Calf Weakness w/ Sciatica any support?
 

Hey, New to the forums here and I stumbled across the site while looking for information on calf weakness because of a herniated disc. I have a herniation at L3-L4 and a bulge at L4-L5. According to the radiologist, i'm looking at nerve compression at both levels, with mild stenosis.

Here's the deal, I have had pain for months and it suck, but it is manageable. About a month ago, after some home inversion therapy my right hamstring was super sore. I woke up the next morning with a limp, unable to do a calf raise on the right leg, unable to flex the outside of the calf or my gluet. I am also unable to raise my big toe. Walking with a limp and unable to run or be active.

I know that all of these symptoms are from nerve compression. But what I don't know is are they permenant nerve damage? Should I be walking staying active or lying in bed? Icing or Heating? My GP sent me to PT and gave me some mobic. I went to PT asked them about my issues and they have me build up my core, thats about it. I finally got a referral to talk to a Neurosurgeon, but since I am in the military I need to wait for this to be authorized, been a week still waiting just to schedule an appointment. To make matters worse. There are no local NS so I will have to fly to a location where there is an NS. This will require me to process a s*** ton of paperwork just to get a consult.

Meanwhile, I have been scouring the internet, reading message boards and medical information sites looking for information on leg weakness. It's all the same stuff I already know. I haven't seem to find any success stories for calf weakness, I do see a lot of people who do not recommend surgery of any type. So what are my options? I'm useless as a soldier since I can't walk, run or do anything that pertains to my job? Do I just play the waiting game and see if my calf returns? I guess I'm really looking for someone with simmilar issues that has any positive outcome from their situation. Or, any insight into how I can make my situation better or what treatment / surgery worked for them.

Does the whole leg hurt from the back down, or is it just the calf? It sounds like sciatica to me, but usually it hurts on the outside of the leg down to the foot, although not ALL the time.

I have severe sciatica and (believe it or not) I've had it for 27 years. :( The sciatic nerve has been permanently damaged. And it hurts!!! :eek: No surgery will work for me because the disc isn't bulging. I've already had surgery at L3-4 and L4-5.

If I were you, I would get a referral to physical therapy and stay with it for as long as you can (especially pool therapy.) Surgery is for mechanical problems ONLY. Surgery is NOT for pain. Chances are excellent that you'll still have the same pain or worse after surgery. Also there is the "Domino Effect" which the doctors don't tell you about. This is where the levels above/below the surgery site fail. That's because they have to take on more of the load after surgery. Then you need more surgery. And after you've had more surgery, you'll need more surgery due to THAT "domino effect." It's a vicious circle.

Later studies have shown that people who have had surgery have gotten the SAME results as people who have gone thru physical therapy!!! What about THAT!!! That's a lot of pain to go thru for basically nothing!

I would try any/ALL conservative methods before opting for surgery. And the ONLY reason I would have surgery is if I was in danger of permanent nerve damage or if my spinal cord was being impinged. When I had my surgery, it was before the internet -- I had no way of researching or talking with other people who had undergone similar surgeries or had similar problems. So I was pretty STUPID -- and just went ahead with the surgery. :rolleyes: NO WAY will they ever touch me again -- but they can't anyway. I'm inoperable.

I wish you the very best. Please take care and let us know what happens, will you please? I'd appreciate it! ;) God bless! Hugs, Lee ;)

Hello
 

Leesa,

Thanks for responding, I'm hesitant to go under the knife but many websites have said that my symptoms are an extreme case which requires surgery in order to prevent nerve damage. I don't know of any cases where PT healed weakness in legs, but I'm optimistic here!

I have no pain in my right leg at all just some numbness on my right shin. I do have a reduction in my basic motor functions in my right leg which leads me to believe that I have nerve damage. I cannot raise the tow or do calf raises.

My pain is in my left leg. The pain starts in my lower back and radiates downward to my hip groin area along the front to my left shin. It is rare that I get the typical sciatica pain down the back thigh. This pain is significantly increased when I sit, especially with no lumbar support.

I'm seriously open to any methods, techniques, herbal remedies or anything else that can fix this without surgery. I asked my PT for spinal decompression but they won't do it. I'm also reluctant to do a whole lot of excursuses that increase my nerve pain as that seems to just aggrevate my condition during cool down.

Also, I have to go to a military provider for my treatment. I am authorized a second opinion but the time frames associated with that aren't practical as I will be waiting a while just to see this neurosurgeon. What are my options here?

