[rypz79]

#32421

Hello Dr. Corenman

I’ve reached the half-way mark of 12 weeks.
My leg strength is improving I’m now able to do 20 toe rises much easier. I will move to sets now, trying to complete 3 sets of 20.
I’ve also got balance problems I’m a bit shaky while standing on this foot, I’m working on it also. There is some pain when I’m dorsiflexing my right foot forward while sitting.

BTW I saw the heel rise exercise for the S1 nerve root it is quite similar to the toe rises but you needed somekind of step for that am I right?

I’ve just walked half a mile and I feel the improvement but still it’s not as my left foot.
It still aching. not painful, not numb but with a loss of sensation. The irritation (feels like burning) grows when I’m crossing my right leg over left one that is one of my favorite ways of sitting.

I’m more worried from the radiculopathy/sciatica then from the motor loss/weakness.
With this progress can I expect all these symptoms to reslove within the the 12 week mark?

Thank you very much Dr. Corenman

[Donald Corenman, MD, DC]

#32423

You are improving well. I think you will be satisfied at the 12 weeks mark. It won’t be perfect, but acceptable.

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.

[rypz79]

#32437

Hello Dr. Corenman

There are somethings that I’m not sure I’m fully understand from https://neckandback.com/conditions/peripheral-nerve-anatomy/ I’ll try to question as precise as I can:

1) It’s written

A nerve is really a collection of thousands of nerve cells in one bundle- something like a telephone cable with thousnds of individual wires within the cable

So when we are talking about a nerve root (cable) damage we can be talking about multiple injury types i.e each nerve cell (wire) can sustain a different type of injury?

2) In axonal regeneration its written that

The nerve ending may terminate in a muscle, a sensory organ (skin sensation) or a proprioceptive organ (coordination sensation…)

So in case of l5 or s1 nerve root damage as this, how can the lower leg/foot recover from paresthesia while it cannot recover from motor/muscle loss or it can’t recover from both? or does axonal regeneration is reserved only for muscle nerve cells?

3) In nerve sprouting it’s written

This sprouting activity can take from 12-16 weeks after the initial injury to occur

While the compression place, degree and time determines the type of nerve injury sustained are all the nerve recovery times written: Myelin injury: 8-14 weeks , Axonal regeneration: 12-18 weeks , Nerve Budding: 12-16 weeks, get restarted from the time of the decompression surgery?

Thank you very much Dr. Corenman

[Donald Corenman, MD, DC]

#32443

So when we are talking about a nerve root (cable) damage we can be talking about multiple injury types i.e each nerve cell (wire) can sustain a different type of injury? Yes

So in case of l5 or s1 nerve root damage as this, how can the lower leg/foot recover from paresthesia while it cannot recover from motor/muscle loss or it can’t recover from both? or does axonal regeneration is reserved only for muscle nerve cells? Paresthesias/sensation dedicated nerves seem to sprout or “bud” at a better rate than motor nerve root cells. Also remember that the cell body of a sensory cell is in the dorsal root ganglion (at the nerve root foramen) but the motor cell body is in the anterior horn of the spinal cord (quite a distance up the canal making the root longer).

While the compression place, degree and time determines the type of nerve injury sustained are all the nerve recovery times written: Myelin injury: 8-14 weeks , Axonal regeneration: 12-18 weeks , Nerve Budding: 12-16 weeks, get restarted from the time of the decompression surgery? Correct.

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.

[rypz79]

#32458

Hello Dr. Corenman,

Well while testing the toe raises again and again I found out that both heads the calf muscles (Gastrocnemius and Soleus I can’t really tell) are weak the outer head feels somewhat dormant. They just won’t contract as in the left leg. You can easily tell by just contracting them both while sitting the right ones feel weaker. The muscle feels like it shrunk but it’s not visible.
When I’ve checked in your article https://neckandback.com/conditions/symptoms-of-lumbar-nerve-injuries/ I’ve found out that those muscle group are fed by the S1 nerve root could I have also some irritation there ?

A question about nerve budding. does exercise encourages this process? i.e the more you try to activate those dormant muscle cells the more chance they can bud with a nearby active cell?

Thank you very much Dr. Corenman

[rypz79]

#32573

Hello Dr. Corenman,

It’s now 3 months since my operation.
S1 is clear I confirmed that with the surgeon.
The remaining issue is numbness mainly in the balls of the foot and in dorsum of it, the same symptoms that led me to do the operation.

The problem with the balls of the foot is that you use them all the time standing, walking, running or doing heel raises. The more pressure there is on this area the more painful/irritated it becomes. There is also a loss of skin sensation (dermatome) in this area compared to the other sole.

Why do I have those symptoms in the terminal parts of the nerve and never in the path of it?

If we are talking about some axonal damage with the myelin sheath still intact does the distance (from l5) plays a role in this situation ?

Thank you very much Dr. Corenman

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