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Originally Posted by jonnyrocket
Please forgive if what I am asking has long been covered here. Being new I thought to dive right in and search later.
In 2001 and again in 2002 I had discectomy/laminectomy at L4-L5. First surgery was to correct profound left foot drop as "accidently" discovered I couldn't heel walk on the left foot - following five months of increasing excrutiating pain localized at left lateral calf, outer ankle, top of left foot into big toe. Immediately after surgery, days after, presented with exact same pain in same area of calf. Lived with that, tried chiro, acupuncture, therapy, and saw different neurosurgeon who suggested he could help me and did the laminectomy. Immediately presented, days after, with same darn pain again. After only two post operative visits to him, guess he tired of me saying it still hurt, was sent to pain clinic where I still go monthly. That's now about four years on oxy 80 and oxy ir for breakthrough. I still work but find the pain unrelenting. The longer I am on my legs the weaker the left one gets, until I limp and must get off it before I fall down. How can the pain come through so clearly with that heavy medicine ? What would it be like without it ?
What I am hoping for here is some advice or suggestions as to what to do now - was told by a third neurosurgeon to have a fusion - I refused when he told me he could probably fix my back pain but not the leg pain - It's never one or the other, just depends what time of day and what activities to see which pain is in the lead.
BTW, my herniation was a far left lateral at L4-L5, a foraminal herniation. What I am told is that because of the initial injury, the surgeries and resulting scar tissue, that the exiting nerve root is now encased and trapped in the scar tissue and no surgeon will touch that area. How can that nerve root ever be free ? And will that make the leg pain cease ? I feel that the first operation happened too late, that even though the foot drop was relieved, the damage to the nerve root by waiting so long was already done and is permanent. I definitely know that leg is weaker, smaller by more than 4 cm, and with daily use, I can't finish the day on my leg.
So, if anyone has had similar experiences, similar problems, any advice or questions, I'd sure appreciate hearing it. I've about reached a place where I just don't see this getting any better. Maybe there are techniques out there I don't know about, that "good" doctors are using. My prior two surgeons sure gave me the boot when I kept telling them it still hurt. I mean, " failed back surgery syndrome " ???! What the heck is that ? Something to say when you just don't know what else to do ?
Thanks for reading, looking forward to replies. Because I work I usually don't get on this until the evening and then depending how I'm doing, not every evening at that, so don't get mad if I am not back as soon as you might think. If I couldn't work I don't know how we'd survive - isn't that terrible ?
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Part of your lower leg pain may be from Myofascial trigger Points (knots in the muscles of thethe lower leg.
Muscles and fascia work together in functional groups. When a muscle in that group gets a trigger point it impacts the function of that group and causes postural dysfunction. Therefore, the whole functional groups of muscles and fascia have to be assessed. Many trigger points cause satellite trigger points in predictable patterns.
In your case trigger points in tibialis anterior muscle which attaches proximally to the lateral condile of the tibia (below and outside the knee cap, about 1 of your hand width and to the outside of her lower leg), the upper half or more of the lateral surface of the body of the tibia (shin bone), and to the surrounding fascial structures . The muscles tendon attaches distally (foot) and to the medial and plantar surfaces of the medial cuneiform bone and the base of the first metatarsal (big toe) in the foot.
The Functions of the tibialis anterior muscle during ambulation (walking) are to prevent foot slap at heel-strike and to help the toes clear the floor during the swing phase.....
The trigger point is a hyper-irritable focus (knot) within the muscle or fascia that causes taut bands and characteristic, predictable, referred pain like that seen in the leg muscles. Trigger point referred pain does not always follow typical dermatome patterns.
Trigger points cause the muscle to become shorter and tighter. This limits the function and mobility of the muscle which causes weakness, decreased circulation and pain. When injured, most tissues heal, but muscles learn, they learn to avoid pain. This muscle memory can produce unexpected pain years after an injury has occurred, especially during times of physical and emotional stress.
Your may have an active trigger point in your tibialis anterior muscle in he impacted leg. This muscle is innervated by the deep peronial nerve with fibers from the fourth and fifth lumbar and first sacral spinal nerves.
Did you have a clear nerve conduction test of the L4-5 to the lower leg?
If the nerve conduction test is mostly clear then a trigger point is more likley
I am a myofascial trigger point therapist and primarily use my hands to locate and treat trigger points. I am not sure trigger points are the cause of your problem but well worth investigating.
The tibialis anterior myofascial pain syndrome rarely presents alone as a single-muscle syndrome, but occurs in association with other TrPs in other leg muscles.
Your Dr.'s may want to palpate your tibialis anterior muscle for the presence of trigger point(s) and treat accordingly. Therefore, foot pain can be caused by satellite trigger points in predictable patterns.
Take a look at this web site :
http://www.latrobe.edu.au/podiatry/myofasc/cover.html
Best wishes