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27 y.o. male large l5-s1 herniation and calf muscle weakness

Been struggling with disc issues and sciatica for about 4 months now. However about 5 weeks ago it got much worse. Walking, which was never an issue before, was very painful -- about 7-9 out of 10.

Got MRI done 2 weeks ago and confirmed "very large" 12mm l5-s1 right side disc herniation with annular tear impinging on the nerve root. No other complications shown on MRI. Had follow up with GP and waiting to see specialists. I'm in Canada though so that may take a while.

My theory is I had a bulging disc before, and that it ruptured 5 weeks ago.

Since then my walking has improved, I'm no longer limping but the pain is still there -- about 2-5 out of 10. Pain typically goes up the more I walk. I've been at this same level for about 2 weeks. Pain goes all the way to my foot. Foot often has tingling pain and one section of it has intermittent numbness. I'm lucky in that most of the time I can lie on my back with little / no pain, though the pain often gives me trouble falling asleep.

The thing that concerns me the most is my calf muscle weakness. It is not severe, but its definitely there. With my right leg I can only do about 1/2 of a calf raise without any help from the rest of my body.

I'll be hearing from some specialists (hopefully) soon, but in the meantime I am trying to suss out my decision making process re: surgery/no surgery. With the information and past stories here I'm finding it could really go either way. On the one hand my herniation is large (12mm) and "Severely" impinges the nerve root. I have pain walking and thus trouble functioning normally. And I have muscle weakness and some foot numbness.

On the other hand, my symptoms are improving at least for now, and I don't have many of those supposed key surgical signs (foot drop, loss of bowel, permanent numbness, severe muscle weakness). My thought process now is that I would push for surgery only if I stagnate for about 6 months, or if it leads to a lower chance of permanent damage.

I'm curious if anyone has a similar set of symptoms, specifically the calf muscle weakness and herniation size, and what they eventually decided/how they're faring now. I will keep updating this post until my (hopeful) recovery.

thank you all,

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  • Hello Recoverpls

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  • wajihwwajih torontoPosts: 27

    Hi Recoverpls

    I had 22 x 8 mm at L5/S1 two years ago which has gone down to 11 x 4 mm on its own. I still have back and radicular pain. Calf weakness comes and goes but mostly OK. I happened to be in Canada as well and let me tell you that that I have been refused 5 times for surgery since the back symptoms are more dominant than the leg foot or thigh. Just a heads up that when you see the specialist you probably would not hear an option but a decision. Honestly, if I was given a choice I would have said yes to surgery. 12 mm is usually the base of disc you also need to know what is the AP size (anterior posterior or front to back). If you are in GTA area then I can only wish you good luck as The wait time for neuro/orthopedic surgeon is terrible and whenever you see one please ensure that you do not leave until the specialist completely satisfies you for whatever decision he makes. Meanwhile keep managing the pain with the help of your family doctor.

    I hope it helped

    Good Luck and wishing you have a good recovery

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  • Hi there,

    Sorry to hear about your pain. Yet, it sounds encouraging to me that you feel like there is an improvement.

    Herniations many times do not need surgery and may resolve over time - although many people find they need a long recovery time.

    My thoughts would be that you may want to try and understand what habits/moves in your daily life may contribute to the original source of herniation - for example bending forward when tying your laces or hovering bent forward around the sink when brushing your teeth - and consider correcting those habits/postures so that you do not further contribute to the pressing of the disc and allow it to relax and hopefully heal. I've just finished reading the book of Stuart McGill and he's got quite a lot of info there about how to move correctly and how to go about your ordinary life in a "back friendly" way. You can check out some of his YouTube videos which are very interesting.


    I wish you the best of luck!

  • I also have a bulging disc L5-S1 for 10 months now and it took 4 months and a CT scan to find the cause of my leg pain. I'm also in Canada and they said I didn't need a MRI as they could see the significant bulge from the CT.

    After unsuccessful treatments that included acupuncture, PT, IMS, medication for 7 months, I was progressively getting worse from May. I thought that I had a bladder issue due to this nerve issue so I went to the hospital. They didn't do anything for me and told me that it was not due to my nerve. Less than a week later I was still having a bladder issue so I went back to emergency but had a different hospital. I didn't have to push them and they were in agreement that I needed to be referred to a surgeon. The good thing was my bladder issue was not related to my nerve issue. They gave me the name of the surgeon they were going to refer me to.

