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  • doug goldberg
    Participant
    Post count: 5

    Dr. Corneman first let me thank you for hosting this amazing resource and supporting it with your time. You are truly an amazing man.

    I’m 61 years old, 6″4, 195 lbs, and a long time marathoner. About 10 years ago I started experiencing sciatica which culminated in the diagnosis of a herniated disk (L5/S1, large, left paracentral) about 7 years ago. Between PT and few steroid injections I made it through without surgery. Eight months ago the pain became debilitating to the point of crawling on the floor. I made the decision to have a mircodisectomy which was performed in May of 2019. It was successful in relieving the pain with the remaining symptoms being some numbness in my left foot. Since the procedure I have been walking, swimming and core-strengthening. I gave up any running but try to walk 30-40 miles a week and swim three days. During the eight months I have had several occurrences of what feels like pulled muscles in upper left leg and buttocks that resolve in few days and have generally felt pretty good. These usually occur after some strenuous activity the previous day. Most recently I have experienced a lot of twitching in the upper buttocks and leg. Its not painful and the twitching seems positional dependent. It has been going on for a number of days. I’m having night mares about re-herniation and am looking for advice on next steps.

    Thank you in advance.

    Doug Goldberg

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    It is less likely that you have a recurrent disc herniation. With compression of that nerve root for so many years, some chronic root injury can be expected. Your root is somewhat sensitive and the high activity (“after some strenuous activity”) that occurs the day before your concerning symptoms develop is typical for the inflammatory cascade time delay.

    “Twitching” is not typical of a nerve compression syndrome unless there is denervation (loss of motor nerve connection) which is unlikely in your case. If the nerve continues to be “persnickety”. you could consider an epidural steroid injection.

    Dr. Corenman

    doug goldberg
    Participant
    Post count: 5

    Dr. Corenman,

    Thank you for your reply. My surgeon has prescribed a round (12 days) of oral steroids (30mg/20/10/5, 3 day ea). The first few doses completely eliminated the symptoms. Now on the mild dose (10 mg) the symptoms have returned with much less intensity. Will wait to see the results when completed but I intend to ask about an epi-injection to stamp out the inflammation.

    Thank you again,

    Doug

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    Great! Please keep us informed.

    Dr. Corenman

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