To,

The Chief
General Medicine

CC:
Dr.Vordoraj
Kanyakumari Government Medical College, Tamilnadu,India.

H/O :
Prolonged Disruptive pain due to the Spinal cord Multiple disc herniation
I have been experiencing severe low back pain since 2019, attributed to disc herniation. The
affected discs are identified as L4, L5, S1, and S2 , and C1 C2 C4 , L4 L5 S1 S2 from the MRI
image administered in 2019, and in 2021 respectively.
I do report persistent and aggressive low back pain, and also pain across entire
Trapizius,Latissimus, Gluteus maximus area/muscles and radaiating down to the foot which has
intensified over time. The pain is described as sharp, shooting, and debilitating, often radiating
down to both legs. Additionally, I do experience numbness and tingling sensations in the lower
extremities, along with weakness in the affected areas. The severity of symptoms has
significantly impacted the my quality of life, leading to limitations in mobility and daily
activities. I couldn’t even walk for 2mints , or to sit for 2 mts continuously.
I am struggling a lot. It makes me bummed out.

Treatment History:
Physiotherapy: I had undergone physiotherapy sessions ( IFT, TENS, THERMOGRAPHY, WAX
PATCH) in the past to manage symptoms and improve mobility. However, there has been no
significant relief observed, and the pain has persisted despite consistent efforts.
Medication: Various pain medications, including NSAIDs, muscle relaxants, and
opioids( Gabapentin NT , Pregaba NT), have been prescribed to alleviate symptoms. While
providing temporary relief, these medications have not addressed the underlying cause of the
pain.
Injections: Epidural steroid injections have been administered to reduce inflammation and
alleviate pain in the affected area. While initially providing some relief, the effectiveness of these
injections has diminished over time.No use at all.

I had consulted with orthopedic and neurosurgical specialists regarding the possibility of surgical
intervention. However, due to the complex nature of the condition and the risks associated with
surgery, the patient has been hesitant to pursue this option.

Current Condition:
As of the latest assessment in March 2024, I got low back pain escalated to a more aggressive
and debilitating level. Despite previous treatment modalities, including physiotherapy, the pain
persists and significantly impairs the patient’s ability to perform daily activities.
Conclusion:
I have utmost experience of severe low back pain due to disc herniation has progressed
significantly since its onset in 2019. Despite previous interventions, including physiotherapy, the
pain has become increasingly aggressive, impacting my daily functioning and quality of life.
Further evaluation and exploration of alternative treatment modalities are warranted to address
the underlying cause of the pain and improve my overall well-being.

I am sincerely requesting the chief of Neuro surgery department to fix the pain by surgery. I am
so grateful and thankful to you.

Regards
Scientist.Dr.Yasin, IP#13541
Nagercoil