Radiculopathy vs Peripheral Neuropathy - weakness in calves

Posted by domiha @domiha, May 15 8:17am

Has anyone noticed a weakness in calves/lower legs when walking? I have numbness in the bottoms of my feet, and sometimes tingling and burning. It has affected my balance a bit, but I find that wearing "nearly barefoot" shoes helps a lot, as I can feel the ground or floor better. But I still seem to have this weakness in my calves. I had lumbar laminectomy in Nov. 2022. For a year before that I could hardly walk because of pain in legs and hips. After the surgery, the terrible hip/leg pain was gone, but I then noticed numbness/tingling in my feet. After waiting 8 months to get in to see a neurologist, he reviewed my EMG and skin biopsy results and he said that rather than peripheral neuropathy he thinks I have radiculopathy, which is coming from remaining compression on some nerves in my lower back that reach down to my feet. Either way, I deal with similar issues. The neuro could not guarantee that a lumbar fusion would help with the radiculopathy. Anyone had lumbar fusion and improved?? Best wishes! Mike

Interested in more discussions like this? Go to the Neuropathy Support Group.

@domiha

My pain management doctor who has done some spinal injections for me... which helped for awhile.... suggested I consider the spinal cord stimulator. But my main issue at this point is the numbness/tingling/sometimes burning in my feet.... and weakness in my calves. There is not a lot of realy PAIN.... so I don't think the SCS would really help me. Sorry your petered out before it was time.

Jump to this post

I had my SCS surgery 3 weeks ago and it is wonderful! I was suffering with terrible neuropathy pain the worst in my feet and lower legs. I was very hesitant at first but now I am so glad that I did this! I have reduced the nerve pain by at least 95%.

REPLY

It has helped me 100% in elimination my lumbar pain. I am so happy for you. God bless you in your journey lovelandmimi. Charles aka brotherchuckles80

REPLY
@domiha

@heisenberg34 What "additional surgery" has been proposed? A re-do of the fusion? More fusion? After my laminectomy, when I began noticing the numbness in my feet, the spine surgeon said, "If I had gone ahead and done the fusion of L4/L5/S1 at the time of the laminectomy, that would probably have prevented the issues with your feet. That was over a year ago and he hasn't mentioned surgery since. They I read that you HAD a fusion and it still did NOT resolve your issues. So it does give me pause. If I felt the fusion had a "good chance" of improving my radiculopathy, I'd jump on the OR table right away. But, of course, there are no certainties or guarantees with surgery. The way he explained it makes perfect sense. "If we fuse, we remove the disc tissue between the vertebrae and place a spacer, which will increase the space back to its original height between the vertebrae. Since I have NO disc left at L5/S1, this would add half an inch just in that one space. Returning the height between vertebrae would open the foramen on each side and allow more space for the nerves to exit the spine without being compromised." So.... mechanically.... it sounds like the perfect solution. But no guarantee. 🙁 Obviously, the skiing may have aggravated or worsened something. Seems it would at least be time to ask for another MRI to take a closer look!!