MRI Results
 

I'd like to upload my MRI image but I don't have enough posts, can an admin or moderator help me with this?

Hi
You can add it as an attachment...look below the posting box when you are typing a reply and you will see the section to Add Attachment...you then upload it from your computer

Hi Joe
 

Welcome to neuro talk. I hope you can post your MRI. Leesa is really good at reading them and may help you to figure it out. I agree with her about surgery. Only as a last resort where nerve damage could be permanent. I had to have surgery, mine turned out well. Others are not quite as good a result. Mine was cervical and I did have the domino effect as leesa told you about. I wish you all the best, and I hope you get to see that neurosurgeon soon. ginnie:hug:

Joe, the pain does NOT go down the back thigh. And many times it CAN radiate to the front to the shin. The key word here is "radiate."

I many times have pain in my shin. And many times the pain is NOT "regular" or "normal" for sciatica. But I DO have sciatica!! It's just that it radiates from other areas.

How long has this pain been going on, from start to finish? Because the AVERAGE time to become permanent, is 18 months. If it hasn't been resolved in that amount of time, the damage is permanent. :( I hope you haven't been going thru this for that long. I would certainly hate to think You'd have to end up like me. This has been miserable, trying to find a doctor who had the GUTS to treat me. The stupid government has hassled doctors so badly, that they're all AFRAID to prescribe the proper medications to keep us comfortable. :mad:
I was lucky enough to find one that thumbs his nose at the government.

Try to attach your MRI to your post. I'm NOT that good at reading the FILMS. I'm better at deciphering the written reports! A member here, Dubious is MUCH better at reading the films, but I'm not sure he's here. Some people were very nasty to him recently, and he may have left, although I begged him to stay. I hope he did.

Hope to talk to you soon. Hugs, Lee ;)

You might ask for an advanced PT, and have them do a fresh assessment /evaluation. If the previous PT was only doing core work for you, they are not addressing all the possible issues.

Can you see anything noticeable on the MRI images?

Have you explored sciatica & related videos on youtube?

hi joe
 

i've had what you have for almost 50 years. for a good year i was dead in the water. i did physical therapy and slowly the strength came back in the leg. i did go on to enjoy skiing, rollerblading , swimming and bike riding when i was injured there were no mris and ct scans. nor were there fancy decompression machines. if you dont have arthritis in the spine do go for the decompression it may do the trick.
be real aggressive on pt and stretching. find exercises that enable you to get in positions that dont hurt.
there was one exercise that really helped me. in fact just after two days of working my butt off with it the pain was almost gone. i got on my back and stuck my legs straight up and then slowly spread the legs out and brought them in. it strengthens the midsection and sucked those discs back in.
your big toe and calf trouble are indicative of pressure from the L4 L5 disc. if L3 were involved you would have more pain in the knee area.
in time for me [30 yrs] everything finally went. from L1 to S1. now i'm crippled. i did try surgery when i was unable to walk but it was too late.
but i did get 30 decent years after being like you are now.
get a few opinions from the neurosurgeons and try what i mentioned and best of luck.....pete

MRI Results
 

Attached is my MRI results...

1. L3-L4 has a large left paracenteral disk herniation, causing nerve compression and mild stenosis.
2. L4-L5 has a medium disc bulge causing nerve compression on the root sleve and spinal stenosis.
3. The (forgot the name of the muscle)?? is unremarkable in size and signal intensity.
4. The Bone Marrow is unremarkable.

I am no expert but I think my L4-L5 may have DDD, lets hope not :winky:.

Leesa to anwser your question I have been having pain since mid Febuary and have been having muscle weakness since mid March.

I am very motivated to conduct some aggressive physical therapy however, I have been told that if I feel pain while conducting stretches I am doing damage and shout stop. Well, my current PT regime is painful. sooo, I am picking and choosing the excersises that don't hurt like you said pete.

Thank you for the information pete I am taking your advice into consideration for sure. I'm trying to stay out of surgery. My biggest problem is that I am a grounded pilot. The Army isn't about to wait 6 months to a year to see if I get better, meanwhile paying me flight pay and my salary while I am doing nothing for the Army. This means the Army wants to see results now, and the current climate of active duty aka sequestration means they might just cut me loose if I don't have a plan for my recovery, this situation has the pressure up and I have a lot of time to research and figure out a plan. Granted, I have the rest of my life and health to think about but I am dedicated to my job and my country and I'll do everything I can to stay in the military, while maintaining my health.

Pete, thank you for your advice, I will start working more on the stretches that don't hurt me.

