Continued numbness in left leg mostly inside of calf muscle and loss of strength in left leg

by Eric
(Midlothian, VA)

Slump test

Slump test

About two months ago I injured my lower back pulling out wisteria. At first, I had no pain, the left side of my back was very tight - and I could not bend. About 10 days in my tightness left and that night I had excruciating pain in my left groin and down my left leg. I went to my doctor who gave me muscle relaxants, which helped but the improvement plateaued. I then was referred to a back specialist who gave me predisone and I started physical therapy.

I have lost strength in my left leg and still have continued numbness, mostly in my calf. And I can tell my lower back is still weak so I am extra careful how I move.

I can raise my big toe, stand on my toes without pain (although numbness seems more noticeable, walk on my heels. I started low level workouts 2 weeks ago - walking in place, body weight squats, light weight lifting for upper body, planks (only front not side) and pushups (note: Prior to my injury, I did interval training 5 days a week and could do almost any exercise including burpees)

Four questions

Is there a time frame that I should look to where the numbness goes away?

Is there a time frame when my lower back will get back to normal?

Will I be able to get back to my exercise training I did prior to the injury?

How can chiropractic visits help my condition, vs physical therapy?

Hello Eric,
The inner calf is supplied by the femoral nerve, either L3 or L4, so mostly the sciatic nerve is unaffected and you can raise the great toe and stand your heel. But what happens if you take weight on your left leg, and bend the knee? Does it feel like the knee is going to collapse?

Did anyone take your reflexes? How was the knee jerk?

As a general rule if the pain in the leg diminishes, the numbness will gradually go away. Of concern though, in your case, is that the leg still feels weak. That's an ominous sign after two months. You may never recover the strength of the leg. Does the knee give on stairs?

Q1. The numbness may never go away entirely, but you can live with some numbness. It's pain and weakness of the leg that you should not allow to become chronic.

Q2. Generally it takes about six to eight weeks to recover from a disc injury with chiropractic care, but in your case, I'm unsure.

Q3. You almost certainly had a large tear in one of the midlumbar discs. I doubt your back will recover entirely it's original strength. Back exercises done every morning before getting out of bed will be a great help.

Q4. To be honest I'm not sure what physical therapists would do for a condition like this, so I'm enable to comment.

I personally have had what I suspect is this exact injury though it could be one of two levels. With chiropractic help from a colleague, I've had a 90% recovery. I can lift beehives, dig in the garden, bend and twist, but I'm careful, and do the exercises very faithfully. The weakness in the quad has recovered completely but I occasionally have numbness for a few days on the inner knee. You can read about it below at femoral nerve damage.

You've started on a journey of enquiry into what is going to work for you. Continue it, it's a very encouraging sign. What I would say is that you've had a serious injury, one a surgeon would love to get his knife into, and a chiropractor his hands.
That means accepting that you may not regain all the territory, but you should try to. I have. Knowing that this or that is beyond one, and accepting it has been important for me. I only lift beehives with two people now.

Is the Slump test negative?

I hope this contributes. Let me know how you get on. I would get an MRI scan if your quad is weak by the way.

Dr B.

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Oct 22, 2015
Response to Dr. B's question
by: EricR

I am sorry I missed this question

Does the knee give on stairs?

The knee does not give on stairs

I do not feel weakness in leg when just walking - I feel it a bit weaker when I come up from bending my knees fully to go down to ground and when working out.

Thanks again. I will keep working to improve and find a full recovery or at least as best as I can get.

This all sounds good.

Oct 22, 2015
Reply to Dr. B's response
by: Eric

Dr. B thank you very much for responding to my post.

The back specialist indicated it was an L4/L5 issue. When it happened pulling wisteria, I had a sharp quick pain in my lower back at about hip level and near spine in middle of the back. Would that still indicate L3/L4

What happens if you take weight on your left leg, and bend the knee? Does it feel like the knee is going to collapse?

I just tried this. The knee does not feel like it will collapse. It feels weaker than the my right leg (which was my stronger side even before the injury)but I can go down almost as far as my right leg. I also feel a slight pain in my left lower back when going down and up about 3-4 inches in from my side and slightly below the top of my hip bone

Did anyone take your reflexes? How was the knee jerk?

My knee jerk was less then my right legs this was taken 4 weeks ago and about 4 weeks after initial injury

No one did a slump test

Back exercises done every morning before getting out of bed will be a great help

On your site the other day I saw several and started doing them at night after my workout - the back and forth hip, bringing knee up on each side and both at one time, and the tummy in, hip in butt up then back up. I find I can do these better on the floor with a mat - can I do them in the morning and at night this way vs in bed?

Did you need to do exercises to get the weakness in your quad to recover?

Hello again Eric,
From what you describe you are making a good recovery from a serious injury; I can't promise you that you would do better with chiropractic at this stage. In fact a heavy manipulation might make it worse.

It's good that you have only minimal weakness in the quad, and probably some numbness still. The reflex may never return, but that doesn't concern me.

I'd be interested in what a femoral nerve stretch now does. It gives an indication of whether the nerve is still entrapped.

It certainly could be L4-L5 as your neurologist said; a herniation into the foramen, same as I had, only one level lower, would still affect the L4 root and the femoral nerve, and the quad, hence the reduced knee jerk.

The only criteria that would cause me to seek out a chiropractor, if I was in your shoes, was if I hit a plateau and further improvement, albeit slow, was not forthcoming. Or if you again get pain in the back or leg.

Be careful of working out. Strengthen the core but be very aware you've had a serious injury and exercises could certainly aggravated the condition again.

It's good that can climb stairs without a problem. Just walking gives that quad plenty of exercise.

Let me know in a month or two how you are doing.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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