Jump to this post

Mike thanks for your inquiries and search. As mine is similar from obviously different circumstances. As they all are, I’ll try and be brief which is difficult with these situations. As the devil’s in the details and they grow fast… Couple ?s to start if ya don’t mind. The feelings in Ur feet is it like numbness and pressure. With occasional searing or shooting pain from a toe or toes? Now the pain/numbness in your feet, doesn’t radiate down Ur leg, right? More so isolated to Ur feet? Also curious why it was 9 mos. Before seeing a neurologist? Alright now to your ?s my situation and my reasonings… Ultimately kind of addressing ?s in cpl. of Ur posts. I’m gonna skip the pregame and try to stick to my points for Ya. I had a long onset drop foot on my left side. Never felt it, just slowly noticed it slapping the floor more. Had a cpl. Incidences where it caught the floor and I went down. Never wore an AFO brace until Jan. of 23. So Apr. 29th of 23 I had a TILF with hardware from L3 -L5. Skipping L5-S1 stating that it would shorten surgery time. But may require maintenance in the future. So of course at the time I thought that’s going to allow me more flexibility. So I went along with the plan. The surgery wasn’t done to address the drop foot but because of tightness I had developed in my glutes and hamstrings. Initially after surgery I wasn’t walking as much as I was supposed to, due to the drop foot. And concern I may catch it and go down with my new fusion and hardware… So I started a new job on Aug 20th a desk job. And began walking more, not crazy amounts but more. And both my feet start to feel odd. Numb as well as pressure like an Ace Bandage wrapped around them. And became aware of three spots on my back. Two at the belt line, one about 6-7 inches up close to my spine all left side. So I called my surgical team to tell them about it and request an EMG. So his PA said we’ll just do another MRI. MRI & L5 nerve root injection later, I get my 90 min. EMG and NCS. 4 days later meet with my surgeon, explains nothing to me. Basically has 4 sheets of paper. Points out the name of the diagnosis, with a pen and circles it. U just have to remember this Mononeuritis Multiplex associated w/ Vascilitis. And we’re sending an order to your primary to refer U to someone who practices neuromuscular medicine at the U of M. So I get the call from the scheduler, who say’s un-solicited They said to send U to a regular Neurologist. Which I didn’t ? as I assumed “They” know wut there doing. 1st avail. Appt. 4 months, mind you Now on top of studying constantly. The fields of Orthopedics and Neurology. I get to add Autoimmune diseases… Vasculitis attacking the feet is not a pretty topic. So in Feb. I ask my primary Dr. to refer me to a Rheumatologist with another health care system. Meet with them and they state. I have no idea how they come up with a diagnosis of Vasculitis without any tests. Then Finally April 2024. I meet with the Neurologist who states the tests don’t match the symptoms. So we’ll have to run them again and we’ll schedule a visit the same day. Go to the Lobby next avail. Appt. 4 mos. Going to 2 part this - last long reply I attempted had difficulty posting. But I will Ultimately pull it all together for U and any other interested Hearers... END PART 1

REPLY
@smn1

Mike thanks for your inquiries and search. As mine is similar from obviously different circumstances. As they all are, I’ll try and be brief which is difficult with these situations. As the devil’s in the details and they grow fast… Couple ?s to start if ya don’t mind. The feelings in Ur feet is it like numbness and pressure. With occasional searing or shooting pain from a toe or toes? Now the pain/numbness in your feet, doesn’t radiate down Ur leg, right? More so isolated to Ur feet? Also curious why it was 9 mos. Before seeing a neurologist? Alright now to your ?s my situation and my reasonings… Ultimately kind of addressing ?s in cpl. of Ur posts. I’m gonna skip the pregame and try to stick to my points for Ya. I had a long onset drop foot on my left side. Never felt it, just slowly noticed it slapping the floor more. Had a cpl. Incidences where it caught the floor and I went down. Never wore an AFO brace until Jan. of 23. So Apr. 29th of 23 I had a TILF with hardware from L3 -L5. Skipping L5-S1 stating that it would shorten surgery time. But may require maintenance in the future. So of course at the time I thought that’s going to allow me more flexibility. So I went along with the plan. The surgery wasn’t done to address the drop foot but because of tightness I had developed in my glutes and hamstrings. Initially after surgery I wasn’t walking as much as I was supposed to, due to the drop foot. And concern I may catch it and go down with my new fusion and hardware… So I started a new job on Aug 20th a desk job. And began walking more, not crazy amounts but more. And both my feet start to feel odd. Numb as well as pressure like an Ace Bandage wrapped around them. And became aware of three spots on my back. Two at the belt line, one about 6-7 inches up close to my spine all left side. So I called my surgical team to tell them about it and request an EMG. So his PA said we’ll just do another MRI. MRI & L5 nerve root injection later, I get my 90 min. EMG and NCS. 4 days later meet with my surgeon, explains nothing to me. Basically has 4 sheets of paper. Points out the name of the diagnosis, with a pen and circles it. U just have to remember this Mononeuritis Multiplex associated w/ Vascilitis. And we’re sending an order to your primary to refer U to someone who practices neuromuscular medicine at the U of M. So I get the call from the scheduler, who say’s un-solicited They said to send U to a regular Neurologist. Which I didn’t ? as I assumed “They” know wut there doing. 1st avail. Appt. 4 months, mind you Now on top of studying constantly. The fields of Orthopedics and Neurology. I get to add Autoimmune diseases… Vasculitis attacking the feet is not a pretty topic. So in Feb. I ask my primary Dr. to refer me to a Rheumatologist with another health care system. Meet with them and they state. I have no idea how they come up with a diagnosis of Vasculitis without any tests. Then Finally April 2024. I meet with the Neurologist who states the tests don’t match the symptoms. So we’ll have to run them again and we’ll schedule a visit the same day. Go to the Lobby next avail. Appt. 4 mos. Going to 2 part this - last long reply I attempted had difficulty posting. But I will Ultimately pull it all together for U and any other interested Hearers... END PART 1

