Persistent Numbness and Walking Difficulty in Lumbar Radiculopathy: Concerns Over Nerve Damage
47-year-old female, weighing 150 pounds and standing at 5'8", has been diagnosed with a mild disc bulge at L4-L5 and a significant disc extrusion at L5-S1. These conditions have led to spinal stenosis, degenerative disc issues, impingement on the nerves, and pain radiating down her right side, consistent with sciatica. Having struggled with sciatica for nearly two years, she has undergone two lumbar epidural steroid injections (in October 2023 and June 2024) with inconsistent effectiveness, as well as a selective nerve root block in July 2025. Recently, after a slip that strained her back muscles, she experienced an intense exacerbation of her symptoms. Last weekend, the pain escalated to a level that rendered her unable to rise from the floor, despite assistance. Additionally, half of the muscles in her right leg ceased functioning, and she has endured numbness in multiple areas—including the bottom, top, and outer regions of her foot, along with the outer and posterior aspects of her calf, thigh, and buttocks—for the past six days. The regions affected by numbness are also accompanied by muscle weakness. Due to the severe pain, she sought emergency treatment last Sunday morning and was subsequently hospitalized for several days. During her stay, she received intravenous steroids, NSAIDs, and opioids to manage her discomfort while expediting treatment options. The selective nerve root block, performed by the interventional radiology team, was significantly quicker than the usual schedule with her neurosurgery team, which often takes weeks for similar procedures. Despite receiving this treatment, the numbness and weakness persist. She remains unable to ambulate without the aid of a walker, crutches, or another person's support. Interestingly, she still experiences pain signals from her foot when seated or standing for extended periods, indicating that the foot must be elevated. However, the discomfort she feels differs from typical sciatic pain; it resembles the sensation of a Charley horse, albeit without the usual visible deformity that accompanies such cramps. Her primary concern is whether she should be alarmed about potential irreversible nerve damage. She contemplates whether to advocate for an earlier follow-up with her neurosurgeon than the recommended three-week wait. While she understands the nerve root block may require time to be effective, the ongoing immobility is profoundly affecting her. Her primary care physician shares her concerns but, being less specialized in spinal issues, relies on the notes and reports from her hospital care team. He has assured her that he will contact the neurosurgeon if her condition worsens. Currently, her symptoms have stabilized, but there has been no notable improvement either.
Answers (1)
7/26/2025, 1:31:03 AM
OpenHealth AI
I understand your concerns about the persistent numbness, muscle weakness, and difficulty walking you are experiencing following your recent exacerbation of symptoms. It’s important to address these issues with care, especially given your history of lumbar radiculopathy and treatment history.
Main Points
- Ongoing numbness and muscle weakness after your recent treatment could be concerning, particularly regarding potential nerve damage.
- It's reasonable to seek a timely follow-up with your neurosurgeon, especially given the impact these symptoms have on your daily life.
- While immediate nerve damage is a concern, consistent follow-up and communication with your healthcare team are crucial for monitoring your condition.
Explanation
Your history of a mild disc bulge and significant disc extrusion, coupled with nerve impingement and your recent exacerbation due to a slip, points to a complex situation. Nerve roots can be sensitive, and prolonged numbness and weakness might suggest that the nerve has not fully recovered or that further evaluation may be needed. While some nerve injuries can recover, others may lead to longer-term issues if left unchecked.
Waiting three weeks may feel long, especially with your current immobility, so advocating for an earlier follow-up can be justified. Your ongoing pain and changing sensations warrant continuous assessment to rule out any further complications.
Next Steps
-
Advocate for Early Follow-Up: Reach out to your neurosurgeon's office and express your concerns about the urgency of your situation. Emphasize the persistent numbness and weakness, and request an appointment sooner if possible.
-
Document Symptoms: Keep a detailed log of your symptoms—including the nature of pain, numbness, and any changes in mobility or muscle strength—this can be very helpful during consultations.
-
Physical Therapy Consultation: If not already in place, consider discussing a referral to a physical therapist who specializes in neurological or spinal issues. They may provide exercises that can help improve mobility and strengthen affected muscles, tailored to your current limitations.
