Low Back Pain and Leg Pain

Added 11 Jul, 2017 [ssba]

Presenting complaint

The patient had been suffering from low back pain and right leg pain of at least 9 months duration. Pain radiated to the outer aspect of his right hip and the lower part of the leg up to the ankle. The pain was exacerbated with standing, sitting, walking, bending and lifting. The patient was unable to carry on with his work as a plumber.


The patient had seen various specialists in the past including the musculoskeletal team, physiotherapists, neurosurgeon and an osteopath. The patient was investigated with MRI scan of the lumbosacral spine which showed wear and tear changes in the lower lumbar discs and the facet joints. At L4/5 level there was a small disc bulge with possible irritation of the right L5 nerve root.

The patient was on a combination of painkillers including Paracetamol, Ibuprofen, and high dose Gabapentin, without much benefit.


The patient saw Dr. Krishna at his private clinic in Bristol, desperate for some pain relief. Dr. Krishna recommended an L5 nerve root block under fluoroscopy guidance to help with the leg pain. The patient was completely pain-free within 48 hours of injection treatment. This improvement persisted beyond 3 months when the patient had a further review with Dr. Krishna. The patient reported the response to the nerve root block as ‘amazing’. He was much more functional now and able to do regular exercise without significant problems.


The patient continues to be pain-free several months after the nerve root block. He gets the odd twinge in his lower back which he is able to self-manage with occasional Paracetamol. He has managed to stop taking Gabapentin completely without any detrimental effects. He has also managed to go back to his job as a plumber.

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