During the week, I do a ton of physical therapy and try and stay active, on the weekends I stretch, and lay in bed with a heat pack trying to rest my back and get ready for the next week. I don't feel that the PT is helping but I will stay optimistic and continue until my neurosurgery appointment. I have an appointment with the chrio on monday, NO MANIPULATION! all I want is spinal decompression, I am still skeptical about chrios....

WOW, you DO have a big paracentral disc herniation at L3-4. And the bulge at L4-5 is no little one either! :eek:

It seems to me that something is going on between L2-3 & L3-4, but I don't know what it is. :confused: Maybe someone else can answer that.

You are right that if physical therapy hurts, DON'T DO IT.

Also, DON'T USE HEAT. This is what I learned by going to "back school" after I was sent there by my Neuro. Heat draws blood to the heated area, causing swelling, pain, and inflammation. ICE reduces the swelling inside (and there IS some), reduces pain, and also reduces inflammation. So you need to be using ICE for 20 minutes every 2 hours. Believe me, it WORKS. I thought he was nuts, so I used heat -- and ended up in bed the rest of the day. :rolleyes: so I did like he said, and it WORKED. I felt much better!!! It reduced my pain, and I was able to walk almost "normal." LOL

OH GOD -- with your spine, DON'T GO TO THE CHIROPRACTOR! Do you want to be paralyzed??? :eek:

As far as DDD -- we all get it. It's part of the aging process. All it is is drying out of the discs. It happens and there's no way to stop it. Everyone walking on the face of the earth has it. :rolleyes: So it's nothing "terrible." You'll just shrink a little as you age. LOL

If you have any more questions, let me know. Hugs, Lee

hi joe
 

we are all fortunate joe to have dedicated men like yourself in the military ....thanks so much...
one exercise i do for my calves is to lean on a counter or railing with my hands pushing to take necessary weight off the legs then i rise up and down with my toes exercising calves. just do as much as you can do and try to increase each day.....pete

Leesa and Pete
 

Hey guys,

Leesa I know what you mean about the herniation, it's a big one.. but I also know they can be easier to treat then small ones so for that, I am thankful. There is something funny going on with the L2-l3, l3-l4 and L1-L2, it seems to me that the vertebrae is rounded towards the back and it looks like something is pressing on the spinal column. Furthermore, I am not to concerend for the DDD as like you said, "it happens to everyone". The past 10 years have been rough on my back, airborne, body armor, ruck marches and multiple deployments I have had a good run. I'm hoping I can keep it going for about 15-20 more years.

I cancelled my appt with the Chriro I'm going to keep stretching and doing my PT. still on standby with the Neuro, I called them today it's gonna take a week for them to determine if they can take me or not. Patience is a virtue, that I don't have... :D

pete, thanks I will try the calf raises, I have been doing some work on the staircase daily, My calf still gets sore from those so I know it aint completely dead. Any ideas for the Gluets?

Just as I am dedicated to my job, I am dedicated to fixing this problem, life without my calf muscle is not an option! Thank you for the support and I will keep this post going so the next poor soul that comes through here looking for calf weakness info can find what they need.

Hi Joe
 

Just reading your MRI report. I would not do any excersises unless cleared by a neuro surgeon. Anytime there is nerve compression, that gets into an area to be careful in, until someone makes a recommendation to you. In the exact wording in your MRI did it say "Mild" or "serious" regarding the nerve compression?. That can give you an idea of what may be done to help you. Usually if the words Mild are used, they don't do a surgical approach. If it is serious nerve compression, then a neruo surgeon will be recommended. Please get a second opinion before you decide on any surgical approach. I really do wish you all the best. Keep in touch. ginnie:hug::grouphug:

Ginne
 

Ok, so I got the report and here is the exact verbiage.

1. At L3-L4, there is a large, central and left paracentral disk herniation,compressing on the nerve root sleeves, and causing marked, central canal stenosis.
2. At L4-L5, there is a large broad-based disc buldge, causing mild central canal stenosis.

I have started a decompression and massage routine this week, feelin better after my second session. I pray to god that this help me, I just want my calf strength back so I can walk normal.. I'm taking it easy on PT I'll still go but if I feel pain I'm gonna stop. Appointment with the Neuro scheduled, week and a half to go! Hopefully this will heal on it's own and I can skip the surgery.