    After about a week I called the surgeons office to follow up when I would get an appointment. His assistant has been amazing and she managed to get me in for an appointment in one month. The resident saw me and asked me a number of questions and he told me that it was likely that they would suggest surgery since nothing had helped with my leg pain and it got worse.

    The surgeon came in and showed me my CT scan and he asked me to do a few movements. He suggested surgery and that it could happen in the fall. This was a lot sooner than I expected.

    My symptoms included numbness on the bottom of my foot, loss of calf muscle, leg pain on the back of my thigh and pain on my glutes on the right side. It has only been in the last three weeks that I have seen improvement and less pain. I think it is the Lyrica that has help me. I'll see my surgeon next week to talk about if he still thinks I should get surgery next month.

    Being in Canada the waits can be really long. I would recommend that you be assertive with the medical staff to make sure you get an appointment with the surgeon.

  • Wow thanks for all the replies and advice - really really helpful. Especially the tips on how to navigate the Canadian medical system as I really have no idea what I'm doing here. I'm still waiting for a call for a specialist appointment through the centralised public system here.. I did however find a way to make some appointments with ortho surgeons through PT clinics here. I'll be seeing one next week and another hopefully next month.

    Wajih - I checked my MRI report again for the AP size, and yeah it is 12mm in the AP plane. I guess that qualifies as "very large" herniation. Glad to hear yours shrank so much that's encouraging, though it sounds like I'm in for a long road to recovery just as you are.

    I'm at week 7 now since the worst of it and I can say I'm still seeing improvements. It's quite slow, but definitely improving. Walking is slowly getting better I would say its between a 1-4 out of 10 now, though I have to walk slowly and haven't done anything longer than 20 minutes. Intermittent numbness in foot is all but gone, tingling pain is less and less frequent. Calf weakness is the same though, or at least no noticeable improvements.

    I've read some studies online that suggest large herniations with annular tear have greater potential to improve and shrink because your immune system is more likely to recognize it as a foreign body and eat away at it. Maybe that is the silver lining to having such a large herniation.. who really knows though it seems like there are still a lot of unknowns with how these things heal..

    I'm lucky bc I work as a software developer, and my company is OK with me working from home. I basically have not sat down at all for 7 weeks now. I've also been able to keep my nutrition, hydration, and sleep at optimal levels and I think that's helping a lot. I've started PT again and this time I really pushed for someone with a lot of experience who specializes in dealing with these issues.

    Violet96 - that sounds really rough, glad to hear you are finally getting some improvements. I'd be curious to hear what you end up doing with regards to surgery, it sounds like we have a similar situation. I think you're right about the assertiveness I'm afraid I wasn't assertive enough when I saw the family doctor and my referral for a specialist will just sit in a waiting list for months and months.. even though I could barely walk at the time. Good luck!



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  • I have L5S1 excruite L4/2

    seeing neurosurgeon 31st and timberline physical therapy specializing in the McKenzie method. (bending forward is a no no),I found really helpful videos on YouTube of people with this injury and those using the McKenzie method. I'm going to stay in prayer and ask the LORD for guidance because this is above my pay grade as they say. I'm using gabopentin for pain,hot water bottle through out the day,ordered an ice bag,laying on my back with knees up like if I had a foot stool under them,log rolling in/out of bed,leading with my right leg to take pressure off the effected area,not bending head down when eating or reading but bringing it up to eye level,tense unit,essential oils,supplements,eating healthy,moving body all at once instead of twisting at the waist,not lifting anything heavy above the waist or lowering anything heavy without bending my knees and sqauting,using my hips to pick stuff up instead of legs. so many bad posture habits I've developed over the years, I've taken my body for granted. I hope this helps and I sure would appreciate any support. thanks and I'll keep you all in my prayers.

  • Hi!

