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Bulging Disc/Weak leg

silverbearssilverbear Posts: 12
edited 11/12/2014 - 11:40 AM in Lower Back Pain
Hello all,

I had an MRI done about a month ago and it showed a bulging disc on L4. This has been causing back pain for about 3 years (CT Scans had been done before, although nothing showed up). Earlier this year, I found it increasingly difficult to walk because my left leg was much weaker than the right. I noticed a slight weakness about a year ago, although thought nothing of it, especially because I wasn't limping when walking, although now I am and have been for about 5 months.

My doctor has referred my to physical therapy.

I've read a lot online and I'm sure I have drop foot. This is scary as it looks to effect the peroneal nerve, and some sites say it's irreversible in some cases.

My question is this: I have lower back pain when I sit for long periods of time that gets pretty bad, plus I have the weak leg. I'm not that old and wonder about the future....if permanent, wouldn't surgery be the best option? If not, what would be the best thing to do?

Any advice appreciated!!


It would be very helpful if you could provide us with more details. Here are some questions that you
should answer:

  • - When did this first start?
    - Was it the result of an accident or trauma?
    - What doctors have you seen?
    - What Conservative treatments have you had? Which ones?
    - What diagnostic tests have you had? And their results
    - What medications are you currently using?
    - Has surgery been discussed as an option?
    - What is your doctor’s action plan for treating you?
Providing answers to questions like this will give the member community here a better understanding
of your situation and make it easier to respond.

Ron DiLauro, Spine-Health System Moderator 11/12/14 17:40


  • Here is some addition information as of the last post:

    -The lower back pain started about 3 years ago. I first noticed a weaker left leg last year although thought nothing of it. More than likely the leg has slowly become weaker over the course of the last 3 years, since the low back pain began
    -The back pain was the result of heavy lifting after the purchase of a new house. I also put stress on the low back with poor sitting posture in an attempt to alleviate knee pain. Excessive stress was the cause of the low back pain, not one incident
    -I have seen only my GP - not other doctors
    -Conservative treatments include Meloxicam, naproxen, and I've just begun physiotherapy
    -Diagnostic test include 2 CT Scans which showed nothing along with 2 x-rays. The MRI 2 months ago showed disc bulging in L4. This is thought to be impringing the Peroneal nerve, causing leg weakness
    -My GP discussed surgery as an opition, although said only if the disc because herniated or more severe than it is now. I am set to see him again next week
    -Doctor's action plan: physiotherapy, monitoring progress

    Hope this helps re: more informaton. As mentioned in the last post, i'm increasingly concerned about the long-term prognosis for the weak leg and associated chronic lower back pain.

    Any input appreciated.
  • I'd get a referral (if you need one) to a spine specialist. I see a spine Neuro surgeon. GPs are the right place to start but they're not really spine experts. With numbness there are other tests they can do. I've got permanent nerve damage & if I could turn back time I'd of seen the correct specialists right from the start. Nerve impingement can be very serious & waiting isn't always a good idea.

    I'm sorry. Best of luck!
    Osteoarthritis & DDD.
  • Thanks for the feedback, English Girl. I'm planning on seeing my doctor next week. I too another look at my MRI and it states, "Intervertebral foraminal narrowing of the left sided L4-5 disc space level along with an annular tear" This sounds like nerve compression, yes?
  • We're not supposed to translate MRIs. I'm glad you're seeing your doc but I'd ask to see a proper spine specialist. Often they see things that a regular GP doesn't. They look at your MRI (don't just read the summary) & examine you. They really are the best people to diagnose you & get you on the correct treatment path. They can offer many treatments that your doc can't do or refer you to the proper specialists & therapists to treat you. Possible foot drop isn't a 'wait & see' situation. Sometimes we have to push a little for the correct care.
    Osteoarthritis & DDD.
  • well i'm going to be quite proactive with me doctor re: a referral to a neurosurgeon. I just don't want any permanent damage, the best health advice. Cheers.
  • I do have a question though that I would really like some input on:

    If been told it's possible that the weak left leg could be due to favoring the right leg for the last 3 years as a result of the bulging disc at L4. Has anyone heard that favoring, because of a bulging disc, could be the cause of a much weaker leg?

