Lumbar Neuropathy … how to heal … ugh

Posted by marvininhouston @marvininhouston, Sep 2 7:14pm

Had slight numbness from playing competitive volleyball after 50 years old. Then, in February, woke with a herniated disc. Reinjured, reinjured and reinjured, spent six months in bed or walking hunched over. At six month mark, after acupuncture, I finally got vertical and my feet got severely increased neuropathy following L5 pattern. I feel when I got my lower back curvature back, it pressed on nerve. I then noticed I failed big toe test, hence, L5 nerve root compression. The next six weeks made good progress, but then I sat in a barstool to watch a ball game, picked a couple of weeds, and the last four weeks it’s gotten worse. It was numbness to around base of toes, now getting closer to ankle. Neurologist did electrical test and said I don’t have a pinched nerve. I think he’s wrong and doing new MRI. I’ve taken nerve vitamins this past year. Blood work is good. Confused on why I’m not healing. Thoughts are appreciated!!

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

I too am wondering if severe stenosis in L4 and L5 is causing my foot neuropathy. Finally pressed a new doctor to get me a current MRI and an appointment with a neurosurgeon who does minimal surgery. I hope that my 3 years of neuropathy will be resolved at least partially in this way. I too have had a life of sports and falls from horses and skiing.

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As noted in my other posts, my foot neuropathy started all of a sudden in left foot only in May 2019. It did not start in toes, started in entire front half of foot all at once. A year later moved to the right foot. It is progressively getting worse in both feet, but it is still numbness, not pain, although almost pain now. Seems worse first thing in the morning. I walk 2 hours a day and that sort of helps it. Blood work is all fine. I have B12 deficiency but have been taking shots for years.

I have always had an issue with my lower back, which seemed minor, and simply ached a bit if I lifted too much — never major pain. I had an MRI done in 2019 (results below) but Docs said they did not see anything

After 2x neurologists, podiatrist and a Chiropractor no cause can be found. My Primary is sending me to a spine doctor and trying to get a new MRI and CT of neck/skull done, waiting for insurance approval.

================

EXAM: MRI LUMBAR SPINE (BONE) WITHOUT INTRAVENOUS CONTRAST
COMPARISON: Abdominal CT on July 16, 2014.
HISTORY: * Back pain, > 6wks conservative tx, persistent-progressive sx, surgical candidate
back pain as well as numbness of feet B/L- left side worse then right. this is getting worse. seen by neuro in the past.
TECHNIQUE: Exam performed on a 1.5 Tesla high-field MRI scanner. Magnetic resonance imaging of the lumbar spine was performed WITHOUT injected contrast using standard department protocols. Sagittal T1, T2 and STIR, axial T1 and T2 sequences were obtained.
FINDINGS:
ALIGNMENT: Exaggerated lumbar lordosis. Minimal grade 1 retrolisthesis of L4 on L5.
VERTEBRAL BODIES: Vertebral body heights are maintained. Bone marrow signal pattern is within normal limits.
INTERVERTEBRAL DISCS: Very minimal desiccation changes and very minimal loss of height of L4-L5 and L5-S1 discs.
SPINAL CORD/CONUS: Included spinal cord has normal caliber and signal characteristics. The conus terminates normally at L1-L2.
Level by level analysis yields the following:
L1-2: No disc herniation. No significant canal or neuroforaminal stenosis.
L2-3: No disc herniation. No significant canal or neuroforaminal stenosis.
L3-4: Shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
L4-5: Minimal bulging with superimposed shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
L5-S1: Minimal bulging disc with superimposed shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
OTHERS:Visualized portions of the retroperitoneal structures are grossly unremarkable. Posterior paraspinal soft tissues are unremarkable.
IMPRESSION:
1. Mild degenerative disc changes at L3-L4, L4-L5 and L5-S1, without causing significant canal or neuroforaminal stenosis.
2. Exaggerated lumbar lordosis. Minimal grade 1 retrolisthesis of L4 on L5.
POS – CDHRADBOARDWS10
Electronically Signed by: XXXX on 10/31/2019 4:05 PM

REPLY
@rickhood

As noted in my other posts, my foot neuropathy started all of a sudden in left foot only in May 2019. It did not start in toes, started in entire front half of foot all at once. A year later moved to the right foot. It is progressively getting worse in both feet, but it is still numbness, not pain, although almost pain now. Seems worse first thing in the morning. I walk 2 hours a day and that sort of helps it. Blood work is all fine. I have B12 deficiency but have been taking shots for years.

