Connection between Neuropathy and L4,L5 Issues

@seidholz You are asking good questions in trying to locate the source. You may be interested in Myofascial Release Therapy. Fascia gets tight with injuries and surgical scar tissue. Having had hip replacements, undoubtedly, you will have some scar tissue that may be adding pressure to your spine or limbs and these very small spaces where the nerves are traveling. If you can loosen all of that and relieve the pressure, it may help.

Here is our discussion where you can learn more,
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
and there is a provider search at https://www.mfrtherapists.com/

I have had great results from MFR work and I periodically have to keep doing this to maintain the ability to move correctly and keep my body aligned like it should be. One of the other Mentors, Chris @artscaping has had benefits from MFR work for her neuropathy and I would like to invite Chris into this discussion. Have you heard about myofascial release before? Mayo does have some chiropractors who do MFR therapy in the rehab area.

Thanks so much. Would love to hear from others with the same issue

Yes, L5 lumbar

Stumbled across your article seeking more answers on my PN. I had same diagnosis and same issues. New neurologist identified bilateral L4/L5 nerve root compression on MRI that others overlooked after being diagnosed with idiopathic PN. After back surgery, required to remove the root cause, this past February, doctor says nerve grows back one foot every 300 days starting at the L4/L5 compression. Doctor elluded that nerve damage was above my ankle causing problems in feet. The nerve itch I had above the ankle was a good "marker" for where the nerve would need to regenerate itself, which will take a couple of years. Additionally, I can run my finger down the nerve along my shin and feel my nerves cascading like a waterfall downwards into my feet. I believe this coincides with exactly where the nerve damage is located. Now, I'm looking at my calcium channel blocks blood pressure meds as a help or hurt of regeneration. Ramping up on the B vitamins, fish oil and the like to help regeneration. Keep up your physical therapy to strengthen your core but don't do the exercises that cause a flare. Learned about nerve gliding/flossing but only told to do two sets at 15, you can easily overdo this where it hurts and no longer helps. Hopefully my thoughts aid in your quest for answers. It's taken me several months to get this little bit of information. Good luck ...

My problem is that the three back specialist I saw suggested it could be the L4,L5 degeneration causing mine- however, non of them could guarantee that they could pinpoint the plac where the nerves are impacted. In fact, they all said there was only a 10% chance it could work. The 4th doctor I saw wanted to get me in the next day for surgery and said he was 90% confident he could fix it. Since I only have numbness and occasional pins and needles, I opted to go with intensive PT to rebalance my back and so far it’s working- the numbness is still there but not as intense and manageable.

Good evening @seidholz, and thank you @jenniferhunter for the introduction. As a matter of fact, I was with my two MFR therapists this afternoon. Right now I am struggling with a hip socket that flakes out on me. All of a sudden, as I turn the corner into the kitchen, my right leg will collapse in pain.

I was diagnosed with SFN (small fiber neuropathy) in 2013 through the use of a stem cell biopsy in my ankle. Fortunately, I knew a wonderful lady in my mountain village who was completing her training in (MFR) Myofascial Release Therapy. I began to see her every week and she explained the process to me. If you have spent a little time reading the posts on @jenniferhunter's MFR discussion introduced in the post above, you will begin to understand how this treatment can help relieve pain and facilitate movement.

And you undoubtedly know by now that SFN and other neuropathies are the result of nerves that have been damaged or restricted by things like post-surgery scar tissue. It is also unfortunate but true that nerve cells can die and the messages to your brain are restricted or misunderstood. The result is pain. We would hope that our bodies would regenerate the nerve cells. However, that takes a long time. So if they are dying faster than being replaced, there will be pain and discomfort.

Some of us have difficulty finding the cause of this condition. In that case, our situation is labeled idiopathic. My SFN is the result of trauma from accidents, injuries, and surgeries. Do you know how you acquired your neuropathic condition?

I am going to give you a link to a series called "Strolling under the Skin". This will introduce you to a visual display of connective tissues that can become involved in your neuropathy. You will be able to see how much tissue is actually inside your body.

Let me know what you think and if you have additional questions.

May you be safe, protected and free from inner and outer harm.
Chris

I had my first hip replacement in 1998. Dr Kevin Garvin at UNMC-incredible—. I waited 4 years -suffering pain, lack of sleep, problems staying physically active and most importantly, favoring my left side which most of my specialists think may have caused my L4,L5 issues. They think it was something as simple as the imbalance created by my hip issues.
As a result, once I started feeling my right hip, I called Kevin and said”Can you get me in tomorrow?”
The bottom line is the L4L5 issue. After multiple tests including genetic, I was deemed idiopathic. However, I started to notice that the neuropathy symptoms were sometimes asymmetrical especially after long walks and working out.
The one back doctor I trust said that indicates that the L4L5 issue is most likely the cause on my PN. He also said that if it’s not seriously corrupting your life, to try to live with it. The chance of any surgery to isolate the nerve and relieve the problem is remote.
So, I am mustering on with PT with the knowledge that it could be far worse if I was dealing with the pain and discomfort that most neuropathy cases have

It is my understanding that nerves do not regenerate. Am I wrong? Then what about spinal dissection?

I also had severe pn and a pinched nerve in my l4,5 area. Eventually I decided on surgery. I've been dealing with this for years. Along with the pn I was truely suffering. Surgeons wanted to fuse and stabalize the area. All too many surgeons look upon this as the way to take care of the problem. I kept looking and eventually found Dr. Gordowski at Vanderbilt. He is a specialist in deteriorating backs and conducts micro surgery. This can be a dangerous procedure but if it doesn't work, then fusion can later be done. I opted for this. The problem with fusions is that they tend to fail within a 7-10 year window. And then you need more fusions. My pinched nerve and the area surrounding it have been freed and that problem is resolved. I must continually do strengthening exercises for the rest of my life to try and keep this area problem free. Unfortunately, there was too much long term damage to my lower area and I continue to have pn. At least I can move my left foot which I couldn't do very well before surgery. Look around and check with surgeons who just do fusions. Afterall, surgeons make money by performing what they can do. I don't know if this info is of assistance, but check with specialists who give you more than one option. My 2 cents.

The way that I understand it is that if you have PN from a compressed disc, once you remove the compression, the nerve can regenerate. I think the amount of time that the nerve was under stress plays a role also. In my case, the doctor said that my muscles did not atrophy and he hopes that once the nerve regenerates itself, reconnects, I should gain strength back in my right foot (of which I currentlyfail the 'big toe test'). He said I might have to deal with the pain, numbness, pins and needles forever, however, I'm seeing other YouTube doctors say it can recover. Therefore, I'm trying to maximize my chances by the right diet, nerve gliding/flossing, PT, exercise and vitamins that promote the healing.
Except for this self inflicted PN because I waited too long to have L4/L5 surgery, I am very healthy. Knock on wood ...
I do not think the nerves regenerate themselves when you get PN from diabetes, RA medicine, chemo or the like.
This is what I understand from reading. It's not like doctors are overwhelming anybody with information. There's a doctor above that was noted as 'great'. If they were that great, why are you here seeking answers? I had to read on and off for a few months, came up with a series of questions, and before I get done asking, it seemed like my time was up. Not sure when patients have PN why can't doctors just give you a standard diet to follow, vitamins to take, and immediately refer you to PT. Such as alpha lipoic acid shows get for diabetic PN but not compression PN. I guess if they gave out standard information I wouldn't be making return visits ... ugh