AMWalker

Thank you Dr. Would you be willing to suggest what some of those other cause may be? Are you available for a remote consultation that might be best done once I am able to forward you some new images?

Hello Dr. Corenman,

I am now roughly two years and two months post endoscopic discectomy for HNP at L5-S1 and severe radiculopathy on the left side. Progress has been slow as discussed earlier in this thread, and it seems over the past six months to have plateaued. I was aware before my surgery that given the nature of my injury that there could be some residual symptoms and almost certainly some limitations going forward. Nevertheless, I am optimistic for future progress and I solicit you opinion on some ongoing issues and how they may be ameliorated if not resolved.

Visits with physical therapists and chiropractors both before and after my surgery have identified a pelvic torsion that occurs and causes one leg to appear longer than the other. It results in added pain, and adjustment by a DC via clicker, or at home with a muscle energy technique taught me by a PT, bring relief. I have been working on strengthening my core for over a year and a half (McGill big three), yet moderate lifting, bending over improperly, or even sleeping wrong can cause my back/pelvis to “go out”. Any advice on what to anticipate with this? Is it prudent to avoid the things that cause this problem at all costs? I am willing to take my PT to the next level, but I fear no amount of muscle strengthening can offset the damage to the connective tissue between my vertebrae.

The second problem I am having is a persistent twitch my left calf in both the gastroc an soleus. It is fairly constant and is made worse when my knees and hips are flexed, as in sitting in the car and even when lying on my back, bending my knees with my feet on the floor. I cannot hold this last position due to the intensity of the twitching which also begins to become painful. Lately the twitching has seemed to become more frequent and occasionally spread further up the leg into the hamstring and hip, and to occur even in positions which normally relieved it some, like lying supine. I am curious if this could be from ongoing compression of the nerve root, or if it is more likely from nerve damage, either from the herniation, surgery or the two ESI’s I had. I first noticed it approximately seven to eight months after surgery and it has waxed and waned since then, becoming most prominent lately. Do you think another MRI is warranted at this point, in addition to a nerve conduction study? Though I am not eager to do things that may potentiate more surgical intervention, I am eager to understand how best to proceed to ensure the best quality of life I can going forward.

I thank you for taking the time to consider my questions and to reply at your convenience.

Thank you for your reassurance Dr. Corenman.