Lumbar Spine Issues: Symptoms, Treatments, and Next Steps

Lumbar spine issues?

Following up on the previous article, I recently visited a neurology clinic and underwent an examination of my limbs.
The doctor mentioned that everything was generally normal, but there was a slight abnormality in the lumbar region, specifically at the fourth and fifth vertebrae.
He stated that the normal value for the H-wave should be below 30, and mine was around 31.
I didn't fully understand that test; I only know it measures nerve response.
I suspect that my sleeping posture, mentioned in the previous article, may have an impact.
The doctor indicated that my numbness in the hands and feet might be related to the autonomic nervous system and suggested that I might be more anxious.
While it is true that I feel anxious, I found the doctor's explanation somewhat vague and not directly addressing the cause of my symptoms.
I requested a blood sugar test, which showed no diabetes, but I have some questions:
1.
My numbness in the hands and feet has improved with medication, but the doctor did not prescribe any further medication.
I'm concerned about whether the symptoms will worsen after stopping the medication.
If they do worsen, which specialty should I follow up with for further examination?
2.
Regarding the lumbar issue, it seems to be related to my sleeping posture.
The doctor mentioned that physical therapy could help, but it requires a long-term commitment.
Since the abnormality is mild, he suggested that I could temporarily forgo therapy.
I'm wondering if seeing a chiropractor would provide improvement, or if physical therapy is still recommended.
Currently, I sometimes feel discomfort in the lumbar area, but it is not painful—more like a slight soreness.
If left untreated, could this potentially develop into a more serious condition in the future? Thank you.

a, 30~39 year old female. Ask Date: 2023/01/14

Dr. Chen Yongxue reply Orthopedics

Hello,
1.
Currently, the numbness in my hands and feet has improved after taking medication, but my doctor did not prescribe any further medication.
I'm concerned whether the symptoms will worsen after stopping the medication.
If they do worsen, which specialty should I follow up with for further evaluation?
2.
Regarding my lumbar spine, I believe it is related to my sleeping posture.
In a previous consultation, the doctor mentioned that physical therapy could be beneficial, but it requires a long-term commitment.
Since the abnormality is mild, I am considering whether visiting a chiropractor would provide improvement.
Would you still recommend physical therapy? At present, I occasionally feel some discomfort in my lumbar area, but it is not painful—more like a slight soreness.
If I ignore this, could it potentially develop into a more serious condition in the future?
I think you might be overly anxious, and living like this can be quite challenging.
If you stop the medication, do you really want to be on medication for life? I wouldn't recommend chiropractic treatment; try not to worry too much.
If there is a real issue, your body will let you know.
Thank you.

Reply Date: 2023/01/14

More Info

Understanding lumbar spine issues can be quite complex, especially when symptoms are vague or when multiple factors are at play. Based on your description, it seems you are experiencing a combination of lumbar spine discomfort and neurological symptoms, such as tingling in your hands and feet. Let's break down your concerns and explore potential next steps.

Symptoms and Diagnosis
From what you've shared, it appears that you have some degree of lumbar spine involvement, particularly at the L4 and L5 levels. The mention of an H-wave test indicates that your healthcare provider is assessing the function of your nerves, which can be affected by various conditions, including nerve compression or irritation due to lumbar disc issues or other spinal abnormalities.

The tingling sensation in your extremities could indeed be related to nerve involvement, possibly stemming from your lumbar spine. It's also worth noting that anxiety and stress can exacerbate physical symptoms, including pain and tingling, which might explain your doctor's comments regarding the autonomic nervous system.

Treatment Options
1. Medication: Since you mentioned that your symptoms have improved with medication, it is crucial to maintain communication with your healthcare provider. If you stop taking the medication and symptoms return, it would be advisable to revisit your doctor for a reassessment. Depending on the severity of your symptoms, they may consider adjusting your medication or exploring other options.

2. Physical Therapy vs. Chiropractic Care: You asked about the potential benefits of chiropractic care versus physical therapy. Both have their merits:
- Physical Therapy: This is often recommended for lumbar spine issues as it focuses on strengthening the muscles around the spine, improving flexibility, and correcting posture. A physical therapist can tailor a program to your specific needs, which may help alleviate discomfort and prevent future issues.

- Chiropractic Care: Chiropractic adjustments can provide relief for some individuals, particularly if misalignments in the spine are contributing to your symptoms. However, it's essential to ensure that the chiropractor is aware of your specific condition and any imaging results you may have.

3. Lifestyle Modifications: Since you suspect that your sleeping position may be contributing to your lumbar discomfort, consider evaluating your sleep environment. A supportive mattress and pillow can make a significant difference. Additionally, practicing good ergonomics during daily activities can help reduce strain on your back.

4. Monitoring Symptoms: If you choose to forgo immediate treatment, it's essential to monitor your symptoms closely. If you notice any worsening of your condition, such as increased pain, numbness, or weakness, you should seek medical attention promptly. Ignoring early signs of discomfort could lead to more severe issues down the line.

Potential Risks of Inaction
If left unaddressed, mild lumbar spine issues can progress. Chronic pain, reduced mobility, and potential nerve damage are risks associated with untreated spinal conditions. Early intervention often leads to better outcomes, so it’s wise to remain proactive about your health.

Conclusion
In summary, it would be beneficial to continue following up with your healthcare provider regarding your symptoms. If your current treatment plan is not yielding satisfactory results, consider seeking a second opinion or consulting a specialist, such as a neurologist or an orthopedic spine surgeon, for further evaluation. Engaging in physical therapy may also provide significant benefits for your lumbar spine and overall well-being. Remember, addressing these issues early can help prevent more severe complications in the future.

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