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Dr. Andrew Rynne

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What causes persistent radiating sensation with numbness in the leg?

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Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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Posted on Mon, 6 Mar 2017 in Back Pain
Question: Hi,

This is related to the reports and question asked in the following post:

https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=310236

I had physio therapy sessions for 1 month and then I came to my home town. I had been to one of the physio and she has given me tense and US for 5 minutes. From that day onwards, i am getting a radiating sensation of my thighs only and sometime feel some kind of numbness in my feet too. I am walking for 2 hours daily and still have pain on my hip and not much on back. Not sure, whats happenning, now i have stopped the medicines and physio sessions as not sure, if its going to help me. I didn't have much radiation feelings earlier but since the last physio session it has been increased. Can you please look at the reports and suggest me what should i do as a next step?

My orthopedic suggesed to walk and even jog when i visited last week after checking physically my condition. he also suggested that sometime this sort of injury will take 4 months to heal up. i had been injured since 6th December 2016.
doctor
Answered by Dr. Mahaveer Patil 38 minutes later
Brief Answer:
Epidural steroid injection / LASER

Detailed Answer:
Hi dear XXXXXXX

Thank you for posting the question.

I am an orthopaedic surgeon and I have gone through your medical history and the question related to the link that you have mentioned.

I feel that you still have nerve root compression at L3-4-5 levels due to slipped discs.

The physiotherapy sessions have not helped you to relieve the pressure off the nerves causing persistent radiating sensation with numbness.

The next step would be epidural steroid injections or LASER treatment for the spine.These are the 2 non-operative options available to you.

If even these do not help,then the only option remaining is a decompressive spine surgery (laminectomy / discectomy).

You are very young and i still recommend that you should avoid surgery as far as possible.

You can take a second opinion from a neurosurgeon regarding the non-operative options that i have mentioned.

You can use lumbosacral belt with back exercises.

I hope the answer was useful.

Feel free to ask me any follow up queries that you may have.

Thank you.
Kind regards.

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Mahaveer Patil 59 minutes later
thanks Sir for your response, my next question is as regard to the MRI report. As per my the orthopedics surgeon whom i was seeing earlier suggested that i had not a slip disc ( L4, L5 not on L3) due to an accident and its more over a disc bulge which is causing pain. I bit worried after your comments that i need to go through some surgery or the non -operative methods, do you think, is there any way, i can avoid some these methods and helped to cure my conditions, any exercises you can recommend me to see, if it works for me. thank you for your time.
doctor
Answered by Dr. Mahaveer Patil 25 minutes later
Brief Answer:
Query answered

Detailed Answer:
Disc bulge is same as slipped disc,just the degree is less.

If the disc bulge causes nerve compression ,then only you will experience these symptoms.

There is nothing to worry about XXXXXXX

Even worse cases than yours get better with treatment.

I am sure even you will be fine soon.

I mentioned surgery only for your information.

Do not think about it at present.

You can find lowe back ache exercises on internet and do it for 10-15 minutes daily early morning.

Thanks
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mahaveer Patil 6 minutes later
Disc Bulge is an injury or a blood clot accumulated due to an accident? Sorry to ask these questions but dont know about these medical terms.
doctor
Answered by Dr. Mahaveer Patil 2 hours later
Brief Answer:
Query answered

Detailed Answer:
I can understand XXXXXXX

Do not hesitate to ask any number of doubts that you may have till you are completely sure.

An intervertebral disc is actually like an eclairs chocolate - firm from outside (annulus fibrosus) with a gel like material (nucleus pulposus) within it.

Normally,the gel is well contained within the outer fibrosus.

In a disc bulge,the inner gel escapes outwards causing the outer layer of disc to bulge.

It happens due to a vertical compressive force injury to the spinal column.

Disc bulge has nothing to do with a blood clot.


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mahaveer Patil 1 hour later
thanks so much i am really happy with your patience with me and answering all the questions, i am having. I am attaching the page where MRI mentioned the issue with my l4-l5 and l5-s1 and also the fluid collection is seen in the left gluten region superficial to muscles. if you can please explain this to me in more naive language how did you explain me earlier that will be great help. Thanks again for your time on this query.
doctor
Answered by Dr. Mahaveer Patil 10 hours later
Brief Answer:
Query answered

Detailed Answer:
L4-5 and L5-S1 disc bulges are narrowing the spinal canals causing compression of the concerning nerve roots as i mentioned earlier.

Fluid collection superficial to muscles in left gluteal region seems to be unrelated to the present symptoms as this collection is just below your skin and far away from the nerves (nerves are situated deep below the muscles).

Although the size of the fluid mentioned is significant,it needs to be confirmed as to what is the cause of this collection.

Is the fluid collection site in the left buttock painful when you touch it?
Is that area warm,reddened?
Did you take any injection at that site in buttock recently?

Aspiration of the fluid collection and testing it in laboratory for organisms can help us diagnose the cause of this fluid collection.

Thanks .
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Mahaveer Patil 9 hours later
Thanks for your feedback. answers to your questions, please see below:

Is the fluid collection site in the left buttock painful when you touch it?
A bit, this is the place where I got a hit and it was reddened earlier from the outside and now this area is no more reddened.
Is that area warm,reddened?
No More reddened and warm but bit of senseless not much.
Did you take any injection at that site in buttock recently?
I took injections after the MRI taken place so i would say this is unrelated.

Please suggest, if the L4-5 and L5-S1 really can be treated by just the exercises?

Any precautions should be taking to avoid the pain any more.
doctor
Answered by Dr. Mahaveer Patil 2 hours later
Brief Answer:
Query answered

Detailed Answer:
1.The fluid collection seems to be in resolving stage. As i had mentioned earlier, taking physiotherapy in the form of lumbar traction,short wave diathermy or LASER therapy along with exercises will definitely help you.

2.At our clinic,we have successfully treated many patients just by these methods.

Avoid lifting heavy weights or bending forward.

Thanks
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mahaveer Patil 50 minutes later
Dear Sir, I am not sure, if i can get these treatment in my home town. Can you please suggest some kit that i can buy and use at home to get rid of these issues. Any specific link will be helpful.

Also if you can please suggest a link for the lower back exercises, that will be great help.

You are suggesting the treatments above are going to help my l4, l5-s1 issue and when you said that fluid collection is resolving at stage means that will heal by itself by the time?

I think, we are getting there. I will be very grateful, if you can please help me with the answers above and i will close the discussion with my gratitude towards your time and help so far.

Thank you very much in advance.
doctor
Answered by Dr. Mahaveer Patil 13 hours later
Brief Answer:
Query answered

Detailed Answer:
You can get this lumbar traction kit that can be applied at home.You get it in medical shops. Also get infra red lamp for hot fomentation.

Short wave diathermy / LASER will not be possible at home.

Apply lumbar traction of approx. 5-6 kg for 1 hour twice daily.

Take a pillow below your thighs and knees while taking traction.

For low back exercises,link- http://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-0000

The redness and pain of the swelling is reducing,so it is expected to heal by itself.

Else it may need surgical drainage.

Thanks
Above answer was peer-reviewed by : Dr. Kampana
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