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Dr. Corenman,

what is the recovery methodology for afferent neurons in cases of axonal death and some myelin damage distal to place of injury? i.e how CAN they recover from such long distance with relatively short time?

I did not questioned it right.
I meant how can I feel some improvement with only 6 months gone by?
Is there a “critical mass” of connected neurons from which the nerve becomes “non-irritable”?

By asking about CAN & Methodolgy I meant about a gradual improvement as opposed to connected/not conneted (on/off) situation I understood from your articles.
Improvement that is some shrinkage in the numb area and less irritation (it takes more time to provoke it).

I’ve read a bit and found out that the 1 mm/day or 1 inch/month is a thumb rule first detailed in “Rate of regeneration of peripheral nerves in man” HJ Seddon et al. J Physiol. 1943. (p191-215)” In “Nerve Regeneration: Tissue Engineering Strategies (2006)” Recknor JB and Mallapragada SK cited that “Human axon growth rates can reach 2 mm/day in small nerves and 5 mm/day in large nerves.” So I guess there are several factors involved here and the axon growth rate is not a constant number.
From your clinical experience what is more accurate in lumbar radiculopathy cases ?(nerve root->sciatic nerve->terminal branches)

Two more questions in your permission:
1) Can the wallerian degeneration process have already started in the distal segment several days/weeks after the LDH together with the denevration process from the proximal segment? 
2) Can TENS treatments promote PN regeneration or mitigate “nerve irritability” symptoms? modernneuropathy.com/5-best-e-stimulation-devices-for-nerve-regeneration/

The buttom line is that it’s more harder for mentally then physically those irritations & limitations increase my level of anxiety and depression and can cause me panic attacks.
I could’ve handle the burning, numbess & pain much better if I only knew that this is a residual phase for a relative short time frame (upto a year or so post-op) after which the nerve will become “stable” or asymptomatic without allodynia pathological lines.
I can live with numb patches and/or some loss of sensation thresholds.

Thank you very much Dr. Corenman

Dr. Corenman,

I miss calculated the post-op time. on 25th it will be 6 months.

I’ve written about my numb skin just to describe to anyone who doesn’t have numbness how it feels like but I guess it wasn’t good analogy.
I think the best way I can describe it is walking on a blister or on a bubble it feels like dead skin.
When walking outside this “bubble” spreads along the the whole sole and to recover from the soreness it produces almost instantly you to need to rest preferably with your leg up.
I think I’m making mistake comparing my right foot to the healthy left one but on the other hand I cannot tell what is a “normal” foot feels like.

Hypersensitivity of the skin (hyperalgesia or allodynia) can occur. A simple brushing of bed sheets on exposed skin can cause intense pain.

No I don’t think I qualify for allodynia, thermal or mechanical. When I said alternates I meant “when it’s painful the pain feeling alternates”…it’s not always painful.
In saying numb/numbness I mean loss of sensation not lack of sensation. The threshold for hot/cold sensation is 70-80% of the other foot that’s fair I can live with that.

Putting all my body weight on my foot balls (standing on my toes in point position) for a period of time will aggravate the nerve there is no such problem in the other foot. It also applies for prolonged sitting leg-over-leg (only for right over left) and for walking distances. The accumulated pressure on the balls of the foot or on their nerve path is currently limited and symptomatic (causes soreness and some burning sensation along the whole sole)

I think I’m doing a little bit better on Idle state the numbness/bubble has shrunk to the area beneath my big toe ball. There are less flairups (i.e feeling of burning feet) after prolonged sitting or walking, but still it’s not asymptomatic (I’ve heard many peopole with lower somatosensoric nerve issues that their sole is just numb, they don’t feel anything) and draws my mind’s attention regularly. also sometimes I feel a little bit of tingling on the dorsum of the foot though it still feels numb the sensations hot/cold/touch feels normal.

I’ve been put on pregabalin (started 75mgx2 /day then after a week 150×2 /day) I really hope it’s temporary and not the real cause of my improvement so I won’t use this medication on a regular basis for the long run.

I’ve measured the distance from the L5 exit (I have a scar there) through the thigh⋚ till the end of the foot it’s roughly 4’1 (I’m 6’1) so if the nerve recovers at 1mm per day it will take it almost 3.5 years to get there seems highly unlikeabke. Like you’ve written and said those wallerian degeneration are generally preserved (may I add exclusively?) for effernt neurons recovery.

If so then what is the recovery methodology for afferent neurons in cases of axonal death and some myelin damage distal to place of injury? i.e how CAN they recover from such long distance with relatively short time ?

Thank you Dr. Corenman