Weakness and Tightness in Legs After Prolonged Sitting - Neurosurgery

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It sounds like you are experiencing significant discomfort and weakness in your legs after prolonged sitting, which can be quite concerning. Based on your description, it seems that you have had episodes of weakness and tightness in your legs, particularly after long periods of sitting or riding, and these symptoms have been progressively worsening.
The sensations you describe, such as "heavy legs" and tightness in the calves, could be related to several factors, including muscle fatigue, nerve compression, or vascular issues. Given your history of prolonged sitting and the specific symptoms you experience, it is essential to consider the following:
1. Muscle Fatigue and Deconditioning: Prolonged sitting can lead to muscle fatigue, especially if the muscles are not accustomed to being used for extended periods. When you sit for a long time, the muscles in your legs may not be engaged, leading to a feeling of weakness when you finally stand up. This is often referred to as "deconditioning," where the muscles lose strength and endurance due to lack of use.

2. Nerve Compression: Your MRI findings suggest that there is some degree of cervical spine involvement, particularly with the potential for nerve root compression due to disc herniation. This could lead to symptoms such as weakness or tightness in the legs, as nerve signals may be affected. The cervical spine can influence upper body strength and coordination, but issues in the lumbar region (lower back) can also lead to similar symptoms in the legs.
3. Circulatory Issues: Prolonged sitting can also lead to reduced blood flow to the legs, which may cause feelings of tightness or heaviness. This is particularly true if you are sitting in a position that compresses blood vessels or nerves.
4. Potential for Peripheral Neuropathy: Given your symptoms of weakness and the feeling of tightness, it may also be worth considering whether there is any underlying peripheral neuropathy, which can cause similar symptoms. This condition can arise from various causes, including diabetes, vitamin deficiencies, or other systemic issues.

5. Consulting Specialists: Since you have already seen an orthopedic doctor and have had imaging done, it may be beneficial to consult with a neurologist. A neurologist can provide a more in-depth evaluation of your nerve function and may conduct additional tests to assess for any neurological conditions that could be contributing to your symptoms.
6. Physical Therapy: Regardless of the underlying cause, physical therapy may be beneficial. A physical therapist can help you with exercises to strengthen your legs, improve flexibility, and enhance overall mobility. They can also provide guidance on proper posture and body mechanics, especially during prolonged sitting or riding.

7. Surgical Considerations: If surgery has been recommended for your cervical spine, it is essential to weigh the risks and benefits carefully. If you are hesitant about surgery, seeking a second opinion from another orthopedic surgeon or a neurosurgeon may provide you with more clarity and confidence in your decision-making process.

In conclusion, your symptoms of weakness and tightness in the legs after prolonged sitting warrant further investigation. It is crucial to address these issues with a healthcare provider who can evaluate your condition comprehensively and recommend appropriate interventions. Whether through physical therapy, further diagnostic testing, or surgical options, taking proactive steps can help improve your quality of life and alleviate your concerns.