  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 11/20/2014 - 3:00 PM
    I'm not very scientifically minded...I've just become an expert on me, if you know what I mean. That does sound logical. Great if it's true because it's a physical therapy fix! I'm still a better safe than sorry believer. If nerve compression is causing this problem it MUST be relieved in one way or another. I don't believe in jumping to surgery. I'd want to know exactly what's causing this. Your neuro can do nerve tests to see if it's your spine, then direct the best course of action. We can share our experiences more once we know. In my case my left leg is more effected by my spine. My right leg pain (from side of spine, into bum, hip & down) has as much to do with my SI joint (often missed) as what the discs & bone spurs are doing in my spine. It all gets so complicated doesn't it??

    When are you seeing the Neuro?
    Osteoarthritis & DDD.
  • Thank you, English Girl. Yes it does get complicated. I was supposed to have an appt. with my GP this past week although it was cancelled...so re-booked for next week. Then I'm going to press him on seeing a Neuro....no appt. yet. I would definitely like to do nerve tests to find out exactly what's going on. the whole left leg, from quads to feet, are weaker....and that's the big question: NERVE COMPRESSION vs. FAVORING. I haven't read anything on these boards or on the internet re: favoring as the cause of a much weaker leg, just nerve compression. That's why I posted this question on the forum to see if anyone else had the same experience. This is frustrating!
  • Even in my 'Other' lives (Arty Forums, Moms group) I've met a lot of spineys. I've never heard this FAVORING thing...other than little kids developmentally. I hope someone who's experienced it will post. Saying, 'favoring one leg with spine pain' might get this on someone's search list out there! ;-)
    Osteoarthritis & DDD.
  • I have searched and I don't see it out there. More than likely there's something effecting the nerves....although not severely. Reflexes are in check and it's likely been a slow weakening of the muscles: I first noticed the weakness in one leg a year ago and thought nothing of it until I started limping earlier this year. So doing physio now and set to see my doc next week....the physic suggested testing the nerves through a neuro...makes sense to me. I don't buy the favoring thing....if that was the case, why would my left foot be much weaker than my right? I've been using them almost the same when walking....?
  • At present my son is attending someone for nerve impingement to s1 and thecal sac due to disc problems and scoliosis. my husband has ddd so i know the complications that come with nerves. my advice would be have someone work on the nerves muscles to try keep everything in working order as if a nerve gets permanently trapped it can cause sciatica on a regular basis..... my son is awaiting a appointment with neurosurgeon but cant risk it when it comes to nerves. my son has the nerve issues also radiating into his leg and his movement was restricted he received treatment via untra sound and physio yesterday and instantly he had more movement so maybe in your case this would be worth a try !!!
  • Thanks for the input, Annegiles. I haven't' had ultrasound yet although sounds like it's worth a try. I don't have pain in my leg....just the weakness. My physio the check reflexes on the knee and on the foot....the knee was normal, he said the left foot might have been *slightly* sluggish although not a lot of difference. Sometimes, I have to say though, that strengthening can be frustrating.....it's so much weaker than my right....I can easily stand on tip toes on my right, can't come close on my left. My physio has recommended an EKG (?) to my family doc which sounds like a very good idea.

    I'm also trying to lose a little weight....I'm far from overweight although thinking 10 lbs. may help...just a bit?
    Thanks for input..... this is definitely worrying me quite a bit as yesterday I found it difficult to walk for long distances without feeling the left leg getting tired
  • Nerve tests (EKG) are a great idea. You need to know exactly what's causing your problems. A good spine specialist can make all the difference. Exercises & treatments that really help with some problems can be too much when there's certain types of damage. The key to everything for a spiney is correctly identifying our pain generators & treating them properly.

    It's kind of a soap box subject for me. It's very worrying when I read about the treatments some members have tried without a proper diagnosis. It breaks my heart when people have surgery only to find the right pain generator wasn't treated. That's why I'm so passionate about specialists & second opinions. I've had physical therapy from a therapist who never knew what my MRI showed (the prescription just said disc herniation) & it caused me so much pain for soooo long!

    Sorry off my soapbox & back to your questions ;-)
    Diagnostics are always (nearly) a good idea. Loosing a bit of weight, good diet & exercise routines are a great idea. It's so hard to get those neglected muscles strong. OMG! I've had 2 kids with spine damage & it's such hard work to get in shape when you can't do regular exercises!
    Osteoarthritis & DDD.
  • Great comments, English Girl. I'm set to ask my GP fro Nerve Tests this week and I'm also going to ask to see at NS.

    I have had some conflicting opinions, however, about the effectiveness of exercise:

    1) If nerve impingement is present, exercise may not be beneficial
    2) Regardless of the cause of the weaker leg, exercise will be of benefit.

