Leg Numbness: When to See a Neurologist After Back Surgery - Neurology

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It sounds like you're experiencing a complex set of symptoms following your previous L5-S1 discectomy, and it's understandable to be concerned about the new developments in your condition. Given your history and the recent onset of numbness and pain in both legs, it is indeed prudent to consider a consultation with a neurologist.


Understanding Your Symptoms
Your symptoms of left hip, thigh, and calf numbness, along with the recent development of similar sensations in your right leg, could be indicative of several underlying issues. The fact that your MRI results showed only mild protrusion without significant compression of the sciatic nerve is reassuring, but it does not entirely rule out the possibility of nerve irritation or other neurological issues.

The intermittent nature of your symptoms, along with the fact that they have worsened recently, suggests that there may be an underlying condition that requires further investigation. The inflammation noted in one of your nerves during the nerve conduction studies could be a sign of neuropathy or another nerve-related issue.

When to See a Neurologist
You should consider seeing a neurologist if:
1. Symptoms Persist or Worsen: If your symptoms are not improving with rehabilitation or if they are worsening, a neurologist can provide a more detailed assessment of your nerve function and overall neurological health.

2. Bilateral Symptoms: The recent onset of symptoms in your right leg, especially when combined with existing symptoms in your left leg, raises the possibility of a more systemic issue that may not be related solely to your previous back surgery.

3. New Symptoms: The emergence of new symptoms, such as numbness or tingling in different areas, should always be evaluated. This could indicate a new or worsening condition that needs to be addressed.

4. Impact on Daily Life: If your symptoms are affecting your daily activities, sleep, or quality of life, it is essential to seek further evaluation.


Potential Conditions to Consider
The symptoms you describe could be associated with several conditions, including:
- Lumbar Radiculopathy: Even if the MRI shows mild protrusion, it could still be causing irritation to the nerve roots, leading to symptoms in the legs.


- Peripheral Neuropathy: This condition can cause numbness and tingling in the extremities and may be related to various factors, including diabetes, vitamin deficiencies, or other systemic issues.

- Sacroiliac Joint Dysfunction: Sometimes, issues in the sacroiliac joint can mimic radicular pain and cause discomfort in the lower back and legs.

- Recurrent Disc Herniation: Although your previous MRI did not show significant issues, it's possible for new herniations to occur, especially if there has been a change in your activity level or if you have sustained any new injuries.


Conclusion
In summary, given the complexity of your symptoms and their recent changes, it is advisable to consult a neurologist for a thorough evaluation. They may recommend additional imaging studies, such as an MRI or CT scan, and further nerve conduction studies to assess the function of your nerves more comprehensively. Early intervention can be crucial in managing neurological symptoms effectively and preventing further complications.
Make sure to document all your symptoms, their frequency, and any factors that seem to exacerbate or alleviate them, as this information will be valuable during your consultation.