    Sorry to hear what you are going through I went through the same thing over a year with having my left leg sleeping. I’m currently 3 weeks out of surgery I had a PLIF & ALIF fusión on L5-S1 on 10/5. I’m 33 yr old female and I have a double a curve Scoliosis with my lower curve being 58’ my left entire leg from my left lower back to my toes slowly began getting worse and worse it became very debilitating I felt numbness everywhere that would get extremely intense with walking, sitting, standing and lifting. It made my everyday life a huge struggle and very painful. I did everything to get better got the MRI, did PT (this made it worse) got epidural injections, steroid injections wore a brace and have seen several Dr. since my spine at the very bottom is so extremely twisted it was the source of the pain. Ultimately my physicians said if I didn’t get the surgery I would deteriorate over time and could possibly lose function of my leg. All prior treatment provided no relief and I didn’t want to be on pain medication since it makes me very sick. After a year of treatment and nothing provided relief and my leg got worse everyday I couldn’t take it anymore and decided surgery was the best option. I’m glad I did it surgery was honestly the worst pain I’ve ever been through but everyday I’ve gotten a little better and I can already feel that my leg is 70% numb free! My Dr said that the cause of the pain was from my scoliosis pretty much my bones on my lower spine by l5-s1 was so twisted my nerves where being pinched by bone against bone. I hope you recover soon and wish you all the best.

  • I hurt my back playing football in early July. My back felt weak and the muscles cramped, And then I woke up on 31st July and could not move my right leg properly. I then began to suffer excruciating pain in the leg, mostly hamstring and calf muscle. I could not stand straight and was literally crawling to the bathroom. The rest of the time I lay curled up in pain.

    MRI showed that I have a large herniation of L4/L5 compressing S1. The last two toes on my right foot were also numb and I had a lot of tingling in my foot. The pain in the calf was like broken glass. I immediately received an epidural steroid injection which gave me some immediate relief. I could walk with a limp and the pain halved. Then I got really sick. Unbearable headaches, high blood pressure and high pulse rate. Drs put this down to a spinal fluid leak caused by the injection. It took me over a month to recover. Although, I still have concerns that it may have been a reaction to the steroid.

    Toward mid-September I tried to get my life back on track but everyday I had pain and the basic plan was to somehow cope, get home from work and curl up in a ball. I took painkillers when the pain was unbearable but for the most part the pain became part of my daily existence. The pain is leg pain, that makes even a light cough unbearable. I tried PT but not much use. Then I noticed my right buttock had basically deflated (atrophy) and at that point I thought surgery is inevitable.

    I then did a lot of research and, as recoverpls points out, large herniations can retract, if the body recognises them as foreign. Or they can dry up. A consultant I spoke with also told me that large hernias do retract but patience is required. He said it only takes a couple of millimetres and I might not feel any pain. I also discovered that I was taking painkillers incorrectly, as I was only taking them on pain rather than loading myself daily thus giving my body time to recover.

    So, I now have a two month plan. I am on a course of painkillers (medium strength) daily, and this has already allowed more movement. The movement will help the recovery. I exercise as per advice found online (exercises seem standard) and I can see muscle improving in my buttock. I had also suffered severe weakness in the calf in that I could not even lift my heel. I can now lift it almost as much as my good leg but it requires a lot of effort. I no longer walk with a limp, which should help bring back strength in my leg. I also bought a TENS machine which I take everywhere to help massage and stimulate the small muscles in the back, my buttock and hamstring.

    I am hopeful that the body can heal itself, given time and reduced stress. Obviously the pain is disguised but the medication reduces the stress. I can now feel a lot of muscle recovery. However, frequent tingling down my leg reminds me not to over do it. I have gone from running regularly, playing football and skiiing to learning to walk again. Recoverpls please keep me up to date on your progress as I think our injuries are very similar.


  • @blairpup that's great to hear you are doing some exercises. My PT showed me some to strengthen my core and glutes. I squeeze my glutes a lot now! I also do a pelvic lift that I think helps.

    @recoverpls I talk with the surgeon tomorrow. What province are you in? I'm in AB and wait times for a surgeon can be 6 months so if things don't improve, be assertive to get a faster appointment. I also work from home and self employed but so lucky I can still work! Keep up with the daily exercises, I didn't think they helped after 5 months but maybe that's how long it takes to improve and I can even sit at the kitchen table to eat now! Miracles do exist!

  • blairpupbblairpup Posts: 1
    edited 10/30/2017 - 3:54 PM

    @Violet96

    I spend most of my free time on the floor doing pelvic exercises and I think the TENS machine is helping the bloodflow in my lower back.

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