    Can anyone comment on this? My reflexes are normal in the weaker leg, although EKG tests are yet to be done. Will exercise be beneficial, regardless of the cause of the muscle atrophy - even if some nerve compression in present?

    Thanks very much.
  • Some people have a disc compressing a nerve & through 'proper' physical therapy & a little time the situation resolves. Some need a combination of the other concervative things like the spine shots. Some need surgery. Only a specialist can tell you which you are.

    I'm a good girl (mostly) so I follow the rules. I've always been told to walk so I walk. I've never really heard of anyone with nerve impingement being told any different. For many good physical therapy is priceless. I keep using words like proper & good because I've had bad physical therapy. That's why having the right diagnostic tests & finding a therapist that really looks at the results is key. Know what I mean?

    Most medical diagnosis is pretty simple. You've got a strep throat you get the same treatment as everyone else who's got it. Spines are different. That's why good specialists are so important. Sauce for the goose is really not necessarily sauce for the gander. Sorry for the metaphors I must have Thankgiving on the mind!

    Weak muscles only get strong with exercise. Ugh! It's sooooo hard!! No alternatives there though.

    I'd hate to see you hurt yourself more. I'd wait until you really know what's going on with you. When I was having my 'bad' physical therapy I used to take a breakthrough narcotic before I went just so I could tolerate some of the stretches without crying. I'd take another pill before I left & lay on the sofa with ice & heat when I got home. My pain just kept getting worse. Then family came to stay for Christmas. I over did things preparing the house & taking care of them. I skipped PT & didn't find the time (inclination really) to do my exercises which I'd been doing religiously for 9 months (yep 9 months. 3x a week, 3x a day at home. Cost a fortune!!) & I started to feel MUCH better!! Rather than quitting I found a new therapist (they manipulated my spine & crippled me for a couple of weeks. Ugh!! I found another. He asked me to bring my MRI & my exercise sheets from the last PT. after studying my MRI & examining me he took a red pen & crossed through most of the moves I'd been doing. Then he explained why I shouldn't be doing them ever again. Together we developed a couple of routines of little moves I could do to strengthen my body without hurting myself & things have been so much better ever since. I only went a couple of times every week at the start. Then I did exercises at home. I pop in to see him if things change & he doesn't charge me!! He's wonderful! He knows I have little kids at home & paying for sitters & paying for treatment gets expensive fast! It's wonderful when you find great specialists who truly care about you! ;-)
    Osteoarthritis & DDD.
  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 11/23/2014 - 11:14 AM
    My PT gets on his soapbox about things people do in the name of health & fitness. He takes his little models & shows patients what happens when you run, jump, jog, machines etc. it's quite frightening! He strongly believes that people with certain types of spine damage should NEVER do 'normal' exercise until they are healed.
    I've been given lists of restrictions by him & by my pain management doctor. They include things I must never do again with my spine conditions. Running, jumping & jogging are at the top of the list. He also taught correct posture, lifting techniques etc. I thought all spineys were given a list. It shocks me that some aren't. If you haven't it's important to ask.

    Best of luck with your tests. Please let me know how you get on ;-)
    Osteoarthritis & DDD.
  • Thanks a lot for your feedback EG. I saw my doc yesterday....summary:
    - he thinks that a nerve is likely being pinched, but not compressed. He said if it was being compressed, it would not be able to walk and my leg would be numb. I asked about permanent nerve damage....he compared what was happening to that of a finger pressing on a water bottle, then being released. Obviously, the water bottle was not being damage permanently...that's what he said was going on with my back
    -He said he could refer me to a NS although that person would tell me exactly what he just told me....that it would have to get much worse before anyone would but a scalpel near me.
    -He says physical therapy and meloxicam are the answers for now....and he will consider steroid injections at some point.
    -I will likely need surgery when I get older.....although is bottom line is: conservative treatment first.....and he thinks that will resolve the issue although I would need to be patient.

    My GP is not a spine specialist, although at this point I'm trusting him. I'm going to continue with the PT and see what happens....I'm also seeing an Oaestopath next week, so I will get a second opinion.

    Yikes....not fun stuff.... although looks like PT, as you say EG, seems to be the preferred approach for now :)
  • I'm glad you've got a second opinion next week but spine problems in my experience can take an irritatingly long time to resolve. You've got a bulge at the moment. I'd take statements like "you'll probably need surgery when you're older" with a pinch of salt. I don't think anyone can predict that right now. If you do everything they tell you to & take really good care of yourself, keep a good strong core etc it could clear up & you might never need treatments or surgery again. I was a good girl but my spine has gone from bad to worse. It's a guessing game at the start.

