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Back Problems Message Board

Back Problems Board Index

Hello :wave: Steve,

Welcome to the Healthboards,

I am very sorry to hear that you re-injured yourself. Who would have thought this could happen In rehabilitation. Have you talked with your doctor about your symptoms getting worse? After all attempts have been tried to elevate you pain and strengthen your back, then the doctors' consider surgery.

From what I read there are four stages of disc herniations: (1) disc protrusion (2) prolapsed disc (3) disc extrusion (4) sequestered disc. Stages 1 and 2 are referred to as incomplete, where 3 and 4 are complete herniations. Pain resulting from herniation may be combined with a radiculopathy, which means neurological deficit. The deficit may include sensory changes (i.e. tingling, numbness) and/or motor changes (i.e. weakness, reflex loss). These changes are caused by nerve compression created by pressure from interior disc material. Also the most common cause for emergency surgery is Cauda Equina Syndrome. This occurs from a central disc herniation and is serious requiring immediate surgical intervention. The symptoms include bilateral leg pain, loss of perianal sensation (anus), paralysis of the bladder, and weakness of the anal sphincter.

As for nerve damage, this does occur with herniated discs. The doctor's have no way of knowing if the nerve will indeed heal itself after surgery. I think so much depends on how long the herniated disc has put pressure on the nerve. The main reason why I agreed to my fusion surgery was because of nerve damage progressively getting worse. I still have no way of knowing if my damage is permanent or not.
Here is some information I found that may explain your symptoms a little better:

The two nerves most commonly pinched are L5 (lumbar 5) and S1 (sacral 1). The L5 nerve supplies the nerves to the muscles that raise the foot and big toe, and consequently, impingement of this nerve may lead to weakness in these muscles. Likewise, S1 impingement can lead to weakness with the large gastronemius muscle in the back of the calf, causing difficulty with foot push off

Numbness for L5 runs over the top of the foot and for S1 it runs on the outside of the foot. The S1 nerve root also supplies innervation for the ankle jerk (tap on the achilles tendon and the foot goes down), and a loss of this reflex indicates S1 impingement, although it does not create loss of function.

The nerve consists of one long cell from the back/neck down to the foot/hand, so the nerves tend to heal slowly. They heal from the top down, and depending on how much damage is done at the time the nerve becomes impinged, it may take weeks to months to heal.

Treatment of neural impingement is directed at relieving the pain and then allowing the nerve to heal on its own. Nerves need both inflammation and pressure to be painful, so either relieving the inflammation or the pressure can relieve the pain.

Please keep in mind that before considering surgery you should get at least a second opinion. I wish you the best of luck today with your calf strengthening test.

Take Care.

Lumbar MRI 10/02
Lumbar Lordosis
L5-S1 disc herniation with moderate thecal sac deformity.
L4-5 disc desiccation with bulge which results in mild thecal sac deformity and mild bilateral foraminal stenosis.
L2-3 disc desiccation with Schmorl’s nodule of L3.
Lumbar Epidural 1/30/03
Lumbar Epidural 2/12/03
Lumbar Epidural 2/26/03
Lumbar Discogram 5/23/03
Lumbar CatScan 5/23/03
[b]Posterior Fusion & Infuse on L4,L5,S1 6/30/03[/b]
Cervical MRI 10/02
Loss of cervical lordosis with reversal of the curvature.
C4-5 and C6-7 disc bulges resulting in flattening of the ventral margin of the cord.
C5-6 there is a left foraminal herniation which results in moderate foraminal stenosis In addition, there is flattening of the ventral margin of the cord due to bulging disc.
Cervical Epidural 5/19/03

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