Hello Thanks for sharing all these details—chronic back pain with new leg symptoms can be frustrating, especially when you’re waiting for specialist care. Here’s how to think about your situation:
### Should You Go Back to Your GP? Yes, it’s reasonable to go back to your GP, especially since: - Your back pain has lasted 14 years, but the leg pain and nerve symptoms (numbness, tingling) are new and only partly improved. - You haven’t had a physical examination by your GP for this episode. - There’s a difference in opinion between your doctor and physio.
A GP review can help: - Reassess your symptoms and do a proper physical exam. - Decide if you need imaging (like an MRI) sooner, especially if nerve involvement is suspected. - Adjust pain management or refer you more urgently if symptoms worsen.
### What to Watch For (Red Flags) Go back to your GP or seek urgent care sooner if you develop: - Weakness in your leg or foot (difficulty walking, foot drop) - Loss of bladder or bowel control - Severe, worsening pain or numbness
### In the Meantime - Continue with physiotherapy if it’s helping. - Use gentle stretching, heat/cold packs, and avoid activities that worsen pain. - Maintain good posture and avoid prolonged sitting or heavy lifting.
Summary:
It’s worth going back to your GP for a re-evaluation, especially with your long history and new symptoms. This can help clarify the diagnosis and ensure you get the right treatment while waiting for your specialist appointment.
Thank you
Given the complexity and persistence of your symptoms, yes, it would be advisable to go back to your GP. While the private physio’s assessment of hyperlordosis is helpful, it’s important to have a comprehensive and coordinated approach to your condition, especially since you have a long history of back pain and newer symptoms in your leg. Your GP can review the diagnosis, consider any necessary imaging or further tests, and discuss the physio’s findings. The GP may consider if other conditions could be contributing, or if adjustments to your treatment plan are needed. It might be beneficial for your GP to reassess whether the referral to the back clinic should be expedited given the chronic nature of your pain. Discussing this with your GP might help in getting more integrated care and possibly earlier intervention if needed. Additionally, if you notice any worsening of symptoms or new symptoms like increased numbness or tingling, prompt medical review is always a wise approach. Addressing potential lifestyle factors—like posture, occupational hazards, or exercise routines—can also be valuable. Continuing with the exercises or recommendations from the physio should be discussed, as these might need to be tailored to your current situation. In the meantime, monitor for red-flag symptoms such as significant weakness, bowel or bladder dysfunction, or sudden, severe pain which would require urgent attention. Bringing any relevant reports or notes from your physio to the GP appointment could also provide additional insight into your treatment so far.
Hello
Yes, it would be reasonable to go back to your GP, especially since you have had lower back pain for 14 years and newer leg pain for 2 months.
Hyperlordosis can contribute to back pain, but it does not necessarily rule out nerve irritation. In fact, pain radiating into the groin, calf, shin, and ankle, along with previous numbness and tingling, can still be consistent with nerve involvement. A physiotherapist and GP may be looking at different aspects of the problem, and both explanations could be partly correct.
Since your symptoms have persisted for a long time and you have not had any imaging, your GP can reassess you, perform a physical examination, review the physiotherapist’s findings, and decide whether further investigations or an earlier specialist referral are warranted.
The fact that physiotherapy has improved the numbness and tingling is encouraging and suggests a conservative approach may be helping. Continue the exercises recommended by your physiotherapist unless they worsen your symptoms.
Seek urgent medical attention if you develop new or worsening leg weakness, numbness around the groin or buttocks (saddle area), loss of bladder or bowel control, or severe worsening pain.
Otherwise, arranging a follow-up with your GP to discuss the ongoing symptoms and the physiotherapist’s assessment is a sensible next step.
Take care Feel free to reach out again
Hello, Yes, I do think it is reasonable to go back to your GP, especially given that:
• Your lower back pain has been present for 14 years. • You have developed new leg symptoms over the last 2 months. • You have not had any imaging studies done. • The diagnosis remains uncertain (possible nerve irritation vs mechanical/postural issues such as hyperlordosis).
It’s worth noting that these explanations are not necessarily contradictory. Hyperlordosis can alter the mechanics of the lower back and may contribute to irritation or compression of nerves. Therefore, your GP’s suggestion of nerve irritation and the physiotherapist’s observation of hyperlordosis could both be relevant. The improvement in numbness and tingling with physiotherapy is reassuring and suggests that conservative treatment is helping. However, the persistence of pain in the groin, calf, shin, and ankle indicates that further assessment may still be warranted.
When you see your GP, I would specifically mention: • The 14-year history of lower back pain. • The newer leg symptoms (2 months duration). • The previous numbness and tingling. • The physiotherapist’s finding of hyperlordosis. • That you have never had imaging performed.
Your GP can then decide whether imaging (such as an MRI of the lumbar spine) is appropriate, particularly if nerve involvement is suspected.
Prescription/Advice: • Continue the physiotherapy exercises that have been helping. • Avoid heavy lifting and repeated bending where possible. • Maintain regular gentle activity rather than prolonged bed rest. • Follow up with your GP to discuss the ongoing symptoms and whether further investigation (especially imaging) is needed. • Seek urgent medical attention if you develop new weakness in the leg, worsening numbness, saddle numbness, or any bowel/bladder control problems.
Overall, because the leg symptoms are relatively new and you have never had imaging despite many years of back pain, a review with your GP would be a sensible next step.
Feel free to reach out again.
Regards, Dr. Nirav Jain Family Medicine Specialist