Jump to this post

PART 2 OK skip a bunch of relevant details. May 1st I have an appt. w/ Neurologist who practices Neuromuscular Med. Says the original study was abnormal, I asked him for a referral to a neurosurgeon at CSC. As the original Neurosurgeon I received from Mhealth was 80 years old. And the scheduler at that office was a Tyrant. We run tests again May 29 after, he states what did they say U had again? I told him and he says yea I don’t think that’s the case. And this could very well be being caused organically by your spine. But We’ll see what Dr P say’s. Out the door he shoots. Meet with Neurosurgeon July 16th insists that since it doesn’t radiate down the leg. It can’t be the cause, it must be neuropathy. So I meet with the Neurologist once more after this visit. And towards the end of the visit we’re sitting talking. And he outta nowhere says, I don’t necessarily agree. I said with what? And he say’s that the feet issues aren’t being caused by the spine. So he put in a referral for a non- surgical spine specialist and pain clinic. But I took a month off from the Doctors. I’m switching health systems. And I’ll try for resolution once more. Now to the nuts and the bolts of it. As for my circumstance obviously an issue with L5- S1 existed causing my drop foot. It didn’t radiate down the leg. When the laminectomy and fusion were performed L3-L5. It’s essentially like building a 3 story building with penthouses on a Limestone foundation… It’s not a matter of if it’s gonna fail, rather When? Obviously your situation with the L5 S1 disc existed prior. Because the disc didn’t disappear in 6 mos. Or however long the onset of this took after your laminectomy. 2 possible factors the laminectomy changed the mechanics of Ur spine slightly. And being freed from Ur prior extreme pain, potentially walking more and being more active, put the L5 S1 joint/disc over the edge. If U check out some nerve innervation images online. U find L5 S1 with minor participation of L4 pretty much innervate the feet. So it would stand to reason that if those are impinged, compressed what have U. That could be the cause. The other consideration and it’s the same I have. As to how long now that nerve has been compressed. And to what extent damage has occurred. As well as, if and how long it would take to heal. But I’ve heard stories where the pressure was relieved and symptoms went away. As to Ur ? About ALIF and S1 L5 if U check out a side view image of the Lumbar spine. From what I understand the angle of the vertebrae. Prevents accessing the disc from the back and is preferred for bracing or as Ur guy said plates. As far as the screws and rods in the back. They look gangley in pictures. But U wouldn’t even know they are there. I’m gonna leave it at that for now. Hope U or someone can gain something out of it. Fight the Good Fight

