Some lower back pain and numbness and tingling in feet

by Tom
(Knoxville, TN)

Good morning Dr. Preston. I am a 65 year old male, 165 lbs. who has always been an active person. I had a diskectomy in 1989 for a herniated L5/S1 disk. Before the surgery I had extreme pain in my left leg and foot. I specifically do not remember having much lower back pain during that time, but the leg pain was so extreme that maybe I just didn't notice it.

The surgery was successful in that the pain in my leg was gone. I had some residual tingling, but that also subsided within a few months. No fusions were done to the vertebrae. After the surgery I would have occasional bouts with lower back pain and some numbness/tingling in my left foot.

At one point a few years after the surgery when I was having a lengthy bout with this the doctor recommended having a caudal block performed. I agreed not really doing any research. In my opinion either the procedure was performed wrong or I never should have tried it. It not only did not help, but after it my right foot also started having occasional numbness/tingling when I would have lower back pain. It would not happen every time my left foot would bother me, but would happen occasionally. Since then I learned to manage the lower back pain with the numbness/tingling by always being aware of not doing the wrong things while working, lifting, etc.

An interesting note here is that during all these years since the surgery if I would lift and carry something heavy (>30lbs. or so) I would notice that there was a feeling in my left leg that the nerve was getting pinched in my back and causing slight discomfort in my left leg/foot. Once I would stop carrying the weight, the feeling would go away.

Continuing on, this past March I woke up one morning with a very painful lower back and numbness/tingling in both feet. I really could not attribute it to anything unusual I had done the previous day. I put up with it for about a month then went to see an orthopedic surgeon. He took xrays, then I had an MRI. According to him both showed no real abnormalities nor serious degeneration. He did the leg lift and other tests which did not cause any pain or added discomfort. He gave me a shot of steroid in both muscles (don't know which ones). The shots were sort of right above my buttoxes on each side. He also prescribed a muscle relaxer (those things have never helped me). The shots did seem to help the muscles somewhat. After that, he basically said there was nothing else he could do for me. He said maybe the chemicals (whatever those are involved I don't know) released in that area are irritating the nerves and causing my current symptoms.

Presently I still have some lower back pain and numbness/tingling (plus every once in a while a little pain) in mostly the left foot. I really don't have pain in the foot, just the numbness/tingling which is very aggravating. I will also add that the lower back pain (which is accentuated when I curve my back inward or activate the muscles down there by what seems like trying to lift my buttoxes up toward my back - so you can see I'm not sure what muscles these really are) and numbness/tingling mostly go away when I go to sleep, but then immediately start to re-occur once I am up and either walking or sitting. So it seems to be mechanically aggravated for sure. Some days are worse than others, but because I have always been active, this has really affected my walking and bike riding for exercise. I have been doing various exercises since since all this started, but they have not fixed my issue.

Dr. Preston, can you please give me some advice? I too have been one of those people who have always been skeptical of Chiropractic medicine, but I am at my wits end. I am looking for help apparently outside the usual box of fixes an ordinary doctor would have. Sometimes I get the feeling they don't want to think outside the normal realm, they are too busy for that. Can you help me? Thank you very much in advance. Tom

Hello Tom,
You have a fairly typical course, frankly whether you go the medical or chiropractic route.

That initial episode where you had minimal lower back pain, but a fire in your leg suggests you had a complete prolapse, extrusion of the disc into the canal. You obviously attended a good surgeon. If he's still about, you might contact him.

Obviously sticking needles, scalpals into the spine is fraught with danger and whether that caudal block actually damaged another nerve or not is very difficult to say. It's possible, and obviously what you think. It is a fairly standard procedure however.

Seeing that axial pressure increases your symptoms, and lying down relieves them, you might consider inversion traction. Done every day in your home for about 10-15 minutes, many get great relief. Buy one that is kind on the ankles, they take your full weight. No good if your blood pressure is raised significantly.

Go on with your exercises, they are obviously helping.

Consulting a chiropractor? Well, that's your choice, but whatever route you go you can't expect a miracle from one click. My programme would consist of a course of treatment, depending on the examination, of course; perhaps 8 to ten treatments, then taper off as we add more rehab exercises, and then an occasional treatment, perhaps once in four to eight weeks. It would be unlikely to "cure" you, but hopefully greatly relieve.

A peripheral neuropathy needs to be considered too. Perhaps start with a few B vitamin shots in the butt. They sting!

Good luck, I hope this contributes.

Find a good chiropractor may be your next step.

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