    I'd keep an eye on yourself for any different or worsening symptoms. I've had really bad nerve compression & it's not strictly true to say you can't walk. I could, it hurt like **** but I could. At times it's been more numbness, pins & needles type feelings with the harsh pain more in my hips & upper thighs. At one point I had bad pain at the top, bum & hip then nothing until you got to my foot! Nerve pain is weird & he oversimplified it a bit.

    You sound happy with your appointment. I'm pleased! I hope the appointment next week does even more to put your mind at rest ;-)
    Osteoarthritis & DDD.
  • Katherine 55KKatherine 55 Posts: 5
    edited 11/30/2014 - 7:05 AM

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    Katherine Peterson
  • Thanks for your comments EG. no question this will be a long haul....I'm doing lots of physical therapy, some days it feels like something is changing, other days not. I agree with what you say about possibly needing surgery one day - he doesn't know that especially as a GP. I will say too though, that the only doubts I have about my doc is the he first said it was "favoring" although now has changed his mind and agrees with the physical therapy that it's more likely related to nerves. I just think the favoring comments shows a bit of a lack of experience in this area...I've goolged "favoring weak leg disc bulge" and NOTHING comes up! Not surprising....that said, he did sound quite convinced that a) No permanent nerve damage could happen (at this point) and b) that seeing a NS at this point is too early and would reveal nothing he hasn't said.

    Just for the sake of common sense, it does make sense that the nerves to my left leg are being *slightly* agitated by the bulge....I say slightly because there is no severe pain, virtually no numbness, and I only feel pain if I sit for longer periods of time....when I stand I feel almost no pain, or lay down.

    I will definitely keep an eye for worsening compression....if that's the case I'll go back to him. So sorry to hear about your experience although glad you are on top of the situation and well armed with the facts.

  • I'm not here often anymore but ruptured a disc (L5/S1) over 5 years ago. I have also become an expert of me. No one here an tell you what to do medically or interpret MRI results. What advice I can offer - back surgery is optional. Even in my case that was 'urgent', I had time to get opinions. That said, your thoughts are logical - favoring one leg can cause issues on the other side. After 2 back surgeries (first unsuccessful and 2nd took 6 months before I saw improvement), I had protected my back so well that it cause other problems - and yes, muscular/skeletal person (I saw a physiatrist) can help get you balanced again. I favored protecting my back and due to damage on my left side, was stronger on my right in some ways, left in others so they gave me exercises to 'balance' me out - and after a couple of months, started doing much better.

    Good luck. Always good to speak to a specialist but not necessarily jump into surgery as a quick fix until you've done your homework - but that's soley my opinion.
  • I was on a trip in Mexico recently and walked EVERYWHERE. I also started walking a lot around my house about 4 weeks ago, although I honestly don't know if there is any improvement at all in the weak left leg. This is enormously frustrating because it's associated with foot drop and everyone keeps commenting on my limp.

    I would have thought that all the walking from the past month (....and especially the last week!) would have made a difference, but just got back from walk and didn't seem much different.

    This is really bugging me. Cause is yet to be determined, although the thinking is the bulging disc is pinching the nerve. I have worried about ALS and MS, although I have no other symptoms, and my physio 2 weeks ago didn't see the typical signs of an upper motor neuron lesion. Will see a neurologist soon.

    Thanks for any support....this is getting depressing!
  • lorla6llorla6 Posts: 1
    edited 03/15/2015 - 10:12 AM
    Hi silverbear! I read through this thread and it seems that I have very similar symptoms to yours. I have had left leg weakness for about 6 months. I had no pain the first few months, and then I began to have slight pain in the upper back part of my leg. About a month ago, I went to a physical therapist who specializes in the spine. At my first visit, and based on her in office tests, she believes I most likely have a bulging disk that is impinging a nerve. I have been doing twice weekly PT visits, as well as exercises/stretches at home. The leg pain is now gone, but the weakness has shown no improvement. I have normal reflexes, and I don't have official foot drop, as I can both walk on my toes and walk on my heels just fine. But when I walk, I have an issue with lifting my toes quickly enough, so I catch them and trip frequently, and I also walk differently (limp) so I do my best not to trip. I'm hoping to see improvement with weakness, as I have with the little bit of pain i was experiencing. But I've had the weakness for months no, and while it hasn't seemed to get worse, it hasn't improved any with the month of PT. Have you seen any improvement with your muscle weakness?
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