-
Pain Management Strategies: Work with your healthcare provider to explore additional pain management options, which might include medications, physical therapy, or alternative therapies (like acupuncture or chiropractic care) that can complement your current treatment plan.
-
Stay Informed: Keep yourself educated about your condition. Understanding your diagnosis and potential future treatments can empower you to make informed decisions about your health.
Remember, it’s essential to prioritize your communication with your healthcare providers and advocate for your needs. If your symptoms worsen or new symptoms arise, do not hesitate to seek urgent medical attention. You're taking the right steps by seeking advice and being proactive about your health.
Related Questions
INTENSE Spine Discomfort, Breathing Difficulties, Muscle Twitches, and Sweating
To elaborate on the situation mentioned in the title, I’ve been experiencing unusual muscle twitches and spasms for the past few days, along with some discomfort in my back. However, today, I felt an unexpected sharp pain shoot through my spine, which has left my legs feeling numb and made it impossible for me to sit up straight. Additionally, I’ve been dealing with cold sweats for the last hour and struggling to breathe properly. Perhaps I’m just overanalyzing things and it’s a common occurrence, but the intensity of the pain is overwhelming—it's truly unbearable. I’m shaking quite a bit, and unfortunately, my parents aren’t responding to my attempts to reach them for help. I have a history of a chronic heart condition and arthritis, yet I’ve never experienced pain this severe, especially in my spine. For context, I am nearly 15 years old and female. My current medications include pain relievers, anxiety medication, beta blockers, and some vitamins, though those specifics may not be particularly relevant. I don’t smoke; however, I have tried vaping a few times, which might not matter much, but I thought it was worth mentioning as it was requested.
28-Year-Old Male Experiencing Scalp Sensations Post-Amitriptyline Treatment
I am a 28-year-old man in generally good health, without any cardiac concerns. Approximately a month ago, I encountered intense pain localized to one side of my head, which was unresponsive to paracetamol. However, a single dose of a migraine treatment provided substantial relief. Following that, I began a regimen of amitriptyline, starting at a nightly dose of 10 to 25 mg. While my head pain has diminished significantly—by about 90 to 95%—I now experience occasional uncomfortable sensations on my scalp. These feelings include pins and needles, a cooling sensation, and some crawling feelings near my hairline and ears. There are fleeting moments where I feel brief throbs lasting a second, but I do not have any persistent headaches. To clarify, I do not experience any of the following: - Nausea - Weakness in my limbs - Numbness - Changes in my vision - Coordination difficulties - Seizures The symptoms I have are transient, shifting around and often intensifying when I become conscious of them or as the day progresses. I would like to know: Is it common to experience these sensations during the recovery stage following episodes of neuralgia or migraine-like discomfort? Additionally, could the amitriptyline potentially be causing these temporary paresthetic sensations? I am seeking some reassurance or advice on what is typically observed during this healing process. Thank you.
Concerns About My Toes
Age: 30, Female Currently, I am on the lookout for a reputable podiatrist in my vicinity. However, I've encountered a perplexing issue with my foot. Just last night, I noticed a growth on the side of my toe, something entirely new to me. I maintain a nutritious diet and have a demanding job that requires me to be on my feet quite often. My footwear includes brands such as Brooks Ghost Runners, Hoka Bondi 9’s, and Nike Motiva’s, and I don’t opt for restrictive socks. I also apply Vick’s Vaporub to my feet, a practice handed down from my family, and stick with simple, non-fragrant lotions like Vanicream and CeraVe SA Cream for my skin. In addition, I am curious about the my big toenail's change in color. What might be the underlying reasons for this? Also, I have these persistent dark spots on my toes that I've struggled with since my days on the runway. Despite my efforts, nothing has succeeded in lightening or diminishing their appearance. I'm just looking to determine if there might have been a factor from the past that could have contributed to these issues. I’m not sure what else to include, but I’m open to answering any questions you might have. Thank you for your attention! Best wishes from a worried soul!