I have always had an issue with my lower back, which seemed minor, and simply ached a bit if I lifted too much — never major pain. I had an MRI done in 2019 (results below) but Docs said they did not see anything

After 2x neurologists, podiatrist and a Chiropractor no cause can be found. My Primary is sending me to a spine doctor and trying to get a new MRI and CT of neck/skull done, waiting for insurance approval.

================

EXAM: MRI LUMBAR SPINE (BONE) WITHOUT INTRAVENOUS CONTRAST
COMPARISON: Abdominal CT on July 16, 2014.
HISTORY: * Back pain, > 6wks conservative tx, persistent-progressive sx, surgical candidate
back pain as well as numbness of feet B/L- left side worse then right. this is getting worse. seen by neuro in the past.
TECHNIQUE: Exam performed on a 1.5 Tesla high-field MRI scanner. Magnetic resonance imaging of the lumbar spine was performed WITHOUT injected contrast using standard department protocols. Sagittal T1, T2 and STIR, axial T1 and T2 sequences were obtained.
FINDINGS:
ALIGNMENT: Exaggerated lumbar lordosis. Minimal grade 1 retrolisthesis of L4 on L5.
VERTEBRAL BODIES: Vertebral body heights are maintained. Bone marrow signal pattern is within normal limits.
INTERVERTEBRAL DISCS: Very minimal desiccation changes and very minimal loss of height of L4-L5 and L5-S1 discs.
SPINAL CORD/CONUS: Included spinal cord has normal caliber and signal characteristics. The conus terminates normally at L1-L2.
Level by level analysis yields the following:
L1-2: No disc herniation. No significant canal or neuroforaminal stenosis.
L2-3: No disc herniation. No significant canal or neuroforaminal stenosis.
L3-4: Shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
L4-5: Minimal bulging with superimposed shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
L5-S1: Minimal bulging disc with superimposed shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
OTHERS:Visualized portions of the retroperitoneal structures are grossly unremarkable. Posterior paraspinal soft tissues are unremarkable.
IMPRESSION:
1. Mild degenerative disc changes at L3-L4, L4-L5 and L5-S1, without causing significant canal or neuroforaminal stenosis.
2. Exaggerated lumbar lordosis. Minimal grade 1 retrolisthesis of L4 on L5.
POS – CDHRADBOARDWS10
Electronically Signed by: XXXX on 10/31/2019 4:05 PM

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I thought lumbar neuropathy starts at toes because it’s the furthest ending of the nerve with the least nutrients. While you said you went to a podiatrist, I would think if you had a pinched nerve in your ankle(s), would that effect the entire foot before the toes? Thus, it’s not your back???

REPLY
@marvininhouston

I thought lumbar neuropathy starts at toes because it’s the furthest ending of the nerve with the least nutrients. While you said you went to a podiatrist, I would think if you had a pinched nerve in your ankle(s), would that effect the entire foot before the toes? Thus, it’s not your back???

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Yeah, I am not at all sure it is my back. Podiatrist says it is nothing in my feet. So who knows? Like with so many others, this is a mystery.

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@karleenhubley

I too am wondering if severe stenosis in L4 and L5 is causing my foot neuropathy. Finally pressed a new doctor to get me a current MRI and an appointment with a neurosurgeon who does minimal surgery. I hope that my 3 years of neuropathy will be resolved at least partially in this way. I too have had a life of sports and falls from horses and skiing.

Jump to this post

I have same issue at L-4 – L-5 and S-1. One of top neurosurgeons in eastern PA said that my narrowing can contribute towards the numbness in both feet but is not the actual cause of my PN. In 2020, Mayo Clinic confirmed as well. But, even now, I touch the lower back areas, strong tingle in ankles and feet. Hard to dispute the opinions of experts. So, no surgery will remedy my PN. And yes, I have lower back pain. Again, each case is different. Wish you the best.

