Nerve Compression: Causes and Treatment for Leg Numbness

Spinal nerve compression causing leg numbness?

Symptoms: Initially, there was only occasional discomfort in the legs, but suddenly the right foot became numb, making walking difficult (no heavy lifting or intense exercise, but prolonged sitting with possibly poor posture).
After walking a few steps, the numbness worsens to the point of being unable to walk, with numbness extending from the back of the thigh to the sole of the foot, but there is no lower back pain.
Bending forward alleviates the discomfort, while lying on the back causes numbness in the legs, and I can only sleep by bending to the right side.
Consultation information: I visited an orthopedic clinic for X-rays, where two doctors provided different diagnoses; one suggested congenital spinal stenosis, while the other believed it to be a herniated disc, stating that herniated discs are uncommon at this age (though there are many cases online).
These two conditions differ somewhat, hence my inquiry here.
Online information: Pain when bending forward suggests a herniated disc, while pain when bending backward suggests spinal stenosis.
Questions: 1.
What is the actual diagnosis? 2.
Should I walk and stretch more, or should I rest by sitting or lying down? 3.
What do the doctors recommend? (Currently, I am only undergoing rehabilitation: electrical therapy and spinal traction).
Thank you very much for your assistance!

hsin, 20~29 year old female. Ask Date: 2022/12/20

Dr. Wang Zhaomin reply Rehabilitation

This is a medical consultation platform and cannot provide diagnostic services.
Both herniated discs and spinal stenosis can produce similar symptoms, and it is not possible to generalize without a proper evaluation by a physician following relevant examinations.
Although discomfort persists, it is important to maintain normal daily activities while also allowing for adequate rest.
However, vigorous exercise is not recommended.
Rehabilitation therapy typically takes some time to show significant effects, so it is advisable to continue with the rehabilitation treatment and discuss the progress of the condition and any potential adjustments to the treatment plan with the attending physician.

Reply Date: 2022/12/20

More Info

Understanding nerve compression and its effects on leg numbness is crucial for determining the appropriate treatment and management strategies. Based on your symptoms and the diagnostic evaluations you've undergone, it appears you may be dealing with a form of nerve compression, possibly related to spinal issues such as spinal stenosis or a herniated disc.

1. Understanding the Condition
Your description of experiencing numbness in your right leg, particularly from the thigh to the foot, suggests that a nerve in your lower back may be compressed. This compression can occur due to various reasons, including:
- Spinal Stenosis: This condition involves the narrowing of the spinal canal, which can put pressure on the spinal cord and nerves. Symptoms often include pain, numbness, or weakness in the legs, particularly when standing or walking.

- Herniated Disc: A herniated disc occurs when the soft material inside a spinal disc pushes out through a tear in the tougher exterior. This can irritate nearby nerves, leading to pain, numbness, or weakness in the legs.

- Postural Issues: Prolonged sitting, especially in poor posture, can lead to muscle tightness and nerve compression. This is particularly relevant if you have a sedentary job or lifestyle.

2. Activity Recommendations
Given your symptoms, it is essential to strike a balance between activity and rest. Here are some recommendations:
- Movement and Stretching: Engaging in regular, gentle movement can help alleviate some of the pressure on the nerves. Stretching exercises targeting the lower back, hips, and legs can improve flexibility and reduce muscle tension. Activities like walking, swimming, or cycling can also be beneficial.

- Avoid Prolonged Sitting: If your job requires long periods of sitting, try to take breaks every 30 minutes to stand, stretch, or walk around. This can help prevent stiffness and reduce nerve compression.

- Posture Correction: Ensure that your workstation is ergonomically designed to support good posture. Consider using a chair that provides lumbar support and keeping your feet flat on the ground.

3. Medical Recommendations
Since you have already consulted with orthopedic specialists and received differing opinions, it may be beneficial to seek further evaluation from a neurologist or a spine specialist. They can provide a more comprehensive assessment, possibly including:
- MRI or CT Scans: These imaging studies can give a clearer picture of the spinal structures and help identify any herniated discs or narrowing of the spinal canal.

- Electromyography (EMG) and Nerve Conduction Studies: These tests can assess the electrical activity of your muscles and the speed of nerve conduction, helping to pinpoint the location and severity of nerve compression.

Conclusion
In summary, your symptoms suggest a potential nerve compression issue, possibly due to spinal stenosis or a herniated disc. Engaging in regular movement and stretching while avoiding prolonged sitting can help alleviate symptoms. However, further evaluation by a specialist is recommended to determine the exact cause of your symptoms and to develop a tailored treatment plan. This may include physical therapy, medication for pain management, or, in some cases, surgical options if conservative treatments fail. Always consult with your healthcare provider before making any significant changes to your activity level or treatment plan.

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