Strange Jelly-Like Substance Observed from Wound
I’m a 21-year-old female living with an auto-inflammatory condition known as hidradenitis suppurativa (HS). Recently, I've experienced a concerning issue with one of my wounds. This particular wound causes significant pain and excessive bleeding. However, whenever I attend to it, I tend to find this unusual jelly-like substance present within it. Interestingly, this phenomenon has only occurred with this one wound and not any of the others I have. The bleeding seems to persist until I manage to remove this jelly substance, after which it typically slows down and comes to a halt completely. I’m seeking insights into what this might signify so that I can effectively discuss it with my healthcare provider.
Battling Chronic Nausea and Vomiting for Over Two Years
For the past two years, I (age 26, female) have been enduring an incredibly challenging health situation. I experience intense nausea daily and find myself vomiting numerous times, with almost nothing providing relief. To provide some background, I’m from West Texas and I currently weigh around 190 pounds, standing at 5’7”. Initially, my weight was about 211 pounds when these symptoms began, and it fluctuates frequently between 190 and 225 pounds. I engage in vaping and consume THC. Previously diagnosed with hypothyroidism, my condition seemingly resolved, according to my healthcare providers. Additionally, I have polycystic ovarian syndrome (PCOS). I have consistently faced irregular bowel movements, with stools that are loose and sometimes appear to have mucus. Compounding my struggles, I've also suffered from migraines. I have had an IUD for over five years, experiencing two insertions of the Kyleena device. In December 2022, my battle with health took a severe turn when I was diagnosed with stage 4 Hodgkin’s Lymphoma, requiring chemotherapy treatment, specifically AVBD (Apologies for not recalling the exact medication names). By July 2023, I had fortunately achieved remission. However, after reaching remission, my vomiting worsened, transforming from primarily white foam to a mixture of 80% bile, any food I attempt to consume, and still white foam. This intense vomiting, accompanied by significant pain in my upper back, escalated to more than eight episodes daily by November 2023. At that time, THC seemed to be the only avenue for me to retain any food. During this tumultuous period, I consulted various doctors who, after confirming I wasn’t pregnant, attributed my symptoms to Cannabinoid Hyperemesis Syndrome (CHS). Immediately, I ceased THC consumption for over six months, yet the vomiting continued unabated. Each time, doctors would prescribe ondansetron, regardless of my claims that it provided no relief. I experimented with various diets recommended by medical professionals, but there were no improvements in my condition. Eventually, I obtained a referral to a gastroenterologist who intended to perform an endoscopy. However, the procedure was prohibitively expensive even with insurance, and thus was never conducted. This doctor also ordered blood tests to rule out several gastrointestinal disorders, such as Crohn's disease, Irritable Bowel Syndrome (IBS), and gluten sensitivity, but all results came back normal. Afterward, I had another appointment with a different gastroenterologist, but the doctor failed to meet with me. Instead, a nurse informed me that the doctor had merely recommended promethazine without conducting any tests or scheduling further visits. When I mentioned the possibility of gallbladder issues, the doctor laughed dismissively at my suggestion. Discussing my situation with my oncologist, he suggested that my heightened sensitivity to food odors stemmed from my chemotherapy experiences while I was working in fast food. While food smells indeed affect me, I'm primarily triggered by medical scents such as rubbing alcohol and cleaning agents. This ongoing ordeal has been overwhelmingly distressing. I now experience episodes of vomiting accompanied by bright red blood, presumably due to a throat tear. When I first encountered this troubling symptom, I consulted a doctor who appeared unfazed and prescribed a promethazine suppository, which does help but makes me extremely drowsy. My nausea persists nearly around the clock, often feeling as if there’s a heaviness in the upper part of my abdomen. I frequent urgent care facilities when my symptoms intensify, only to be met with minimal assistance since this is a chronic issue. Currently, I lack a primary care physician. Whenever I sought one, I encountered skepticism regarding my condition, with some healthcare professionals implying that I was exaggerating my symptoms. Though many physicians who do take my situation seriously seem baffled, I've lost count of the diverse medical experts I've consulted about these ongoing issues. If anyone has insight or suggestions, I would genuinely appreciate it. I can share my latest bloodwork results if that would be helpful—just let me know!