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
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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.
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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.
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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.
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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.
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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.
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