Hi Joe
 

Yeh, be careful with any PT until you see the neurologist. If it hurts don't do it. Hope there can be some good resolution. Anytime there is nerve root compression it is a good idea to have someone evaluate it carefully. I will be thinking of you. ginnie

Thanks,
 

I will definitely take that into consideration, I'm having a Neuro consult soon, and another Neuro consult a week after. My spinal decompression therapy seems to help as well, 2 days into it and my mobility is already increasing, no calf strength yet but I'm feeling more limber while walking.

Hi Joe
 

I had a similiar issue.
For about 5-6 weeks I had pain but I was able to do stuff. It only hurt when I bent down, but I was still able to bend down with my knees and be completely functional.
Then I was playing volleyball one day and I really hurt my back. It hurt to even make a slight movement.

The doctor gave me medicine to reduce inflammation, and pain killers for the pain. I tried it a couple of weeks(took the pain killers only when the pain was unbearable) the pain had reduced but then all of a sudden one day I was limping.

I was refered to a spine specialist. By the time I got an appointment it was two more weeks. The pain was minimal but I was still limping.

After looking at my MRI he said it was Sciatica due to a herniated disk. But since I wasnt in too much pain any more and he said it didnt look bad he recomended Physical Therapy.

A few days later I started PT. He focused on my back and not the weak calf. I was worried because I was reading up stuff online and people wrere saying it takes forever to get better.

The excersises I did was
1. Bending backwords while standing
2.Laying on my stomach and arching back while trying to keep the hips on the ground
3.He did some stretch on me which is hard to explain, basically pushing down my thighs to one side and the opporsite shoulder to the other side.
4. Compressing the lower back while I lay on my stomach
5. And after i expressed my concern about my calf, he streched that leg by lifting it up while i lay on my back
6. I also tried to work my calf muscles by lifting my self up with both legs and letting go of the strong leg.
7. Since i usually spend alot of time sitting at work, I started work standing up too. Its hard at first but you get used to it.
8. When I layed down, or when sleeping, I tried to stay on my stomach as long as i could instead of my back.

I did PT twice a week the first week, and then 3 times a week the next two weeks.

I'm not fully recovered now, but I can lift myself up with my weak leg now. Its not as strong as the other leg but its getting better and I am relieved.

I still have some back pain...its more like a soreness though. I dont feel the shooting pain any more when i do my stretches.

My case might have been less severe than yours, but I thought this post might help you.

When i went to the PT initially I wasn't in too much pain. The bad pain had lasted about 3 weeks prior to visiting the spine doctor.

Good luck...hope you feel better soon.

@Frad,

Thanks for the reply... It's nice to hear a success story, how long since you initially injured your back?

I am doing spinal decompression about 3 times a week and I am doing PT 3 times a week as well, I also use my inversion table on non decompression days. Your physical Therapy schedule sounds like they used some of the Robin Mckenzie stretches from the book treat your own back. I have taken a break from those because I find it really hard to get up off the floor when I do those. My PT regime is like this...

15 min warmup elliptical.
3 min piriformis on foam roller.
3 min hamstring stretch on foam roller.
3 min rubber-band walks side to side.
3 min rubber-band walks to the front.
3 min leg extensions with ball.
Some other stretches, push ups and plank excersises.

Update: My calf and big toe are getting stronger, not sure if it is the PT or the spinal decompression. I can hold my body weight up with my right calf but I am unable to do a calf raise. I feel like every week I am getting stronger. I should probably hit the PT a little more but it's hard when i'm in pain.

surgery?
 

i know you dont want surgery but it might get you back in the drivers seat sooner than anything else so if thats the priority ask surgeon about it....pal pete

Hi JoeP
 

[Let me know how the neurologist goes. I am glad you are going for the evaluation. If you can bring someone with you. The docs tend to take it more seriously when you have witness to what you are going through. I kept a pain journal, with complete discription of the pain with me also. That way I didn't forget anything. I sure will be thinking of you.

Also to all other back sufferers, I hope that you can find some good help so you can get back in the swing of life. Though mine was cervial in nature, I do not regret for one minute doing the surgery I did. ginnie:hug:

hello
 

Joe

I hurt it really bad around the 1st week of March(5-6 weeks before that it hurt ony when i bent..but it wasnt bad). Started PT begining of April. Was able to to calf raises only towards the end of the 3rd week of PT which was last week.

The place I'm going to is kind of small. I'm thinking he doesnt have the equipment you use.

Rad

---GOOD NEWS------ CALF IS BACK BABY!!!

