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Help with L5/S1 nerve damage

spacefruitsspacefruit Posts: 1
edited 07/21/2015 - 12:50 AM in Back Surgery and Neck Surgery
Hi everyone,

I am a 30 year old female in relatively good health. I work as an RN, and have had ongoing SI joint pain for approximately 3 years this December. This last year flare-ups have been pretty frequent. Approximately six weeks ago I got a wicked bout of sciatica which was effectively treated with gabapentin. However I began to experience a slight foot drop/limp and had an MRI 10 days ago which confirms an L5/S1 herniation of approximately 1.4cm with moderate degenerative disc disease.

It is hard to say whether or not the herniation has been the issue all along which progressively got worse until it burst or what. I had been seeing a chiropractor for my SI joint issues, but do not think I want to continue on that course anymore. I have also stopped taking the gabapentin for about 2 weeks because I am no longer in pain. I'm not sure if the initial herniation was greater than 1.4 cm or it was just the resulting inflammation that made the pain and spasms so severe. However, of great concern to me is that I am still experiencing this foot drop. It will be 6 weeks today.

I will probably get a referral for a specialist next week, but no one knows whether surgery is really an option at this point. To be honest, the risk of scar tissue causing more (and permanent) pain is very scary to me. I asked my doctor for a referral for an electromyography and nerve conduction velocity study to try and understand the extent of damage.

My question is this: because I am still experiencing this foot drop and cannot rise onto the toes of my left foot... How long should one wait before considering surgery as an option? I am very worried that I may not recover from this injury and I will forever be limping. It's more than just looking different though- my pelvis is pulled out of alignment with every step I take because it is like I am walking on a peg-leg.

Does anybody have experience with this problem, and what happened to you? How long did it take for your motor function to return, or did it not return at all? Did you require surgery? Was it helpful if you went that route? Most of the literature I am reading states that beyond the 6-week mark you should really begin to consider surgery. My chiropractor, family doctor and a doctor I work with all seem to feel that conservative watch and wait treatment is best, and honestly, if I had more confidence, I wouldn't be stressing about it so much. If anyone has had a similar problem or knows someone who has, I would sincerely appreciate hearing from you!


  • LizLiz Posts: 7,832
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    Spinal stenosis since 1995
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  • edited 07/22/2015 - 10:05 PM
    I'm in the same boat! I've got DDD, bulging L4/L5 & herniated L5/S1 and have reoccuring numbness in both legs from the knee down along with loss of motor control, weakness, unsteadiness.... My ortho doc said the nerves don't have enough space... I'm stressing out cause I don't really want to get surgery but I'm petrified that the problem with my legs will be permanent if I don't. I have some who say wait and a lot of times it gets better and others who say I'm risking permanent nerve damage. Right now I cannot even skate very well which is my life. In the condition I am now I cannot compete at the National level or even anything other than the local level. Doc would go in there and do a spinal fusion, since I also have spondilolythesis... But I have a doc friend who is adamant not to go the pins, screws, plates, rods, route.... So as she said, anyone with any experience with this please speak up! I'm torn!

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  • I can only tell you my experience....Very long story short, I was 35, had extreme and debilitating nerve root compression from a major ruptured disc at L5/S1. After a couple of unsuccessful microdiscectomies and repeated ruptures, I had a fusion with screws and rods and spacer. Disc rupturing problem solved....but I left that surgery unable to stand on my toes and with a limp much like you are describing. That was 10 months ago. Nothing for me has changed. I too worry about causing further problems with my spine due to the limp throwing everything off (I also have one leg clinically shorter than the other, so I'm all out of whack!).

    I can't tell you what decision to make (I know you know that) but I was under the impression that foot drop is a more serious symptom than "just" pain. I think I'd definitely talk with a couple of surgeons and see what they think. I know that my situation is somewhat different and that my nerve damage is most likely permanent at this point, but I know what it's like to be young (I'm 36 now) and look at life with a potentially permanent disability. If I could go back and avoid it (by in my case pressing for better treatment sooner) I would in a heartbeat.

    Best wishes in whatever you decide.
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • I endorse everything that coltsfan 78 has said. If I could have prevented the nerve damage by having a fusion earlier I would have done. Unfortunately I believed my G.P. and didn't press for further investigation.
  • kevheadkkevhead Posts: 42
    edited 07/22/2015 - 5:24 PM
    I second everything Coltsfan and Jill55 have said. Very similar story to Coltsfan, I had multiple Micro-D procedures over the course of 3 years and ultimately had a fusion done. I had moderate pain and weakness in my right leg into my foot, ended up getting worse over time. Long story short, after pain and weakness were too much had an MRI which showed compression of L5/S1 nerve root and Ortho had me in for a fusion in less than 48 hours. The fear I had regarding the fusion/surgery is nothing compared to the fear that I may have perm. nerve damage. My Ortho surgeon was extremely honest, an epidural will not fix the underlying issue and a Chiro can't "fix" this. You are too young to risk nerve damage so don't wait and get in soon. Keep us posted, good luck!
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