Trapped nerve in back, numb feet!
Moderators: talkhealth, Geckoella
Trapped nerve in back, numb feet!
I have suffered with back pain for 20 years now caused by a trapped nerve (see MRI scan below), the main problem is also that my feet are very numb, especially my right foot, which means that I am unable to drive great distances except just locally.
I had a minor op in 2019 to free the nerve, that did not work and I was told that I would need to live with it!
GP sent me to the pain clinic, they tried various injections, that did not work and I was told that I would need to live with it!
GP then tried Physio, they tried all sorts, non of them worked and I was told that I would need to live with it!
GP has tried various medication including Gabapentin and Pregabalin etc, non of those have helped.
My right foot numbness is getting worse, worried that I may need to consider packing up driving.
Any suggestion's as what to try, below is my MRI scan report.
Here is my complete MRI Scan report, if you can understand it:
His lumbar MRI scan shows scattered aging changes throughout his lumbar spine. He does have evidence of a degenerative scoliosis with the apex in the mid lumbar area convex to the right and there is a fractional curve below with the concavity facing the right side. The degree of scoliosis is not marked but is sufficient to produce foraminal-narrowing at both the L4/5 and L5/S1 levels on the right side. However the foraminal narrowing at L4/5 produces L4 root entrapment and he does not seem to have any relevant L4 symptoms. He also has a Grade 1 degenerative spondylolisthesis at the L4/5 level and not surprisingly there is a bilateral lateral recess stenosis which clearly would produce the L5 nerve root symptom. At the L5/S1 level he also appears to have a small disc protrusion which encroaches to the traversing S1 nerve root and he has a mild degree of lateral recess stenosis at L5/S1 as well so that it would be difficult to tell whether the current leg pain is also contributed to from the L5/S1 level.
As he is primarily a claudicant I reassured him that he does not have any serious pathology responsible for the symptom and there is always an option for him to persevere with conservative care. In the long run injection treatment would have no value and I do not think that a facet injection would produce any positive effect for nerve root symptom as it is designed primarily to relieve facet joint pain which in his case does not seem to have had a positive effect. Assuming that his lower extremity symptom is primarily related to the lateral recess stenosis at the L4/5 and L5/S1 level, the main surgical option would be to decompress the lateral recess and being an anteroposterior decompression it would be relatively straight forward. However, doing so would not be able to address the foraminal narrowing and there is a possibility that he can develop subsequent L4 root symptom and if that becomes a problem surgical treatment would be rather more difficult as it would involve at least a total facetectomy and in situ fusion of the relevant level and the cranial caudal narrowing of the foramen may even be best addressed by an interbody fusion, which clearly is an even bigger undertaking.
I therefore-explained that if he can tolerate the current-level-of-symptom-by-punctuating the walking and standing- with some sitting he certainly would not come to any harm. Otherwise, he would have to contend with the potential risk of surgery and despite the best surgical solution there may still be incomplete relief of his symptom..
I had a minor op in 2019 to free the nerve, that did not work and I was told that I would need to live with it!
GP sent me to the pain clinic, they tried various injections, that did not work and I was told that I would need to live with it!
GP then tried Physio, they tried all sorts, non of them worked and I was told that I would need to live with it!
GP has tried various medication including Gabapentin and Pregabalin etc, non of those have helped.
My right foot numbness is getting worse, worried that I may need to consider packing up driving.
Any suggestion's as what to try, below is my MRI scan report.
Here is my complete MRI Scan report, if you can understand it:
His lumbar MRI scan shows scattered aging changes throughout his lumbar spine. He does have evidence of a degenerative scoliosis with the apex in the mid lumbar area convex to the right and there is a fractional curve below with the concavity facing the right side. The degree of scoliosis is not marked but is sufficient to produce foraminal-narrowing at both the L4/5 and L5/S1 levels on the right side. However the foraminal narrowing at L4/5 produces L4 root entrapment and he does not seem to have any relevant L4 symptoms. He also has a Grade 1 degenerative spondylolisthesis at the L4/5 level and not surprisingly there is a bilateral lateral recess stenosis which clearly would produce the L5 nerve root symptom. At the L5/S1 level he also appears to have a small disc protrusion which encroaches to the traversing S1 nerve root and he has a mild degree of lateral recess stenosis at L5/S1 as well so that it would be difficult to tell whether the current leg pain is also contributed to from the L5/S1 level.
As he is primarily a claudicant I reassured him that he does not have any serious pathology responsible for the symptom and there is always an option for him to persevere with conservative care. In the long run injection treatment would have no value and I do not think that a facet injection would produce any positive effect for nerve root symptom as it is designed primarily to relieve facet joint pain which in his case does not seem to have had a positive effect. Assuming that his lower extremity symptom is primarily related to the lateral recess stenosis at the L4/5 and L5/S1 level, the main surgical option would be to decompress the lateral recess and being an anteroposterior decompression it would be relatively straight forward. However, doing so would not be able to address the foraminal narrowing and there is a possibility that he can develop subsequent L4 root symptom and if that becomes a problem surgical treatment would be rather more difficult as it would involve at least a total facetectomy and in situ fusion of the relevant level and the cranial caudal narrowing of the foramen may even be best addressed by an interbody fusion, which clearly is an even bigger undertaking.
I therefore-explained that if he can tolerate the current-level-of-symptom-by-punctuating the walking and standing- with some sitting he certainly would not come to any harm. Otherwise, he would have to contend with the potential risk of surgery and despite the best surgical solution there may still be incomplete relief of his symptom..
Join with Google
Join with Facebook