Prolapsed intervertebral disc with femoral nerve compression
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I was diagnosed with likely intervertebral prolapsed disc (L1 - L2) with femoral nerve compression, by my gp 2 weeks ago. This followed an injury at work, whereby I jolted my back humping a heavy trolley with 3 bulky boxes down some steps. I am a 48 year old woman with some history of lower back problems which had always been muscular up until now.
My symptoms 2 weeks ago began with lower back pain which had radiated into my left hip by the evening, by the following morning this had radiated further down my upper frontal thigh, causing numbness and excruciating pain in my thigh. I was unable to sit or lay on my back or left side - standing or laying on my right side were the only positions which offered slight relief. However, it was possible for me to bend forward, with some discomfort, to pick something up off the floor.
I had started to feel that things were improving slightly a few days ago - the numbness in my frontal thigh had subsided somewhat, sitting had become slightly easier and I found that I was able to lay on my back for short periods of time.
At this time, I also decided to try to reduce and change the prescribed medication that I had been taking, to over the counter analgesia and anti-inflammatory medications. My reasons for doing this were two fold. Firstly, I wanted to test for real improvement and not just a masking of symptoms brought about by taking prescribed medication, as I was desperate to get back to work but needed to be confident that I was truly fit enough to return to my strenuous nursing job. Secondly, the side effects of feeling 'zonked out' a lot of the time, together with bad constipation were becoming hard to bear!
However, over the last couple of days I have noticed a change in my pain - my thigh is no longer numb - the pain in my upper thigh seems slightly higher and closer to the groin, it is now sharp and searing - it feels as though I have red hot pokers going into my thigh. Bending forward has now become impossible as this brings about the searing 'red hot poker' feeling. Sitting has also become very painful again and my back feels weak. I have some lower back and hip pain but the overwhelming pain is in my thigh.
Is it commom for pain to change in this way? If so, what is the cause of this? My gp told me that I would know that things were improving as the numbness subsided, but instead this has been replaced by another type of pain which is almost worse. I am now back on my original prescribed medication to help with the pain. I was hoping to return to work tomorrow but no way is not possible. Please can you advise what may be happening and when I might be able to expect to return to work?
This is a tough one. A prolapsed disc may heal of itself over an extended period as the bulge is reabsorbed but it would take several months of great care, and there's no guarantee it would settle.
Bending forward with a slipped disc to pick up something off the floor was not wise, and probably aggravated the prolapse. You're certainly in no position to return to work, and probably won't be for a month or more.
What's good is that you make no mention of weakness developing in the quadriceps muscle; did your GP test the knee jerk? When only the sensory nerve is affected, it's not as complex. However, I have my suspicions. Can you manage the stairs without that leg conking?
Best, seeing you're in the medical world is to get an MRI done; that will tell you the extent of the damage and the exact level.
That disc needs to be reduced and it can either be done surgically, or with skillful chiropractic manipulation. Either way you have to stop, not sit, do exercises and stay at home for a month or more. Sorry I know that's not what you want to hear.
Surgeons will try to convince you this can only be fixed with surgery, chiropractors like me will challenge that. In fact, I have had a very similar injury myself, just one level lower and am fine chiropractic care. You have to decide for yourself what you want to do with your body; don't let others bully you. Good luck.
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