HeydeMemberJanuary 21, 2012 at 1:53 pmPost count: 1
Hi Dr.: I am asculler. 18 yrs. 1st surgery L4-L5. Rowed again – 2nd surgery L5-S1. Major back pain before both. Key was I could not move my toe (surg.1) and atrophy of my calf and I could not elevate on my toes (surg. 2). My neurosur. said these were the 2 largest ruptures he had seen. Quit rowing for 10 yrs until 2011. Had one minor issue (back hurt) which was resolved after a week. Now (rowing or the mating ritual related)I have a cramp in my calf (always the lt leg). Cramp sometimes goes up to the outside of my knee. But NO BACK PAIN AT ALL. This is new territory for me because I always have had huge back pain. Cramp in my leg – given what I have been thru for 30 yrs -is no big deal – but I know something is up. Cramp is same place as L4-L5 rupture from years ago. I know there is deterioration at L4-L5 but I am thinking I have a fragment that broke off and that is problem. Conservative approach is take whatever the new Vioxx is to shrink nerve. If that does not work – MRI and what I am thinking is the inevitable – go in there and get the no longer useful stuff out. What do you think? I also know the xrays from 20 years ago showed the verterbae rolling over with spurs.
Thanks – Heyde – age 55Donald Corenman, MD, DCModeratorJanuary 22, 2012 at 3:15 amPost count: 8408
You have had two prior herniations at L5-S1 and L4-5 with good results post surgery. You have started to row again and have developed cramping in the left calf. The prior herniations always caused lower back pain along with the leg pain and this episode has no related back pain.
Repeat or recurrent disc herniations occur in 10% of the athletic population and most likely this is what is causing symptoms. Other disorders can cause these symptoms too. Cramping can be associated with motor weakness and in my practice, if there is significant motor weakness present, the patient would get a microdiscectomy soon.
You can test your L5 and S1 nerves yourself. Stand on one leg while balancing yourself with a hand on a counter. Perform 10 quick heel raises on the non-affected side and repeat with the left leg. If there is noticeable performance difference, you have motor weakness. Do the same action with toe/foot raising on each side.
If there is no weakness, an MRI may be indicated and an epidural steroid injection might be helpful. By the sounds of your symptoms, this is more likely herniation but spur formation can occasionally cause the same symptoms. In either case, the treatment is the same and the surgery is similar.
Dr. CorenmanPLEASE 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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