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Severe Pain on back, buttock and legs
My mother's MRI (Feb) shows: Mild L5–S1 retrolisthesis, Modic changes, L3–4 left foraminal disc protrusion, and L4–5/L5–S1 disc prolapse with caudal migration causing severe foraminal stenosis.
She has pain mainly in the buttock radiating to the leg. She is currently taking Nervite Plus, Gabapin-NT, and Vitamin D3 60,000 IU. The pain has reduced slightly but is still persistent.
Would you recommend any change in medications (add, reduce, or switch), or any specific physiotherapy/exercises that are safe and effective?
Any lab tests to do for check-up the parameters???Please tell me best possible way...
Your mother’s MRI shows multilevel lumbar disc disease with severe foraminal stenosis at L4–L5 and L5–S1, which explains the buttock pain radiating to the leg (sciatica). Since she has experienced only partial relief with medications, it is important to reassess her clinically rather than simply changing medicines.
Physiotherapy focusing on McKenzie extension exercises, core strengthening, hamstring stretching, and nerve-gliding exercises may be beneficial if performed under the guidance of a trained physiotherapist. However, exercises should be individualized, as some movements can worsen symptoms in severe stenosis.
Next Steps
She should undergo a detailed neurological examination to assess for weakness, numbness, or reflex changes. Routine blood tests such as CBC, ESR, CRP, Vitamin B12, Vitamin D, HbA1c, and renal function tests may be considered depending on her overall health and medications, but they will not determine the severity of nerve compression. If pain persists despite adequate conservative treatment or if she develops weakness, an epidural steroid injection or surgical decompression may need to be considered. You can also book an online consultation with me and share her MRI images, current symptoms, and examination findings so I can review whether continued conservative treatment or surgical intervention is more appropriate.
Health Tips
Avoid prolonged sitting, forward bending, and lifting heavy weights. If she develops progressive leg weakness, numbness around the groin, or loss of bladder/bowel control, seek immediate medical attention as these require urgent evaluation.
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