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Old 09-18-2008, 06:46 PM   #1
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dljbarber HB User
Sciatic leg pain due to herniated L4-5 disc

Is it common to only have leg pain when standing or walking? I am fine when I sit or lay down, but have right leg pain just after a minute of standing or walking. On meds, doing PT, and looking at epidural injections. No relief now one month into this. 90-95% of pain is in the right leg, only 5-10% in lower back. Also have bulge at L5-S1 and doc said he would inject both places. This is second doc, 1st doc wanted to operate (fusion) immediately. I'm 43, seems like surgery should be last resort. Anybody in the same boat?

 
Old 09-18-2008, 07:14 PM   #2
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mznell HB User
Re: Sciatic leg pain due to herniated L4-5 disc

Hello dljbarber ~

Welcome to the board. What you are experiencing is VERY common and I can speak from personal experience.

Was your condition diagnosed by a spinal specialist (rather than a PCP, family doc or regular orthopedic doc)? I gather you have had a MRI since you know you have a disc herniation and a "bulging" one as well?

The herniated disc is causing pressure on the nerve root at at least one level, and possibly at both levels. These nerve roots exit the vertebrae through each vertebra's foramen and the nerves kind of bundle together at this level into what is called the cauda equina (horse's tail). (Up above the L2 level, they would make up the "spinal cord.") The cauda equina runs the length of the lumbar and sacral vertebrae and branches into the sciatic nerves. These are large nerves, about the size of a little finger. The L4 and L5 nerve roots refer pain to part of the side of the hip and buttocks, down the back outside of the leg and calf and down into the outside of the foot to the outer toe/s (for most people). Your nerve root is being pinched in your lower lumbar spine, but you feel the pain in your leg. Due to the structure of your spine, when you get off your feet and gravity is no longer pressing down on your spine, the nerve is not being compressed, and thus, you do not feel pain. But when you're standing or walking, you are affected by the compression and it causes the pain. The epidural injections are designed to bath the nerves in a steroid which will reduce any inflammation, and hopefully, reduce the compression. Sometimes this works! Often, it doesn't.

Do you know why the first doc was recommending fusion? Usually a decompression procedure is recommended if the disc is just herniated. Fusion is recommended if the decompression will result in instability.

You are absolutely right. Surgery should always be a LAST resort unless you have bowel or bladder involvement or develop foot drop. As long as you can still flex your foot, you're OK in that regard. If you have bowel or bladder involvement, call your doc right away, or go to the ER. This is considered an emergency and should be treated right away so there is not permanent damage.

Please feel free to post with any and all questions or comments. This is a great place to gather information and discuss your fears!!

xx MM

 
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Old 09-18-2008, 09:35 PM   #3
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Mel52 HB UserMel52 HB UserMel52 HB UserMel52 HB UserMel52 HB UserMel52 HB UserMel52 HB UserMel52 HB UserMel52 HB User
Re: Sciatic leg pain due to herniated L4-5 disc

I had the same pain but mine got to the point I couldn't deal with the pain in the leg. My toes were going numb and I felt like my leg was going to give out. I didn't want to get into a fusion situation, so I had a laminectory and discectomy on L3, L4 and L5. I am 5 months post op. My back is doing much better. No leg pain in one leg but my other leg aches and feels heavy. No sciatic pain though

 
Old 01-12-2009, 03:34 PM   #4
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karate_mom HB User
Re: Sciatic leg pain due to herniated L4-5 disc

Quote:
Originally Posted by dljbarber View Post
Is it common to only have leg pain when standing or walking? I am fine when I sit or lay down, but have right leg pain just after a minute of standing or walking. On meds, doing PT, and looking at epidural injections. No relief now one month into this. 90-95% of pain is in the right leg, only 5-10% in lower back. Also have bulge at L5-S1 and doc said he would inject both places. This is second doc, 1st doc wanted to operate (fusion) immediately. I'm 43, seems like surgery should be last resort. Anybody in the same boat?
Are you still available to answer this?? I have the same problem. My hip/right leg hurts when i walk. i have L5-S1 bulging disc. It feels like it going to give out, or snap. It is pretty bad today. Did you ever have any success in treating this?

Thanks,

Karate mom

 
Old 01-13-2009, 06:08 AM   #5
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dljbarber HB User
Re: Sciatic leg pain due to herniated L4-5 disc

Epidural injections gave me no relief, so Dr. recommended micro-discectomy/laminectomy. I had outpatient procedure Tue. before Thanksgiving and had immediate relief from leg pain. Surgery pain lingered a few weeks, but now am pain free. Just walking daily per dr. orders. Surgery isn't the answer for everyone, but it was successful for me. Good luck!

 
Old 01-13-2009, 08:30 AM   #6
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karate_mom HB User
Re: Sciatic leg pain due to herniated L4-5 disc

[QUOTE=mznell;3733361]Hello dljbarber ~

Welcome to the board. What you are experiencing is VERY common and I can speak from personal experience.


The herniated disc is causing pressure on the nerve root at at least one level, and possibly at both levels. These nerve roots exit the vertebrae through each vertebra's foramen and the nerves kind of bundle together at this level into what is called the cauda equina (horse's tail). (Up above the L2 level, they would make up the "spinal cord.") The cauda equina runs the length of the lumbar and sacral vertebrae and branches into the sciatic nerves. These are large nerves, about the size of a little finger. The L4 and L5 nerve roots refer pain to part of the side of the hip and buttocks, down the back outside of the leg and calf and down into the outside of the foot to the outer toe/s (for most people). Your nerve root is being pinched in your lower lumbar spine, but you feel the pain in your leg. Due to the structure of your spine, when you get off your feet and gravity is no longer pressing down on your spine, the nerve is not being compressed, and thus, you do not feel pain. But when you're standing or walking, you are affected by the compression and it causes the pain. The epidural injections are designed to bath the nerves in a steroid which will reduce any inflammation, and hopefully, reduce the compression. Sometimes this works! Often, it doesn't.

Do you know why the first doc was recommending fusion? Usually a decompression procedure is recommended if the disc is just herniated. Fusion is recommended if the decompression will result in instability.


Thanks to both of you, as this information is very helpful.

 
Old 08-21-2010, 03:51 PM   #7
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mikecincy HB User
Re: Sciatic leg pain due to herniated L4-5 disc

Quote:
Originally Posted by Mel52 View Post
I had the same pain but mine got to the point I couldn't deal with the pain in the leg. My toes were going numb and I felt like my leg was going to give out. I didn't want to get into a fusion situation, so I had a laminectory and discectomy on L3, L4 and L5. I am 5 months post op. My back is doing much better. No leg pain in one leg but my other leg aches and feels heavy. No sciatic pain though

So you are pain free now. Great. How long after surgery was it before you noticed the pain was not as bad?

 
Old 08-23-2010, 06:33 AM   #8
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dljbarber HB User
Re: Sciatic leg pain due to herniated L4-5 disc

Relief was felt immediately after surgery

 
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