Help on follow up to Bad week.

[mathematics]

After getting an MRI at A and E urgently referred by chiropractor it appears there are things wrong and one of them is a bony infarction of the lower lumbar vertebrae L4. my husband is having trouble walking anyway due to SPMS he is also having excrutiating pain so popping pain killers, and has no reflexes on his right knee and right ankle and feels numb and sore in his nether regions down below. We have been told by the brilliant nursing practitioner at A and E to nag our doctor for urgent referrals to orthopedics and neurology. But our GP at present is still waiting to see what A and E do as she said they will refer not them if there is a problem. Feeling very frustrated however going to return to chiropractor and go to physiotherapy on the NHS and see where we can go. At least he is able to sleep at present and tramadol is giving some relief but any mobility is causing pain and problems.

[AquaZumbaFan]

I am so terribly sorry to hear this but at least maybe you’re on the right track to get the help he needs. Did they mention this can be a side effect of heavy steroid use? This is something I have worried about my bones as with having MS so many years that has been the solution to a lot of the problems that I’ve had. It seems like PT should help quite a bit. Sending up magical healing thoughts… And I pray that you can both get some rest! You would think with an abnormal MRI like that somebody would refer you to ortho . Please let us know how he’s doing and try to take good care of yourself as well.

[mathematics in reply to AquaZumbaFan]

Thank you so much for your kind words

[Frances_B]

I am not a doctor but I know from my own researches (in appropriate places I might add!) that dropped reflexes and bad leg pain and numbness in what is known as the "saddle area" can be symptoms of a condition called cauda equina - and it needs to be followed up on ASAP - the nurse practitioner is 100% right and you do need to nag your GP very loudly and long to get some action on this - maybe kick them up their metaphorical backside.

Chronic Cauda equina can be managed to a certain extent with physio (not chiropractor - at least the chiropractor knew the limitations of their scope of practice and of the potential that they could do more harm if they did not refer their patient on for appropriate tests/ treatment). However, cauda equina does have the capacity to cause permanent and irreversible damage if not monitored very carefully. Despite what the Spine Health website on the link below says, surgery is not used anywhere near as much as it used to be because it can cause as many problems as it solves, however, the explanation of what cauda equina is is very clear.

spine-health.com/conditions...

Although not mentioned, gait and mobility problems caused by conditions such as MS or cerebral palsy which make people walk weirdly and use their muscles wrongly/ badly/ strangely can be a contributing factor to developing cauda equina and other spinal problems.

It sounds from your post that A&E seems to think your GP should be doing the referrals to orthopaedics and neurology/ neurosurgery for assessments while your GP seems to think that A&E should be doing them but someone needs to take responsibility for these and if your GP says it is A&E who should do them then your GP needs to nag A&E to get them done.

[mathematics]

Thank you they did check it out apparently on the mri and he has not got this it is not pinching his nerve but they were checking it out at a and e. There was a number of things wrong and the bone infarction was just one of them. Going to have to push to find other results. It is restricting his mobility which has already been assessed as an edds 6. I have been in touch with his MS nurse who thanked me on the up date. Thank you again for this useful info. We may have to go to PALs to get referrals eventually if GP does not respond.