What Could Be Causing Back Pain, Leg Pain And Gait Problems?
- Posted By:
- 'Kar Mun Chan' on
- 1 Answer
- Pramod Kerkar, MD, FFARCSI, DA
Thanks for detailed presentation of MRI report, EMG and NCV test results. It seems your symptoms are caused by failed back syndrome. I am not sure about signs of foot drop. Foot drop causes atrophy of foot muscles. The foot drop will cause thinning of left foot as well as inward bend of toes and foot towards ground. The history and MRI findings suggest you have S1 radiculopathy. The S1 nerve is irritated or pinched by scar tissue. Radiculopathy are the group of symptoms like pain, tingling, numbness and weakness. Laminectomy surgery creates large space for nerve so nerve is not irritated or pinched. Patient's symptoms are substantially reduced after laminectomy in most cases. There are few unfortunate individuals who may suffer with pain after surgery because of scar tissue pressing on nerve. The surgical wound heals with scar tissue, though few individuals develop higher volume of scar tissue that occupies larger space around the nerve. The scar tissue then causes pressure on nerve resulting in pain, numbness and weakness. Weakness is temporary in most cases and gets better once pressure is removed. If pressure on nerve continues then nerve damage become permanent and then numbness and weakness become permanent. Weakness results in foot drop.
You should consult Interventional Pain Specialist with several years experience. You should consider series of trans-foraminal epidural injection, which is performed under X-Ray image. You should avoid spinal fusion surgery until you try 3 to 5 cortisone injection and 6 to 8 weeks of physical therapy. You should avoid opioids. Opioids are excellent pain medications but also causes dependence and addiction.