Neurological Disorders Online Doctors Consultation — page 3

Hi Ruthra, from whatever you are describing and considering your profession involving meeting deadlines, stress and higher screen times, you might be suffering from Tension headaches. When it's recurrent, it is very disabling and difficult to manage without treatment. Management includes 1) Stress management using relaxation techniques 2) For prophylaxis - low dose Amitriptyline or Propranolol or Flunnarizine for few months I hope this answers your question. Regards.

Shahid, I can completely understand how frustrating and exhausting it must be to deal with constant pain for two years. Living with discomfort 24/7, not being able to stand for more than 10 minutes, and now experiencing pain radiating to your thigh must be affecting your daily life in every way. Since your MRI confirmed L4-L5 and L5-S1 disc prolapse with vertebral canal stenosis and loss of lumbar lordosis, and despite medications and exercises, you’re still struggling, it’s time to reassess things. 1. Pain & Nerve Involvement – Since the pain is now radiating to your thigh with movement, it suggests nerve compression is worsening. NSAIDs helping but not completely resolving the pain means inflammation is still a factor. 2. Sacroiliitis Symptoms? – Morning stiffness in your SI joint region that improves with NSAIDs does resemble sacroiliitis, but we need to confirm it with a clinical examination and MRI of the SI joints. 3. Why No Relief from Treatment? – When pain persists despite NSAIDs, pregabalin, methylcobalamin, and physiotherapy, it means either the nerve compression is severe, or the current approach needs modifications. What You Can Do Now: 1. Stronger Pain Management: Since your pain is constant and affecting mobility, epidural steroid injections or nerve root blocks could help in reducing inflammation and nerve irritation. 2. Revised Physiotherapy Approach: Your current exercises may not be effective anymore. McKenzie therapy, core strengthening, traction therapy, and hydrotherapy (swimming, water exercises) could be more helpful. 3. Surgical Consideration: If pain is significantly limiting your daily activities, a microdiscectomy or laminectomy could be an option to relieve nerve compression. 4. Checking for Sacroiliitis or Ankylosing Spondylitis: Since morning stiffness in the SI joint region is present, we should rule out seronegative spondyloarthropathy with HLA-B27 testing and MRI of SI joints. 5. Lifestyle Adjustments: • Avoid prolonged sitting, standing, or lifting heavy weights. • Use lumbar support while sitting and maintain good posture. • Try an anti-inflammatory diet (foods rich in omega-3, turmeric, and ginger). • Swimming or water therapy can reduce strain on the spine while keeping you active. What’s Next? Since your pain is worsening despite treatment, I strongly recommend a follow-up MRI and consultation with a spine specialist. If sacroiliitis is suspected, a rheumatologist’s opinion will be helpful.

Hello Mr.Vishal. Persistent anxiety could stem from depression, anxiety disorders like generalized anxiety, social anxiety or panic disorder. It may be due to faulty neurocircuitry or imbalance of neurotransmitters in the brain. This requires treatment with anti-depressants like SSRIs/ SNRIs. Zapiz 0.5mg can only provide temporary relief and do not provide any long term solution for your problem. And such low doses of Zapiz would not affect the liver. Kindly consult psychiatrist for further evaluation and asssessment of your anxiety. Regards, Dr. Charan Kumar, MD Psychiatry (NIMHANS).