Cold burning sensation in the legs after prolonged sitting

Tagged: burning sensation, Disc problems

Viewing 6 posts - 1 through 6 (of 6 total)

Author

Posts
CureAP
Participant

January 11, 2017 at 12:54 am

Post count: 3

#24100

Hello Dr.Corenman,

I have been having back issues for the past 6 years. It started in the year 2010 and after an MRI it was found that I had an L4-L5, L5-S1 disc bulge/herniation. The symptoms were not being able to sit for long due to burning sensation in the disc area. I also used to get burning sensation in the legs (shin, calf, hamstring, thighs). In march 2015, I injured myself while doing some ball exercises and the disc burst open. The herniation was around 20mm. I had to get operated. I underwent microdiscectomy surgery in the month of May 2015 and have been recovering ever since.

Problem:

I still get burning sensation all over the legs when I sit for long hours. It seems like a cold burning sensation and I feel that the legs have become cold. It starts with the Tibialis Anterior region, then calf and then finally moves to the tip of the thighs. The cold burning improves with rest and I am better the next day. When I start the period of prolonged sitting my legs are not as bad as they are after prolonged sitting.

I underwent an Electromyography(EMG) / Nerve Conduction Test(NCV) test twice after the surgery and it came out to be entirely normal. Post surgery MRIs show no nerve compression. Some of the areas (in the leg) where the burning occurs do not correspond to the L5/S1 nerve dermatome and was told by my doctors that it is not coming from my spine. I also have some scar tissue after the surgery but I don’t think this has anything to do with my burning sensation since the symptoms were present even before the injury.

Any help is appreciated.

Donald Corenman, MD, DC
Moderator

January 14, 2017 at 8:29 pm

Post count: 8660

#24118

EMGs are generally worthless for leg pain without motor weakness as the pain nerves are too small to test.

I assume you do not have arachnoiditis but with that large a disc hernation, that is one possibility if it was overlooked. Do you have bilaterally symmetrically symptoms (equal on each side) or is one side significantly more symptomatic?

Another possibility is peripheral neuropathy. See the section on this website to understand that disorder.

Can I assume that your statement “When I start the period of prolonged sitting my legs are not as bad as they are after prolonged sitting” should be “When I start the period of prolonged standing my legs are not as bad as they are after prolonged sitting”?

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

CureAP
Participant

January 14, 2017 at 10:46 pm

Post count: 3

#24124

Dr.Corenman,

Appreciate your help in taking the time to reply to my question.

My symptoms are slightly more on the right leg as compared to the left. But after prolonged sitting both the legs have burning sensation.

I will be getting a skin biopsy test done for small fiber neuropathy just to rule out this condition.

As far as arachnoiditis is concerned, none of my doctors told me I have this condition. I have consulted two neurologists, one in Stanford and the other in Palo Alto Medical Foundation. I can check with them again. I even got an MRI multiple times after the surgery. There was no disc herniation then. The Stanford doctor said that the burning sensation is coming from my spine but the other doctor did not think so.

I am not sure if it is Peripheral Neuropathy as my feet feel okay. There is no numbness or burning sensation in the feet. It is mostly in the shin, calf and thigh region. I also have burning sensation near the disc area when I sit for long. It is worse in the morning.

Can a painful disc cause burning in the legs even though it is not pinching a nerve ?

>>> Can I assume that your statement “When I start the period of prolonged sitting my legs are not as bad as they are after prolonged sitting” should be “When I start the period of prolonged standing my legs are not as bad as they are after prolonged sitting”?

Sort of yes. Prolonged standing is much better (in terms of burning sensation) than prolonged sitting.

What I meant was – at the start of sitting I am okay i.e. burning sensation is less. It gets worse after an hour or so of sitting (without any breaks in between).

Donald Corenman, MD, DC
Moderator

January 16, 2017 at 10:30 am

Post count: 8660

#24135

Disc disorders that do not cause nerve compression can occasionally cause referral pain into the pelvis and posterior thighs but this pain is specific (called sclerotomal pain). It would start with severe lower back pain and then refer down to the buttocks and legs only then. This sclerotomal pain would not refer down below the knees.

If you do not have arachnoiditis, this could be chronic radiculopathy (see website). You might try epidurals and keep a pain diary to determine if this is chronic radiculopathy (you will have temporary relief for 2-3 hours). The steroid might help to give longer term relief. If you gain no long term relief and your pain is bad enough, you might consider a spinal cord stimulator.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

CureAP
Participant

January 16, 2017 at 3:42 pm

Post count: 3

#24144

Thanks for the reply Dr.Corenman.

If it is chronic radiculopathy, it must be present all the time, correct ? My condition only gets aggravated with prolonged sitting. Do you think it could be a circulation problem of any kind ?

Donald Corenman, MD, DC
Moderator

January 20, 2017 at 7:41 pm

Post count: 8660

#24188

Mild chronic radiculopathy can occur intermittently but you are correct that significant chronic radic should be present continuously but can change in intensity. Circulatory problems are associated with muscle cramping with activity.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
Author

Posts

Viewing 6 posts - 1 through 6 (of 6 total)

You must be logged in to reply to this topic.

Donald Corenman, MD, DC

Average rating:

81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel