Question
Dear Dr. Margot,

I am coming to you cause i am totally helpless. My wife has been suffering from a severe back pain since she delivered our first baby. We have gone to several doctors here in India and nobody has been able to help us. I am writing to you with a lot of hope and prayer that you can help me help my wife ( Pari Sekhri). I will write to you in detail about the development of her problem in the below lines.

To begin with I would like to take you down her case history so it would be easier for the doctors to understand her case.
This problem which Pari is suffering from started in the 5th month of her pregnancy. It initially started with a slight pain in her left groin area. But over the next few weeks the pain got aggravated which caused her to limp while walking. At that time her gynecologist increased her calcium intake as she felt it was due to a calcium deficiency. But unfortunately that led to kidney stones, so the calcium dosage was thereon minimized.    
With the start of her 7th month the pain started in her right groin area as well and with the passing week   it came on both the outer areas of the thighs. This additional pain went right after her delivery but her pain in the left groin area still persisted very strongly.  
Our Orthopaedic recommended her to get an MRI for her pelvic area, which showed a slight abnormality stating
NOTE IS MADE OF WELL-DEFINED LOBULATED LESION MEASURING APPROXIMATELY 2 *1.8 CM IN LEFT LATERAL AND ANTERIOR WALL OF LOWER VAGINA SHOWING SIGNAL INTENSITY SIMILAR TO SUBCUTANEOUS FAT ON ALL SEQUENCES ? LIPOMA.
NOTE IS ALSO MADE OF HYPERINTENSE SIGNAL IN THE SUBCUTANEOUS FAT OF LEFT UPPER GLUTEAL REGION ON STIR IMAGES POST INJECTION STATUS.
So there on the Orthopedic diagnosed it as an adductor strain for which she was put on FLEXON MR and PAN 40 which is a painkiller and an antacid.
After 2-3 weeks the pain started occurring in her lower back region as well, then on the Orthopedic recommended us to get on to physiotherapy, which entailed  搖ltrasonic rays?, 揑FT?, and Heat packs. But after taking 10-12 sessions the pain had no change rather found an increase in the intensity in the lower back area.
Physiotherapy was thereon stopped and with no effect in the pain the pain killer was changed to MYOSPAZ and MYOSPAZ FORTE along with additional calcium ALFA OSTEOBON  twice a day and was told to wear a brace for my back. Again when the painkillers showed no relief, she was put on a stronger painkiller MEFTAL FORTE and MYORIL (4) along with regular calcium. After that with every passing week the pain spread to the entire back from the lower back, so the Orthopedic advised to get another MRI SCAN done for the L1 to S2 .
On getting the MRI the reports detected a small change which stated
THERE IS STRAIGHTENING OF USUAL LUMBAR LORDOTIC SPINAL CURVE.
L5-S1 INTERVERTEBRAL DISC SHOWS EARLY DEGENERATION EVIDENCED BY LOSS OF HYPERINTENSE SIGNAL OF NUCLEUS PULPOSUS ON T2 WEIGHTED IMAGES. THERE IS MINIMAL DIFFUSE ANNULAR BULGE AT L4-5 AND L5-S1 LEVELS WITH MILD ENCROACHMENT UPON BILATERAL NEURAL FORAMINA , MORE TOWARDS LEFT SIDE AT L5-S1 LEVEL.
On reviewing the reports the Orthopedic couldn抰 understand why the pain was in the entire back whereas by the reports it should only be in the lower back area and with a very low intensity, so he just asked her to continue with the painkiller and wait out for 10 days or go for an injection in the spine.
Not wanting to get any intra venous procedures in the back we consulted another Orthopedic who recommended blood tests like
CBC, CRP, ESR, URIC ACID , RA FACTOR, ANA FACTOR, ANTI CCP ,VIT B12.
On getting these tests all turned out to be normal except high levels of EOSINOPHILS which were 23.60 %. Thus she was put on a new painkiller and muscle relaxant ULTRACET, but again no relief was felt.
With every passing week my pain intensity in her back kept on increasing stopping her to presume regular daily activities and thereon the pain spread to her neck area as well
After seeing various orthopedics  we decided to go to a chiropractor who detected that her  bones have become very weak , started degenerating  and stated she was suffering from a severe case of  osteoporosis thus started doing very severe physio treatments and put her on very strong painkillers such as , ETOBRIX  90, MEDROL 4MG , PRORAB 朌 , CELOL-XT , OSTEOFOS ?35 AND GRANULES CALCIROL .
With these medications there was about a 10% relief for 2 days but then the pain was back again and with the physiotherapy he was giving the pain got unbearable , so we went for a bone density test to find the severity for osteoporosis but the test came back completely normal , with no sign of osteoporosis.
Presently the pain in the neck has also intensified not inabling her to sit for longer than 10 minutes in the car also.

I sincerely hope you can guide me in the right direction

God Bless!!

Siddharth Sekhri


Answer
Hi Siddharth,
  I found your question in our question pool and thought I may be able to help.

Since you have already consulted several orthopedics and chiropractors, I would suggest you consult a neurosurgeon. Consulting a neurosurgeon does NOT necessarily mean surgery. I have learned from my own experience and the experience of others I have talked to that a neurosurgeon can often diagnosis difficult back problems better than any other kind of doctor.

Consulting a pain management doctor may also help.

I hope this helps. If you have any questions or need additional information please don't hesitate to ask.
          Thanks
              Tracy