It isn't 100% yet but I am walking normal and both neurosurgeons say I have no major weakness, someone was really looking out for me. I still have leg and hip pain and I am borderline abusing narcotics to get around during the day, but I am functional. Neurosurgeon has recommended surgery due to the large size of my herniation. The Neurosurgeon believes that the herniation is too large to heal on it's own accord and the Micro D is the best choice for me due to my career, my age and my good health. I feel very positive abut it, especially considering I am taking drugs to function day to day.

1. I dropped my Physical Therapist but not my physical therapy. I do the excersises that don't hurt me and make me feel like I am making progress, pre surgery now and I intend on doing PT, lots of elliptical cardio and swimming everyday with breaks on sunday.

2. I am continuing with my spinal decompression and massage routine up until I have my surgery. My Chiro has agreed that surgery is my best choice at this point, injury to today has been over 3 months.

I am flying to a military hospital in Texas to have the surgery, this NS is very experienced and there have been very little complications for Micro D's from this department. I am praying that this pain goes away from the surgery.

Microdiscectomy Post Op Day 3
 

I had my microdiscectomy on Tuesday the 28th of May. A large herniation at L3 / L4 with severe femoral nerve pain running from my groin down the front of my leg to my shin.

From the moment I was wheeled out of the surgery room I have been pain free. even my surgeon told me when he was pulling the disc material out of my back he said "ladies and gentleman the pain has left the building". Since my surgery I have had 0% pain from my groin, hip or shins. I even have no pain at all on my incision site. I have completley stopped taking all meds, no neurontin, oxycodone or even motrin.

I admit the recovery is the hardest part and that I have a long road to recovery. I thank god that I am out of pain and for all of the support I have recived through friends and family.

I have been walking about 1 mile, 3 times daily. I will increase my walking distances every week but I have no plan on doing any working out, excersises or stretches for at least a month and a half.

I consider myslef to be one of the lucky few who has had no post op pain or neuropathy. I will keep you guys updated on my progress.

Hi! I too, was experiencing the same problems you were having. I had a severe disc herniation with nerve root compression on my L5/S1. I also had a discetomy/lamintectomy but it was open rather than micro surgery. I too was completely pain free afterwards but as time has gone on it has become disabling. Went 12 years in Law Enforcement to now disabled. Anyway, I just wanted to say that I am glad your surgery went so well and to not over do it even though you feel so much better. Also, treat your back real nice. Even though you feel good it will not be back to 100 percent mechanically wise. No bend and twists! Glad you are doing great!

Pendora,

How did it become disabling? Did you end up going back to work after the operation? Was Surgery non another option? I'm still taking it easy almost to the 2 week mark. Not out of the woods yet.. I will keep posting my progress.

Hey JoeP, Well like your surgery, I was completely pain free right after and it did last for about 3 years. I went back to work after 12 weeks. I had 2 weeks of doing nothing then the rest of the time I had PT 3 times a week. I walked also. I had no problems at all but as time went on the arthritis set in and now I have a large disc bulge in the same level and the one above and moderate to severe facet arthritis and DDD. At the time, I couldn't walk and I basically was told I was going to have surgery. I did have to do a lot of bending,twisting, and carry heavy things at work so I think that took it's toll. I now can't stand, sit , or lay down for very long before I have to move and am in constant pain. I am doing the PT and have a fusion surgery looming it's ugly head at me. Surgery will be my last resort. Anyway, my point was I just don't want you to overdo things because I know how you feel so much better. Build your strength back slowly. I think you are going to do good. My surgery was also an open rather than micro so that might make a difference. I am cheering you on! I think things will go well for you.

Spinal Decompression Calf weakness
 

I am having spinal decompression and laminectomy next friday. I have sever S1 weakness(can't do a single Bilateral calf raise) and numbness in both heels. No Achilles Reflex S1. My quads are getting week. I have been a practicing Chiropractor for 32 years seen 45,000 new patients. My Mri demonstrates sever spinal stenosis. L4/5 both anteriorly and Posteriorly I will try and add image. The worst I have ever seen. Walking is a chore and can't play any sports. Have a Experienced Surgeon 25+ years of doing this lumbar procedure, University Prof. Says statistics say 65% chance of very favorable outcome.
Was looking for some post-surgical posts, but I will post to his site in a few weeks and let you all know how it turns. out. A good chiro would not adjust the lumbar spine. I adjust the Sij all the time with lumbar problems. Adjusting the Sij will free up the lumbar spine with minor stenosis. I do it all the time, but when the stenosis is sever with + mri, + neuro symptoms, and sever weakness, Surgery is necessary. Keep ya posted.

Good luck!