Hey ustalaugh, that's good news that you've had some improvement post-surgery! It's very good that it happened so quickly, too - i've read that the weakness takes a while to improve, so if you're already seeing some change, you're in a good place. Sorry to hear about your fall today. ooh, that must have been scary so soon after surgery.
I was told by a physiatrist that nerve healing is a slow process. Here's what I've been told by doctors. What they told me is based on a non-surgical treatment, so the answers may be different and improvement might happen faster if you have surgery to decompress the nerve.
osteopath: said that the leg weakness takes months to heal and requires PT to see improvement. Also quoted study showing that outcomes in surgically treated vs. conservatively treated patients are identical at 3 and 5 year followups. However, I don't know if this study included people with nerve damage (muscle weakness and atrophy) or just pain alone.
physiatrist: Also quoted the study of outcomes at 3 and 5 years. Said that there are no guarantees, but that muscle strength should improve with physical therapy. He said that it is slow...that in 3 months I should show some improvement. He said to think of healing from this in terms of a *year*, not a few weeks or months. He also said that the affected muscles may never return to the same size as they were before the injury. He said 20 years ago, he had drop foot (couldn't lift front of his foot, he demonstrated) with muscle atrophy on one side from a disc herniation, and didn't have surgery. He said that he regained full function, but that the muscles never returned entirely to their original size. Showed me the difference in his calf muscles - they looked about the same size to me, but his bad leg had a bit less muscle definition. He also said that his affected leg worked as well as the good side, but that even 20 years later, would have less endurance, meaning that the muscles fatigued earlier than the good side in endurance activities like long bike rides and stuff.
Yes, my left leg is smaller than my right. The physiatrist measured with a tape measure. Left calf is 1 cm smaller now. My glutes and top thigh muscles are smaller on the left side now, too.
Yes, my affected foot has poorer circulation than the normal leg. I asked the physiatrist about it. He said that the regulation of blood flow to the capillaries is affected by the nerve damage. It doesn't mean that my foot doesn't have blood flow, but that the smaller capillaries supplying the surface are less able to regulate temperature. Sometimes my left toes look paler than my right toes.
I've been putting a heating pad on my left foot when it's cold to help with circulation. I also noticed that there is less numbness when my foot is warm. Also less numbness after I do the daily 1-2 mile walk. After walking, I can feel the circulation in my legs increased. Looking forward to trying the elliptical to get the circulation moving better again.
Sorry to go on so long, but I've done lots of reading on this stuff. I searched on the terms discogenic paresis, and found a french study of the recovery from leg weakness caused by disc injury. Some recover fully, some partially, some not at all. That article also mentions other studies that have documented improvement at 1 year, 2 years and even 3 years, which contradicts what some doctors say about nerve healing being complete at 18 months. Worth checking out if you're interested.
And one last thing...know how when you flex a muscle you can clearly feel it contracting? At the point when my leg was weakest, I tried to flex my gluteus maximus and couldn't even feel the muscle react at all. Same with my calf muscles. After increasing my walking, trying to consciously use those muscles when going up and down stairs, and doing some exercises to try to strengthen those specific areas, I can now feel the muscles contract when I flex them. My glutes are noticeably stronger - I can now balance on my left leg, knee bent, without falling over. Couldn't before. My calf is still not strong enough to let me push off with the toes when stepping forward, but now at least I can flex the muscle. Hopefully this is the start of further improvement in those muscles