REPLY
@rickhood

As noted in my other posts, my foot neuropathy started all of a sudden in left foot only in May 2019. It did not start in toes, started in entire front half of foot all at once. A year later moved to the right foot. It is progressively getting worse in both feet, but it is still numbness, not pain, although almost pain now. Seems worse first thing in the morning. I walk 2 hours a day and that sort of helps it. Blood work is all fine. I have B12 deficiency but have been taking shots for years.

I have always had an issue with my lower back, which seemed minor, and simply ached a bit if I lifted too much — never major pain. I had an MRI done in 2019 (results below) but Docs said they did not see anything

After 2x neurologists, podiatrist and a Chiropractor no cause can be found. My Primary is sending me to a spine doctor and trying to get a new MRI and CT of neck/skull done, waiting for insurance approval.

================

EXAM: MRI LUMBAR SPINE (BONE) WITHOUT INTRAVENOUS CONTRAST
COMPARISON: Abdominal CT on July 16, 2014.
HISTORY: * Back pain, > 6wks conservative tx, persistent-progressive sx, surgical candidate
back pain as well as numbness of feet B/L- left side worse then right. this is getting worse. seen by neuro in the past.
TECHNIQUE: Exam performed on a 1.5 Tesla high-field MRI scanner. Magnetic resonance imaging of the lumbar spine was performed WITHOUT injected contrast using standard department protocols. Sagittal T1, T2 and STIR, axial T1 and T2 sequences were obtained.
FINDINGS:
ALIGNMENT: Exaggerated lumbar lordosis. Minimal grade 1 retrolisthesis of L4 on L5.
VERTEBRAL BODIES: Vertebral body heights are maintained. Bone marrow signal pattern is within normal limits.
INTERVERTEBRAL DISCS: Very minimal desiccation changes and very minimal loss of height of L4-L5 and L5-S1 discs.
SPINAL CORD/CONUS: Included spinal cord has normal caliber and signal characteristics. The conus terminates normally at L1-L2.
Level by level analysis yields the following:
L1-2: No disc herniation. No significant canal or neuroforaminal stenosis.
L2-3: No disc herniation. No significant canal or neuroforaminal stenosis.
L3-4: Shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
L4-5: Minimal bulging with superimposed shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
L5-S1: Minimal bulging disc with superimposed shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
OTHERS:Visualized portions of the retroperitoneal structures are grossly unremarkable. Posterior paraspinal soft tissues are unremarkable.
IMPRESSION:
1. Mild degenerative disc changes at L3-L4, L4-L5 and L5-S1, without causing significant canal or neuroforaminal stenosis.
2. Exaggerated lumbar lordosis. Minimal grade 1 retrolisthesis of L4 on L5.
POS – CDHRADBOARDWS10
Electronically Signed by: XXXX on 10/31/2019 4:05 PM

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You need a good PT program to strengthen your back muscles and your core so your bulges don’t progress further. You certainly want to avoid surgery at all costs and PT has been a godsend for me s/p L4-S2 fusion, L5 laminectomy in 1990 following a fall down stairs during a small earthquake in Los Angeles. Forward to 2022 I have osteoarthritis, osteoporosis (they didn’t know abt vit. K2 back then for calcium absorption) and bilateral lower extremity PN in great part for not continuing my HEP from PT all those years. I was glad to just be back working after 5 yrs on disability. Do yourself some good and get in shape.

REPLY
@njed

I have same issue at L-4 – L-5 and S-1. One of top neurosurgeons in eastern PA said that my narrowing can contribute towards the numbness in both feet but is not the actual cause of my PN. In 2020, Mayo Clinic confirmed as well. But, even now, I touch the lower back areas, strong tingle in ankles and feet. Hard to dispute the opinions of experts. So, no surgery will remedy my PN. And yes, I have lower back pain. Again, each case is different. Wish you the best.

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Do you mind sharing the name of the neurosurgeon and the location/area where they practise? I recently had an MRI with significant lumbar changes from last one 4 years ago, not sure what to do.

