T Nation

L5-S1 Protruding Disc

Back in October 2009 while training Jiu jitsu I stopped mid session due to numbness in my left leg and pain in my back. After months of physical therapy and progress in getting better I am back to square one, with numbness in both legs and glutes with no pain in my lower back (I wish I could feel pain instead of being numb).

Since I know every case is special I was wondering if anyone had advice on what type of specialist I should see. Also a few words of comfort wont hurt, so if anyone has experienced such a disheartening experience due to a bad back let me know. All I want to do is be able to deadlift something light and train some kind of martial art.

Both legs have constant numbness rather than shooting pain? Yeah sounds like some variance of sciatica. Did your recurrence occur due to an acute injury or what happened exactly?

[quote]saps wrote:
Both legs have constant numbness rather than shooting pain? Yeah sounds like some variance of sciatica. Did your recurrence occur due to an acute injury or what happened exactly? [/quote]
Sciatica huh? Thing is the MRI results indicated that the protrusion isnt touching the nerve, therefore it has “No Significant Mass Effect.”

Two things:

  1. I have not been very mindful of my posture as of late.
  2. Noticeable pains in the gym in my lower back as of last week and pain today while walking.

Ive been working out at a new gym as of late and the leg press machine there operates odd (fucking retarded that is). I might just avoid it and use the leg press machine the old people use.

Are you having any problems with incontinence of bowel or bladder? Are you having any symptoms of weakness?

I would suggest seeing a Physical Medicine and Rehabilitation specialist. Specifically, one who has fellowship training in Pain Medicine or Sports Medicine.

Another type of doctor you could see is a Family Medicine doctor who has done a Sports Medicine Fellowship.

Certainly, an Orthopedic spine or Neurosurgical spine doctor can answer some of your questions more specifically about the spine.

However, my concern is that if your MRI does not show nerve root impingement, there may be a different process going on causing bilateral lower extremity paresthesias (i.e. peripheral neuropathy). In which case an EMG/NCV and/or laboratory tests may be waranted. However, without examining you, this obviously limits what I can tell you about your condition.

beef

Did the MRI have comment about ‘anterolisthesis’ or ‘spondylolisthesis’?

beef

[quote]beefcakemdphd wrote:
Did the MRI have comment about ‘anterolisthesis’ or ‘spondylolisthesis’?

beef[/quote]
Neither the MRI nor the specialist mentioned either of these two terms. However after a few stretches and with corrected posture I feel much better a day later.

[quote]beefcakemdphd wrote:
Are you having any problems with incontinence of bowel or bladder? Are you having any symptoms of weakness?

I would suggest seeing a Physical Medicine and Rehabilitation specialist. Specifically, one who has fellowship training in Pain Medicine or Sports Medicine.

Another type of doctor you could see is a Family Medicine doctor who has done a Sports Medicine Fellowship.

Certainly, an Orthopedic spine or Neurosurgical spine doctor can answer some of your questions more specifically about the spine.

However, my concern is that if your MRI does not show nerve root impingement, there may be a different process going on causing bilateral lower extremity paresthesias (i.e. peripheral neuropathy). In which case an EMG/NCV and/or laboratory tests may be waranted. However, without examining you, this obviously limits what I can tell you about your condition.

beef[/quote]
No bowel or bladder problems, and with the numbness comes significant weakness.
Btw thanks for the insight, when I do see a new specialist I will have to look into the possibility for an EMG/NCV.

The MRI will only show the Disc buldge, not nerve root impingement.
CT will show impingement.

Anyways, what is happening is the disc between the vertebrae is becoming more and more deranged. With this derangement peripheralization has occured, as described by McKenzie. Basically your pain has moved from the spine down your legs, this is not a good thing. If the pain was decreasing in the legs and only was occuring in the spine, this would be a better situation. Best to trial conservative management first and avoid surgery at all cost.

Start with these exercises. Read the entire article before you begin.
http://www.communigate.co.uk/ne/eppsg/page8.phtml

[quote]dsauve wrote:
The MRI will only show the Disc buldge, not nerve root impingement.
CT will show impingement.

Anyways, what is happening is the disc between the vertebrae is becoming more and more deranged. With this derangement peripheralization has occured, as described by McKenzie. Basically your pain has moved from the spine down your legs, this is not a good thing. If the pain was decreasing in the legs and only was occuring in the spine, this would be a better situation. Best to trial conservative management first and avoid surgery at all cost.

Start with these exercises. Read the entire article before you begin.
http://www.communigate.co.uk/ne/eppsg/page8.phtml
[/quote]
I appreciate the link and the advice, however I have McKenzie’s book and it states these exercises should NOT be done with numbness in the legs. Id advice anyone who has numbness in their legs to follow that guideline.

However, when the numbness subsides I assure you I’ll be doing these exercises.