from ACR Appropriateness Criteria: Low Back Pain. 3 Figure 3. “Red flags” for potentially serious underlying causes of low back pain. [jaoa.org]

Thoracic disc herniation presents most commonly as chest pain or spine pain, and occasionally in numbness, weakness, or spasticity. [uclahealth.org]

Low back pain and/or leg pain (sciatica) are the most common symptoms of a herniated disc in the lumbar (lower) spine. Pain may vary from mild to severe. [treatingpain.com]

Pain moving your neck Deep pain near or over your shoulder blade Radiating pain in your upper arm, forearm, and possibly your fingers Pain from a bulging disc may start slowly and get worse over time or during certain activities. [depuysynthes.com]

See separate leaflet called Back and Spine Pain for a general overview of the different types of back pain.) The most common age to develop a prolapsed disc is between 30 and 50 years. Twice as many men as women are affected. [patient.info]

On physical examination a compensatory gait, paravertebral muscle spasm, and a restricted right straight-leg raising test were demonstrated. Plain x-ray films revealed a narrowed L4–5 intervertebral space. [thejns.org]

Change of Gait -Severe paravertebral muscle spasm changes gait. Gait change follows postural abnormality, muscle weakness and atrophy of lower leg muscles. [epainassist.com]

How many days of bed rest for acute low back pain? A randomized clinical trial. N Engl J Med. 1986;315:1064–70. 17. Malmivaara A, Hakkinen U, Aro T, Heinrichs ML, Koskenniemi L, Kuosma E, et al. [aafp.org]

DC, PT: Comparison of Classification-Based Physical Therapy With Therapy Based on Clinical Practice Guidelines for Patients with Acute Low Back Pain: A Randomized Clinical Trial. Spine. 2813:1363-1371, July 1, 2003. [hss.edu]

Spinal Manipulative Therapy and Mobilization - Spinal manipulative therapy and mobilization leads to short-term pain relief when suffering from acute low back pain. [physio-pedia.com]

Three patients did not undergo MRI because of claustrophobia and were excluded. Two more patients were excluded because their data were not available. Data for one patient were incomplete: Four segments were evaluated instead of six. [ajronline.org]

Secondary outcomes included sciatica severity as measured by the Sciatica Bothersomeness Index, satisfaction with symptoms, self-reported improvement, and employment status. [ncbi.nlm.nih.gov]

Sciatica is a common diagnosis in the general population. Sciatica is most frequently caused by LDH. [sogacot.org]

Sciatica due to a herniated lumbar intervertebral disk is common and has an estimated point prevalence of roughly 5% in the general adult population. 1 Numerous prospective studies have reported excellent recovery of acute sciatica in the absence of significant [cmaj.ca]

A 29-year-old woman presented to the spine clinic with new-onset pain in her right leg, accompanied by paresthesia. There were no bowel or bladder symptoms. [nejm.org]

CLINICAL FEATURES: A 31-year-old man presented with severe lower back pain and pain, paresthesia, and plantar flexion weakness of the left leg. [ncbi.nlm.nih.gov]

His history was significant only for a spontaneous onset of lumbar back pain noted immediately after awkward bending six months prior, followed two to three days later by severe leg pain, paresthesias and ankle weakness, consistent with an L5 radiculopathy [cmaj.ca]

Foot drop is defined as inability to dorsiflex the foot at the ankle joint. [ncbi.nlm.nih.gov]

In those with severe extensor weakness, especially painless foot-drop, diskectomy does not improve the outcome.” Discrimination between foot drop and severe extensor weakness may not be possible or reasonable. [healio.com]

Weakness in the foot is especially common, with difficulty lifting the foot (known as foot drop) often reported in those with L4/L5 herniation. [sportsinjuryclinic.net]

Additions symptoms of lumbar spondylosis include: Localized pain Pain after prolonged sitting Worsening pain after repeated movement Muscle spasms Regional tenderness Tingling, numbness in the limbs Weakness of affected limb due to possible nerve compression [bodhiwellnesscentre.com]

We report a 45-year-old male who presented with sudden onset right lower limb weakness after lifting heavy weight. Magnetic resonance imaging of the cervical spine showed C5/6 disc prolapse with intradural extension. [read.qxmd.com]

[…] non-draft ICD-10-CM) 2017 (effective 10/1/2016) : No change 2018 (effective 10/1/2017) : No change 2019 (effective 10/1/2018) : No change Disorder (of) - see also Disease disc (intervertebral) M51.9 Neuritis (rheumatoid) M79.2 ICD-10-CM Diagnosis Code M79.2 Neuralgia [icd10data.com]

Community Wiki Code: M54.16 Code Name: ICD-10 Code for Radiculopathy, lumbar region Block: Other dorsopathies (M50-M54) Excludes 1: current injury - see injury of spine by body region discitis NOS (M46.4-) Details: Radiculopathy, lumbar region Excludes1: neuralgia [aapc.com]