Much less pain, gaining strength but still can't lean back on heel

by Beth

I have an L4-L5 foraminal disc protrusion. I am going to physical therapy and am gaining strength in my leg but still cannot lean back on my left heel, I have reduced ability to tap my left foot, that is at about 40% of my right foot. My leg feels like it is asleep when I stand and I have moderate burning and stabbing pain in my outer left calf, but mainly in the evening and when I go to bed. This has been going on for six weeks. My pain first started in my lower back but that has pretty much subsided (sometimes I have a pinched feel, but not as often. Surgery is recommended. Could this rectify itself without surgery?

Yes, Beth it can but it requires great patience and care on your part, and skill on the part of the PT. In fact research shows that if you can manage the pain and get through the next few months you'll be much better off.

But there are some not so good signs.

Firstly that your back pain is much less, but not the leg. That's actually not good news.

Secondly that bending backwards (leaning back on your heel) produces pain in the leg presumably. It shows that there is indeed a large prolapse in the foramen.

And thirdly that the leg is obviously weak; called paresis in medical jargon. Probably you have difficulty raising your big toe. Is that right? Or perhaps raising the whole forefoot. Tibialis anterior is the big tendon on the front of the foot.

That weakness needs to be monitored very carefully because you can end up with a permanent dropped foot.

But if the pain is lessening and the leg is getting stronger, then you can be encouraged. But you mustn't now think that you are well on the road to recovery, and start doing silly things. You have to continue to be very careful for at least another month, probably two. Your PT will guide you.

At this website you'll find the Slump test for Sciatica, using the search function key. It gives you a good measure of your progress.

Look for and follow our Slipped Disc Rules and follow them religiously. With great fervour!

Good luck, I hope you win. Let me know in a month how you are doing.

Dr B

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