KB32

Hi Dr. Corenman,

It’s been 6 weeks now since my symptoms started due to reherniation of the L4/L5 disc. Over these past 6 weeks I tend to get better, then have a severe flare up, then I tend to get a little better, then experience another severe flare up. Flare ups would include extreme lower back pain and nerve pain in my calf. I also notice a hint of nerve pain in my other leg as well. I do not have any motor weakness. I recently started experiencing severe butt pain and tightness again.

I find that sitting really upsets the nerve and causes extreme lower back pain which then leads to nerve pain in my leg. I talked with my surgeon and he is willing to do another microdiscectomy. We both agreed to continue conservative treatment for a little while as I’m not in too much pain at the moment. We also discussed an l5 nerve root block or epidural. I did find out my most recent ct scan showed that my herniation was larger than my first herniation. My first herniation before surgery was 2 cm.

I have a couple of questions:

1. How long should i give the conservative treatment? Another 6 weeks? If I have another severe flare up within these next 6 weeks, I was thinking that I would move forward with surgery. If i continue to feel better, then obviously no surgery would be necessary.

2. With a huge herniation that is greater than 2 cm, does that mean that conservative treatment will take longer than say a 5-7 mm herniation? Do larger herniations suggest that surgery is more likely necessary in the future?

3. What are your thoughts on nerve root block or epidural? I feel like the nerve root block will mask the symptoms too much and I will then become more active. Which could result in not healing. Currently, I am not in too much pain. But that is because I have been laying down a lot and not moving much these past 6 weeks. The more active I become, the more aggravated my nerve gets. So Ive kept everything to a minimum. But I worry inactivity will start to lead to other problems.

Look forward to hearing your thoughts

Thanks for the quick reply!

After a week of rest, massage therapy, and acupuncture my sciatica pain went away and so did my lower back pain. The only symptom I am currently feeling is pins and needles in both of my legs. The last time I had a herniated disc only one of my legs was affected. Is it possible to have pins and needles all over both legs with a L4/L5 herniated disc?