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#9684

Hi Dr. Corenman,

I have some burning sensation in both legs (thigh and calf) which get worse after riding a bike or swimming and I was reading about Peripheral Neuropathy in your web site in order to get more info about it. Symptons get worse in a seated position as well as it seems to be enhanced by wearing pants.

You named 4 potential causes for peripheral nerve malfunction: damage to the nerve membrane by autoimune disease, damage to the myelin sheath again by autoimune disease, inability to transport protein machines and the lack of blood supply.

My last blood test is unremarkable, since I´m kind of athlete and I like to exercise myself almost everyday, except for the fact of my Lipoprotein A level is higher (55mg/dl). Interestingly, my LDL is normal and I don´t have cholesterol problems.

I wonder, since Lipoprotein A is a possible cause of atherosclerosis, would this be a possible cause for my burning sensation? You could ask me now why don´t you look for a cardiologist instead a Orthopaedic, right? That´s because I´ve got a L4/L5 god damned protusion causing lots of back ache and disconfort, and I wonder if the burning sensation could be caused by something else instead of my spine disorder.

It´s important to say that I don´t have pain through my sciatic nerve, at least until now. Also, i must say that I´m a regular drinker. Love beer from USA and Belgia and wine from South America. Doesn´t help into my nerve situation recovery, right? Not even into my LPa level.

Ok, thank you for your time. You have kindly answered few questions of mine before and I really apreciate.

When in USA, I´ll stop by for a visit.

[Donald Corenman, MD, DC]

#9689

A good wine will help your symptoms but won’t change any nerve pathology. I recommend a Pinot Noir.

Burning in your legs could be from peripheral neuropathy but with a large disc herniation in your back at L4-5, suspicion would also be placed on this herniation compressing the nerves and causing this pain.

An epidural steroid injection would be beneficial to differentiate peripheral neuropathy from radiculopathy (nerve pain from compression in the spine). The first three hours after the injection give anesthetic relief (numbing). If you get this injection and gain good relief of leg symptoms in the first three hours, the diagnosis is most likely from radiculopathy. If no significant relief, this could be peripheral neuropathy.

Atherosclerosis by itself is not related to peripheral neuropathy. Now, diabetes can cause both atherosclerosis and peripheral neuropathy so there is some relationship in an indirect manner.

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.

[WELL]

#9716

Indeed Dr. Corenman, wine gives me good relief and Pinot Noir is in my Top 5 list.

Ok, let´s assume my burning sensation is caused by nerve compression due L4/L5 disc protusion (which is most likely): would be ridding a bike or swimming activities I should avoid in order to spare the nerve? Would those activities cause more harm than benefits since it seems to irritate the nerves even more? I had first MRI when my back start hurts and them, few months later after legs start burning, I had another MRI which show that my lumbar spine is stable (no difference between both MRIs). I have this type of pain for almost 1 year and it´s not disabling, but causes me a lot of anxiety and makes me wonder if I should be concern or not.

For last, which is the nerve in charge of burning feelings in the leg? Does it belongs to Sciatic nerve fibers?

Thanks again, Doc.

[Donald Corenman, MD, DC]

#9811

Disc herniations in the typical location (posterolateral-90% of herniations) will cause increased pain with flexion (sitting, bending forward, lifting the affected leg). Cycling fits into this mechanical picture however, if you can cycle and not develop much pain, then cycling is an acceptable activity. Swimming, since this activity is normally performed in extension (you have to get your head out of the water) typically will not irritate leg pain from a normal herniation.

Nerve pain generally is a sign of increased injury that may be temporary or indicate some increased damage. It is generally not a good idea to perform activity that increases nerve pain but there are some exceptions.

Low back pain is another story. Mild to occasionally moderate low back pain is part and parcel of our human condition due to our spinal anatomy and degenerative susceptibility. Mild lower back pain from typical degenerative disc conditions is something that is acceptable as long as it is containable.

Burning pain in the leg could be from nerve compression but I always worry about peripheral neuropathy and chronic nerve injury as the cause.

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.

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