Neuropathy from lumbar stenosis?

Posted by westcom @westcom, Aug 21, 2022

Has anyone experienced neuropathy in the buttock and posterior thighs as a symptom of L4-5 nerve compression from spinal stenosis. If yes, did surgery help?

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Yes, I have failed lumbar back surgery. Developed neuropathy almost immediately after surgery. I had zero leg pain and mid-hip pain before surgery. I did have bursitis in both hip joints prior to surgery. Orthopedic surgeon said the bursitis pain was caused from my back problems, and would go away after surgery. That didn’t happen, I’m in far greater pain post surgery than I was before. It’s been 12 years ago, still have original back pain except it’s much worse, neuropathy in both legs, and bursitis in both hip joints. I do not recommend back surgery. Try everything else first.

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@njed

Quick comment about Mayo Rochester. I live 1200 miles from Rochester MN. After seeing various neuro docs in South Jersey and Philadelphia, I figured if I want to get the best advise, I have to see the best. Went in Feb 2020. Brrr!! They were above fantastic and although I walked away with no conclusive reason for my neuropathy, to this day, I have no regrets in going. They are on the cutting edge of many types of tests and are sensitive to your schedule while being there. The best without any doubt.

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I spent a week at Mayo Rochester in June 2021, for idiopathic small fiber neuropathy. Did a ton of test and bloodwork. No cause for my neuropathy was found. I also have moderate to severe stenosis at L3-4 and L4-5. Talked with a neurosurgeon at Mayo and she said there was NO connection between the stenosis and my neuropathy. She wanted to do a multi-level laminectomy. I do have some back pain but nothing compared to the neuropathy, so I decided against the back surgery. I think all the time if I had the surgery is there an outside chance the neuropathy would get better. Who knows. There is no end to the suffering in sight. No drugs work, except marijuana gummies does help some.

Investigate going to a pain clinic and discuss with them spinal cord stimulation.

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@jenniferhunter

@westcom I was a patient that surgeons couldn't correlate the imaging with my symptoms, and 5 of them got it wrong before I came to Mayo. The spinal cord compression in my neck was causing pain all over my body. It's called "funicular" or referred pain. My Mayo neurosurgeon knew about this, and if fact, I found out about it because of one of his papers. Here is a link to medical literature that describes it.
http://europepmc.org/article/PMC/3111492
I think that if you have something happening at a couple different levels at the same time, it might bring this on. I have a bulging lumbar disc, and I had cord compression at C5/C6. After cervical fusion, it stopped all the pain. When you have listhesis, and one level is slipping over another, essentially that makes the spinal canal smaller at that location and it could put more pressure on the spinal cord if there is no fluid space left around it. I had 2 mm of slipping and when muscle spasms moved that, it caused me to limp with an uneven gait. I couldn't get any surgeon to help me until I came to Mayo. I sent a copy of this literature when I applied to be seen at Mayo.

Do you have surgery scheduled now?

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Jennifer,
You said you had cord compression at C5/C6 and had cervical fusion. Did you have neck pain also because of the cervical problem?

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@martyk Thanks for asking. Yes, I did have neck pain, and pain all over my body. I think there was pain generated from the bad disc too, and it was slipping a bit causing cord compression. I would get muscle spasms in my neck and bad cervicogenic headaches on the back of my head, and even some vertigo intermittently. My physical therapist was treating me with a Dolphin neurostimulator on the nerve roots to block pain signals.

Are you having similar symptoms?

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@magnum52

I spent a week at Mayo Rochester in June 2021, for idiopathic small fiber neuropathy. Did a ton of test and bloodwork. No cause for my neuropathy was found. I also have moderate to severe stenosis at L3-4 and L4-5. Talked with a neurosurgeon at Mayo and she said there was NO connection between the stenosis and my neuropathy. She wanted to do a multi-level laminectomy. I do have some back pain but nothing compared to the neuropathy, so I decided against the back surgery. I think all the time if I had the surgery is there an outside chance the neuropathy would get better. Who knows. There is no end to the suffering in sight. No drugs work, except marijuana gummies does help some.

Investigate going to a pain clinic and discuss with them spinal cord stimulation.

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magnum52 - I did attempt spinal cord stimulation 4 years ago for a 25 minute treatment and literally got home and that night, had trouble standing. Back pain a 6 -7 and doc could not figure out why. Following week, went back for 15 minute treatment, same thing, not good. Idea was to stimulate lower back area which might help with reduction in numbness lower legs and feet. This doc refuses to try again, I told him that he didn't have to worry about that. But makes me wonder in percentages how many folks with back issues have PN.

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@magnum52

I spent a week at Mayo Rochester in June 2021, for idiopathic small fiber neuropathy. Did a ton of test and bloodwork. No cause for my neuropathy was found. I also have moderate to severe stenosis at L3-4 and L4-5. Talked with a neurosurgeon at Mayo and she said there was NO connection between the stenosis and my neuropathy. She wanted to do a multi-level laminectomy. I do have some back pain but nothing compared to the neuropathy, so I decided against the back surgery. I think all the time if I had the surgery is there an outside chance the neuropathy would get better. Who knows. There is no end to the suffering in sight. No drugs work, except marijuana gummies does help some.

Investigate going to a pain clinic and discuss with them spinal cord stimulation.

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Why do so many of us have spine problems and neuropathy? Can any one answer this?

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Yes and YES! I was in the absolute worst pain of my life until my back surgery. The surgeon removed a large triangle-shaped piece of cartilage which he said had calcified and was "hard as bone". He said it would never have gotten better without surgery.

The recovery was not a cakewalk, but I'm thankful I had a great surgeon who "fixed" me.

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@lewin

Why do so many of us have spine problems and neuropathy? Can any one answer this?

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The million dollar question! But, I did try. In Aug 2019, I went so far to have targeted injections in the L-4 -L-5 area, the following day, pain level below one. It was an epidural lumbar spinal injection and my walking for 3 days improved 50%. Had second treatment a month later, got 5 days. Because the relief didn't last longer, the pain management anesthesiologist would not do 3rd injection. My neuropathy did not go away but decreased. Boy, those five days were terrific. My problem is that when a doc sees me walk in with supports and a cane... yet I do walk in on my own, I think they are afraid to do a procedure making me worse off than when I walked in. So, the spine problems continue along with the PN. Any connection or simply a coincidence??

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@lewin

Why do so many of us have spine problems and neuropathy? Can any one answer this?

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Probably because the nervous system runs through the spinal cord and nerves do not like it when they get compressed or damaged by spinal issues. At least that's what this side of the peanut gallery thinks. 🙃

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@johnbishop

Probably because the nervous system runs through the spinal cord and nerves do not like it when they get compressed or damaged by spinal issues. At least that's what this side of the peanut gallery thinks. 🙃

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I'm with you on that 100%. The "sensations" (for lack of a better word) in my feet if anyone touches any area of my back is something my docs can't figure out. Best described as chills, vibrations, intense feeling bottom of foot. Remove hand from back, instantly stops. I told one doc it's like my peripheral nervous system in the back is fired up...electrified. Response..hmm.
Thanks for your insight.

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