SACROILIAC JOINT PAIN- PRESENTING AS SCIATICA- A COMMON DIFFERENTIAL DIAGNOSIS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 12
Abstract
PRESENTATION OF CASE A 72-year-old elderly male, 5 feet 7 inches in height, thin built, weighing 58 kg, farmer by occupation came to our pain clinic for chronic and severe left leg pain along with mild to moderate low back pain for past two and half years. Patient gives history of fall on buttock in March 2013. Patient was operated for a herniated disc at L4-L5 in 2015. After surgery pain did not subside. After trying number of conservative modalities for pain management (physical therapy, analgesics and adjuvant medicines), patient was referred to a psychiatrist. Signs of psychopathology were absent. Then patient was referred to our pain clinic. Leg pain was more than back pain. Pain started in the low back on the left side and referred to left buttock then to the back and along the side of the left leg, ankle and lateral side of the left foot. Pain intensity was 8 out of 10 on numerical rating scale (NRS). Pain and discomfort were sharp, continuous and severely disturbing his sleep pattern. Quality of life was affected significantly. Pain was aggravated on sitting for long, standing, and change of position from sitting to standing. Pain increases on walking and patient feels heaviness as well as weakness of the leg. Patient prefers to sit for few minutes to take rest and then can walk again. Low back pain is mostly on the left side and increases on sitting especially crossed leg within 4-5 minutes. He gets pain on change of position from sitting to standing. Pain also increases significantly on climbing the stairs and prolonged standing. Pain is relieved partially with lying down. Pain is maximum in the morning hours and feels better as the time passes. There is no history of trauma, infection or fever. No Red Flag sign seen. There was no history of any other comorbidities or medical illness. Treatment was already started by the psychiatristPregabalin 75 mg once daily, combination of Tramadol Hydrochloride and Acetaminophen tablet twice daily, Tablet Amitriptyline 10 mg once daily at night. But there was no relief at all despite of continued treatment, so patient was referred to our pain clinic.
Authors and Affiliations
Asha Satish Barge, Satish Mahadeo Barge, Siddhesh Satish Barge
Keywords
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- EP ID EP555656
- DOI 10.14260/jemds/2019/211
- Views 76
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