Spinal Degeneration: Managing Nerve Compression and Pain

Spinal degeneration, leg numbness, nerve compression?

On November 12, I consulted the rehabilitation department at e-Hospital in Taiwan regarding my condition.
In March, after an X-ray examination in the orthopedic department, it was explained that my lower back pain was due to degeneration of the lumbar and sacral vertebrae.
Since then, my condition has not improved; after sitting down and standing up, my lower back becomes stiff and immobile, requiring 30 to 60 seconds before I can stand and walk normally (this often occurs).
There are also times when the pain is severe enough to cause a noticeable tilt in my posture, with clear asymmetry and significant pain that prevents me from walking normally for several minutes to hours (this happens occasionally).

In August, I returned to the rehabilitation department, where they only reviewed the X-ray and issued a rehabilitation prescription.
In October, due to rhinitis, I experienced frequent sneezing, which 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.
After brushing my teeth in the morning and sitting down, I experience continuous pain in the middle of my calf, thigh, and pelvis, making it impossible to sit comfortably; this pain lasts for more than five minutes whenever it occurs.

I have undergone an electromyography (EMG) test, which suggested that there may be nerve compression causing the numbness, and I have been scheduled for an MRI.
If it is a spinal issue, can rehabilitation alleviate the symptoms? What treatment options would traditional Chinese medicine (TCM) offer? Dr.
Lin Jianzhong responded that the initial diagnosis is a herniated disc, which will be confirmed after the MRI.
He explained that the physical therapy arranged by the rehabilitation department could help relieve symptoms, and for TCM treatment, I should consult another TCM practitioner.

Therefore, I would like to inquire how TCM treatment would proceed (for example, would I need to take medication or undergo other treatment modalities)? Would it be advisable to pursue a combined treatment approach with both Western and traditional medicine?

Josey, 30~39 year old female. Ask Date: 2022/11/17

Dr. Lü Bingcheng reply Traditional Chinese Medicine

Based on the situation you described, it is recommended to undergo a combined treatment of Western and Traditional Chinese Medicine under the continuous follow-up of a specialist.
After the examination, the Traditional Chinese Medicine practitioner will provide treatments such as acupuncture and herbal medicine as needed based on the patient's condition.

Reply Date: 2022/11/17

More Info

Understanding spinal degeneration and managing nerve compression and pain is a multifaceted issue that often requires a comprehensive approach. Based on the details provided, it seems you are experiencing significant discomfort due to lumbar spine degeneration, which has led to nerve compression and associated symptoms such as pain, stiffness, and numbness in the legs.

Spinal Degeneration and Nerve Compression
Spinal degeneration, particularly in the lumbar region, can lead to a variety of issues, including herniated discs, spinal stenosis, and facet joint arthritis. These conditions can compress nearby nerves, leading to symptoms such as pain, numbness, and weakness in the legs. The fact that you experience stiffness and difficulty standing after sitting for a while suggests that your spinal condition may be affecting your mobility and overall quality of life.

Diagnostic Imaging
You mentioned undergoing X-rays and planning for an MRI. MRI is crucial in this context as it provides a detailed view of the soft tissues, including discs, nerves, and ligaments. It can help confirm the presence of a herniated disc or other degenerative changes that may be contributing to your symptoms. The results of the MRI will guide your treatment options.

Treatment Options
1. Physical Therapy: As indicated by your rehabilitation physician, physical therapy can be beneficial. A tailored physical therapy program can help strengthen the muscles supporting your spine, improve flexibility, and reduce pain. Techniques may include manual therapy, exercises, and modalities such as heat or electrical stimulation.

2. Medications: Over-the-counter pain relievers like NSAIDs (e.g., ibuprofen) can help manage pain and inflammation. If your pain is severe, your doctor may prescribe stronger medications or muscle relaxants.

3. Interventional Procedures: If conservative measures fail, options such as epidural steroid injections may be considered to reduce inflammation around the affected nerves.

4. Surgery: In cases where conservative treatments do not provide relief, surgical options may be explored. This could involve decompression surgery or spinal fusion, depending on the specific diagnosis.

Integrative Approaches
You also inquired about traditional Chinese medicine (TCM) and its role in your treatment. TCM can offer complementary therapies, such as acupuncture, herbal medicine, and dietary recommendations. Acupuncture has been shown to help alleviate pain and improve function in some patients with chronic pain conditions. Herbal remedies may also support overall health and reduce inflammation.

Combining Treatments
It is often beneficial to combine Western and Eastern medical approaches. For example, while you undergo physical therapy and possibly medication management, you could also explore acupuncture or herbal treatments. This integrative approach can provide a more comprehensive management plan, addressing both symptoms and underlying issues.

Conclusion
In summary, managing spinal degeneration and nerve compression involves a combination of diagnostic imaging, physical therapy, medication, and possibly surgical intervention. Integrating TCM can also provide additional support. It is essential to work closely with your healthcare providers to develop a personalized treatment plan that addresses your specific needs and symptoms. Regular follow-ups and adjustments to your treatment plan based on your progress will be crucial in achieving the best outcomes. Always consult with your healthcare provider before starting any new treatment to ensure it aligns with your overall health strategy.

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