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@centre

Do you mind sharing the name of the neurosurgeon and the location/area where they practise? I recently had an MRI with significant lumbar changes from last one 4 years ago, not sure what to do.

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centre – I went to Phila – Jefferson Univ Hosp last name Harrop.

REPLY
@rickhood

As noted in my other posts, my foot neuropathy started all of a sudden in left foot only in May 2019. It did not start in toes, started in entire front half of foot all at once. A year later moved to the right foot. It is progressively getting worse in both feet, but it is still numbness, not pain, although almost pain now. Seems worse first thing in the morning. I walk 2 hours a day and that sort of helps it. Blood work is all fine. I have B12 deficiency but have been taking shots for years.

I have always had an issue with my lower back, which seemed minor, and simply ached a bit if I lifted too much — never major pain. I had an MRI done in 2019 (results below) but Docs said they did not see anything

After 2x neurologists, podiatrist and a Chiropractor no cause can be found. My Primary is sending me to a spine doctor and trying to get a new MRI and CT of neck/skull done, waiting for insurance approval.

================

EXAM: MRI LUMBAR SPINE (BONE) WITHOUT INTRAVENOUS CONTRAST
COMPARISON: Abdominal CT on July 16, 2014.
HISTORY: * Back pain, > 6wks conservative tx, persistent-progressive sx, surgical candidate
back pain as well as numbness of feet B/L- left side worse then right. this is getting worse. seen by neuro in the past.
TECHNIQUE: Exam performed on a 1.5 Tesla high-field MRI scanner. Magnetic resonance imaging of the lumbar spine was performed WITHOUT injected contrast using standard department protocols. Sagittal T1, T2 and STIR, axial T1 and T2 sequences were obtained.
FINDINGS:
ALIGNMENT: Exaggerated lumbar lordosis. Minimal grade 1 retrolisthesis of L4 on L5.
VERTEBRAL BODIES: Vertebral body heights are maintained. Bone marrow signal pattern is within normal limits.
INTERVERTEBRAL DISCS: Very minimal desiccation changes and very minimal loss of height of L4-L5 and L5-S1 discs.
SPINAL CORD/CONUS: Included spinal cord has normal caliber and signal characteristics. The conus terminates normally at L1-L2.
Level by level analysis yields the following:
L1-2: No disc herniation. No significant canal or neuroforaminal stenosis.
L2-3: No disc herniation. No significant canal or neuroforaminal stenosis.
L3-4: Shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
L4-5: Minimal bulging with superimposed shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
L5-S1: Minimal bulging disc with superimposed shallow central disc protrusion. No significant canal or neuroforaminal stenosis.
OTHERS:Visualized portions of the retroperitoneal structures are grossly unremarkable. Posterior paraspinal soft tissues are unremarkable.
IMPRESSION:
1. Mild degenerative disc changes at L3-L4, L4-L5 and L5-S1, without causing significant canal or neuroforaminal stenosis.
2. Exaggerated lumbar lordosis. Minimal grade 1 retrolisthesis of L4 on L5.
POS – CDHRADBOARDWS10
Electronically Signed by: XXXX on 10/31/2019 4:05 PM

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My goodness Rick, I doubt anyone here who hasn't had a medical background, wouldn't know the slight's of what you have posted! That's a lot of typing , must've taken hours for you to accomplish!

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Any one who has delt with lower back pain and neurophy would get the L1-L5 type references. Or it just could be that having had many MRIs over the last 30 years it just sounds like standard talking.

I did find out that after 20 years I got enough feeling bask that I could tell if I was on carpet or tile and got the movement back of my toes thanks to my primary care doctor noticed a slightly above range levels of calcium but within the standard deviation for error. Luckily it was followed with a test of Parathyroid levels and they were through the roof.

Within hours of the hyperactive parathyroid removal I could move my toes and had feeling back. Lasted for 5 months now feet are numb 24/7 but still can move toes.

Hope this helps someone. My neurosurgeon has said as soon as the bulging hit the spinal cord insurance will pay for 2 rods to be attached to every vertebrae. Although I have heard of 2nd stage trial that the inject a fluid into your discs.
Wishing you success in your journey.

REPLY
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