Q I have been having some stiffness in my back and pain in my butt/back radiating in the back of my thigh and occasionally below my knee. What could this be?
A This type of pain is consistent with nerve compression coming from the low back. It may be worse with coughing or sneezing and can be associated with weakness, numbness, and tingling. The pain usually will improve in the first four to six weeks. Steroid injections are moderately successful for mild to moderate compression. However, if it is worsening and/or there is simply too much pain to deal with, I would recommend evaluation by a doctor for medications, physical therapy, and consideration of an MRI. I would not recommend an MRI initially unless there is severe pain and weakness. If the pain is persistent despite reasonable care then an MRI should be sought to rule out severe compression. If severe compression is found, consider outpatient micro surgical decompression. Newer techniques involve stereotactic guidance as well as microscopic approaches which improve the accuracy of the decompression as well as expedite the recovery.