Leg cramps

[Dr. Ice]

Have a patient with moderate lumbosacral stenosis that I did bilateral S1 tfesi about 6 weeks ago with good relief of radic symptoms but consistent cramping throughout legs after the procedure. Encouraged hydration and after two weeks symptoms persisted. EMG was normal, started low dose neurontin without much benefit. Any thoughts on this? More time? Referral to neurology?

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[lobelsteve]

A whole class of meds exist for this.

 

[RoloTomassi]

I see this sometimes after esi but 6 weeks a little long. Rec K + Mg OTC

 

[bedrock]

Have a patient with moderate lumbosacral stenosis that I did bilateral S1 tfesi about 6 weeks ago with good relief of radic symptoms but consistent cramping throughout legs after the procedure. Encouraged hydration and after two weeks symptoms persisted. EMG was normal, started low dose neurontin without much benefit. Any thoughts on this? More time? Referral to neurology?

Which steroid was used ?

 

[Dr. Ice]

Which steroid was used ?

Depo 40mg

 

[bedrock]

Depo 40mg

Depo causes more cramps (as someone who uses a lot of depo).

I haven’t one go that long, but I have had patients where this resolved after I repeated the ESI at S1 with dex or beta or at L5 with dex.

 

[clubdeac]

Yeah I see this more with depo in stenotic patients. I recommend tonic water, magnesium and baclofen or tizanidine

 

[Ducttape]

studies have shown that tonic water really only works when it is mixed with Tanqueray. or Bombay Sapphire.

 

[Dr. Ice]

studies have shown that tonic water really only works when it is mixed with Tanqueray. or Bombay Sapphire.

Or grey goose