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【PhD Win Medical Case】Sudden sharp pain| Burning/radiating pain| Numbness and pins and needles| Constant fatigue in R leg for 6 years
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He sent us an email one week ago, and told us his medical history. He wanted to make an appointment.
“Hi there,
My name is M and I am contacting you to request an appointment as my stepfather has highly recommended your services.
I have suffered back pain since 2018. I have been referred to multiple physiotherapists, a chiropractor, an osteopath, an Orthopaedic & Spinal Surgeon, and a rheumatologist with limited success or relief.
Current symptoms:
Sudden sharp pain through my lower back
Burning/radiating pain through my right buttock, in my right knee, and all the way down my right leg
Numbness and pins and needles in my right buttock, right calf, and right foot
Constant fatigue Stiffness and difficulty walking. Waking up stiff and sore.
I look forward to hearing back from you regarding your availability.
Thanks”
Blow is the his leg pain history of diagnosis and treatments.
January 2018
Fall off deck on NYE.
Visited Physio for treatment for lower back pain.
March 2019
Sitting at work with sudden searing back pain and numbness down my right leg and foot.
Visited White Cross and was treated for sciatica.
August 2019
Visited Physio for further treatment.
Referred to Orthopaedic & Spinal Surgeon by GP.
MRI comes back normal.
February 2021
Visited Chiropractor for treatment/attempted relief from pain. Massage & adjustments.
September 2022
Visited Osteopath for treatment/attempted relief from pain. Massage & acupuncture.
Visited Physiotherapist treatment/attempted relief from pain. Massage & acupuncture.
Referred to Rheumatologist by Osteopath.
MRI comes back normal.
December 2022
Referred for nerve conduction study by Rheumatologist.
Nerve conduction study comes back normal.
January 2023
Informed of Ankylosing Spondylitis in the family (maternal grandmother, aunty and cousin).
Blood tests. Inflammation markers are normal. HLA-B27 negative.
February 2023
Back to Physiotherapist treatment/attempted relief from pain. Massage & acupuncture.
October 2023
Terrible pain flaring again. Radiating pain through my right leg and my back and dull pain down my right arm.
February 2023
Terrible pain flaring again. Return to physio for massage treatment through February, April, June.
July 2023
Pain continues and worsening. Dry needling and cupping treatment.
2024 Current symptoms:
– Sudden sharp pain through my lower back
– Burning/radiating pain through my right buttock, in my right knee, and all the way down my right leg
– Pains that feels like it’s inside my kneecap
– Numbness and pins and needles in my right buttock, right calf, and right foot
– Constant fatigue
– Stiffness and difficulty walking. Waking up stiff and sore.
I feel I have had limited success with Paracetamol, Ibuprofen, Gabapentin, Norflex, Diclofenac, Celecoxib and Amitriptyline.
Codeine provides short-term relief.
He came to see me today. I performed a neurological examination.
The Straight Leg Raise Test was negative.
The right knee reflex, Achilles reflex, lower limb sensation, and lower limb muscle strength were all normal.
There was tenderness in the right buttock, radiating to the right lower leg.
Sensation in the right buttock was normal.
I think it is pseudosciatica.
I used a long needle, inserted it deeply at two points【居髎,环跳】, touched the bone surface, performed minimal manipulation, and withdrew immediately.
He felt the right leg was light and warm.
What do you think about his right leg pain?
Please leave your opinion here, thanks.
After three sessions acupuncture he feels much better, it is almost normal.
So Accurate diagnosis is the key to accurate treatment. This patient exemplifies it perfectly
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