Nerve Compression: Back Pain and Leg Numbness from Spinal Degeneration

Spinal degeneration, leg numbness, nerve compression?

In March, after an orthopedic consultation and X-ray examination, it was determined that the lower back pain was due to degenerative changes in the lumbar and sacral vertebrae.
Since then, there has been no improvement; after sitting down and standing up, my lower back becomes stiff and immobile, requiring 30 to 60 seconds to stand and walk normally (this frequently occurs).
There are also severe instances where I present with a crooked posture, with noticeable asymmetry and significant pain that prevents normal walking, lasting from a few minutes to several hours (occasionally occurs).
Therefore, in August, I returned to the rehabilitation department, where they only reviewed the X-ray and issued a rehabilitation order.
Subsequently, in October, due to rhinitis, I experienced multiple sneezes that led to a persistent numbness in my right leg throughout the day.
I can feel a distinct numbness in my foot without touching it, and there is a numb sensation when I touch my calf.
In the morning, after brushing my teeth and sitting down, I experience continuous pain in the middle of my calf, thigh, and pelvis, making it impossible to sit comfortably; whenever this occurs, the pain lasts for more than five minutes.
Currently, an electromyography (EMG) has indicated possible nerve compression causing the numbness, and an MRI has been scheduled.
I would like to inquire about the cause of these symptoms.
If it is a spinal issue, can rehabilitation provide relief? What treatment options would traditional Chinese medicine offer?

Josey, 30~39 year old female. Ask Date: 2022/11/12

Dr. Lin Jianzhong reply Rehabilitation

Dear Ms.
Josey,
Further evaluation can wait for the MRI examination to make a final diagnosis.
Based on your description, the preliminary consideration is a lumbar disc herniation.
The likely cause of the herniation, in your case, is prolonged pressure due to improper posture, although a small number of cases may be triggered by trauma, such as from a car accident, a fall, or sports injuries.
The physical therapy arranged by the Rehabilitation Department should help alleviate your symptoms.
For traditional Chinese medicine treatment, please consult with another practitioner.
Dr.
Lin Jianzhong, Rehabilitation Department, Nantou Hospital

Reply Date: 2022/11/12

More Info

Understanding nerve compression, particularly in the context of spinal degeneration, is crucial for managing symptoms such as back pain and leg numbness. Based on your description, it seems you are experiencing significant discomfort due to lumbar and sacral spine degeneration, which can lead to nerve compression. This condition often manifests as pain, stiffness, and numbness in the legs, particularly after prolonged sitting or standing.

Causes of Your Symptoms
1. Spinal Degeneration: As we age, the intervertebral discs and joints in the spine can degenerate, leading to conditions like osteoarthritis or degenerative disc disease. This degeneration can narrow the spaces through which nerves exit the spine, causing compression.

2. Nerve Compression: When the spinal structures degenerate, they can impinge on the spinal nerves. This is often felt as pain, numbness, or weakness in the legs. The symptoms you describe, such as difficulty standing up straight and the need to wait before walking, suggest that the nerves in your lumbar region are likely being compressed.

3. Muscle Imbalance and Spinal Alignment: The asymmetry you mention, where one side of your body feels different from the other, can be due to muscle imbalances caused by pain or discomfort. This can lead to compensatory postures that further exacerbate nerve compression.

Treatment Options
1. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can help you with exercises that strengthen the core and back muscles, improve flexibility, and promote better posture. This can alleviate some of the pressure on the nerves and improve your overall function.

2. Medication: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and pain. If your pain is severe, your doctor may prescribe stronger medications or muscle relaxants.

3. Interventional Procedures: If conservative treatments do not provide relief, options such as epidural steroid injections may be considered. These can help reduce inflammation around the affected nerves.

4. Surgery: In cases where there is significant nerve compression that does not respond to conservative treatment, surgical options may be necessary. Procedures such as laminectomy or discectomy can relieve pressure on the nerves.

Alternative Treatments
1. Acupuncture: Traditional Chinese medicine, including acupuncture, may help alleviate pain and improve function by promoting blood flow and reducing inflammation.

2. Chiropractic Care: While some patients find relief through chiropractic adjustments, it is essential to ensure that the chiropractor is aware of your spinal degeneration and any other underlying conditions.

3. Massage Therapy: Therapeutic massage can help relieve muscle tension and improve circulation, which may provide some relief from your symptoms.

Conclusion
Your symptoms of back pain and leg numbness are likely due to nerve compression from spinal degeneration. While physical therapy and medication are primary treatment options, exploring alternative therapies like acupuncture and chiropractic care may also provide relief. It is crucial to continue working closely with your healthcare providers to monitor your condition and adjust your treatment plan as necessary. Regular follow-ups and imaging studies, such as MRI, will help assess the progression of your condition and guide further interventions. Remember, early intervention can often prevent further complications and improve your quality of life.

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