REPLY

@smn1 Thanks for taking the time to share your story. And like many others here, it seems you are still in the midst of what may a "neverending story." As to your questions, I didn't see a neurologist for 9 months because it took that long to get in to see one. In the meantime, my podiatrist did a skin plug biopsy on my feet... and she referred me for an EMG.... which revealed there was probably still some compression of nerves at some point. The skin biopsy revealed the "beginnings" of neuropathy. When I did FINALLY get in to see the neurologist, he did a number of exams and in the end simply said that he felt it was more likely that I was experiencing issues from radiculopathy rather than neuropathy. My numbness and tingling is in my feet... and a bit up into my ankles, but not, the feeling doesn't run down my legs to my feet. I don't have real pain in my feet.... just the numbness/burning/tingling and at times it's worse than at others. It's typically a bit better first thing in the morning.... before I have stood or sat and put the weight of my body on my spine. I saw four different surgeons for the laminectomy before I decided on one.... and in the end went with one who I feel to be very competent... and young enough to be up on newer procedures. The laminectomy was L2-S1. One of the consults I had was with a neurosurgeon at Emory and he said he would do the same laminectomy but he would put a spacer between L5 and S1 (where I have no disc left). If not, he said I would be back within a year. The surgeon I chose did NOT add the spacer.... and didn't do any vertebral decompression/fusion at all. Afterwards, with the numbness and burning in my feet, he said that if he had done a fusion that may have solved those issues. And he is willing to revisit that if and when I decide. Just not sure I want to go through a fusion of L3 to S1 on the assumption it "might" help. My laminectomy was a relatively easy recovery... but I understand a fusion will be much more daunting. And if it doesn't help my foot issues? And if it makes them worse? The neurologist I saw does not do surgery.... and I saw him primarily because I wanted to rule out things like ALS, MS, etc. Again, I thank you for sharing.... and I hope that you, too, will be able to find some answers and get some relief. And I'm sure your story will reverberate with others here, as well. My lot could be a whole lot worse.... and I try to remember to be thankful for my blessings. I've learned over the years with any issues I have faced that one has to be his/her own health advocate. Doctors can be great... but they can get busy and sometimes overlook things. I live in this body, so I'm aware of it every single day, while they are only concerned with it when I present to them seeking help. And there are times when we have to be that proverbial squeaky wheel .... to get some grease! Best wishes to you in your journey!! Mike

REPLY
@domiha

@smn1 Thanks for taking the time to share your story. And like many others here, it seems you are still in the midst of what may a "neverending story." As to your questions, I didn't see a neurologist for 9 months because it took that long to get in to see one. In the meantime, my podiatrist did a skin plug biopsy on my feet... and she referred me for an EMG.... which revealed there was probably still some compression of nerves at some point. The skin biopsy revealed the "beginnings" of neuropathy. When I did FINALLY get in to see the neurologist, he did a number of exams and in the end simply said that he felt it was more likely that I was experiencing issues from radiculopathy rather than neuropathy. My numbness and tingling is in my feet... and a bit up into my ankles, but not, the feeling doesn't run down my legs to my feet. I don't have real pain in my feet.... just the numbness/burning/tingling and at times it's worse than at others. It's typically a bit better first thing in the morning.... before I have stood or sat and put the weight of my body on my spine. I saw four different surgeons for the laminectomy before I decided on one.... and in the end went with one who I feel to be very competent... and young enough to be up on newer procedures. The laminectomy was L2-S1. One of the consults I had was with a neurosurgeon at Emory and he said he would do the same laminectomy but he would put a spacer between L5 and S1 (where I have no disc left). If not, he said I would be back within a year. The surgeon I chose did NOT add the spacer.... and didn't do any vertebral decompression/fusion at all. Afterwards, with the numbness and burning in my feet, he said that if he had done a fusion that may have solved those issues. And he is willing to revisit that if and when I decide. Just not sure I want to go through a fusion of L3 to S1 on the assumption it "might" help. My laminectomy was a relatively easy recovery... but I understand a fusion will be much more daunting. And if it doesn't help my foot issues? And if it makes them worse? The neurologist I saw does not do surgery.... and I saw him primarily because I wanted to rule out things like ALS, MS, etc. Again, I thank you for sharing.... and I hope that you, too, will be able to find some answers and get some relief. And I'm sure your story will reverberate with others here, as well. My lot could be a whole lot worse.... and I try to remember to be thankful for my blessings. I've learned over the years with any issues I have faced that one has to be his/her own health advocate. Doctors can be great... but they can get busy and sometimes overlook things. I live in this body, so I'm aware of it every single day, while they are only concerned with it when I present to them seeking help. And there are times when we have to be that proverbial squeaky wheel .... to get some grease! Best wishes to you in your journey!! Mike

Jump to this post

Amen Brother 😉

REPLY
Please sign in or register to post a reply.