L4/L5 decompression plus microdiscectomy

Slump test

Slump test

I had the above operation in June, but unfortunately my latest MRI shows that the disc L4-L5 shows small right sided paracentral recurrent disc protrusion surrounded by scar tissue, obliterating right anterior epidural space and lower half of right neural foramina compressing the descending right L5.


I saw the surgeon who then recommended a nerve root block injection which I had 2 weeks ago. Unfortunately, I have not seen any decrease in the pain.

I seem to be somewhere between your Grade 3 and 5 detail. I have virtually no pain in the lower back, but cannot stand for long periods of time. My right leg is a constant problem, mostly at night, when it feels hypersensitive and I can't get comfortable, even with pillows. I have an itch on the top of my right big toe, the top of my foot feels tender, my knee feels larger than it is and solid.

I find I can't walk too far anymore, but still enjoy swimming although a lot of the above sensations are felt whilst swimming too. About every six weeks I have a relapse where I am in agony and have to resort to painkillers for a few days, then start all over again.

I was doing Pilates but am reluctant to push myself anymore. What might be the answer? Many thanks.

Hello,
There's no simple solution.

1. If you are able, do nothing and there's a fair chance the disc material will be gradually reabsorbed. It means six months of staying at home, hard discipline about exercising, not sitting too much and trying not to take too many painkillers. Not really what I would recommend, but worth a consideration.

2. Go for repeat surgery, this time recognising that rehab is vital after both surgery or chiropractic care; the pain goes away much faster than the disc heals. Get back in the deep end too quickly, back to sitting and bending before the hole in the disc has healed and more disc material ruptures through.

3. Have complete decompression and stabilisation with a cage or plates and screws.

4. Find a good chiropractor, with experience in this sort of thing, and give yourself a solid two months to recover.

I've treated many such cases, in fact been there myself which you can read at femoral nerve damage, producing very similar symptoms to what you are having. Each case is tough and to be judged on its own merits; I was lucky myself, went to a very good colleague (my daughter) and recovered completely.

In all the above scenarios you are faced with a couple months at home, and much gnashing of teeth. Good luck. Meantime take a look at our slipped disc rules.

How much pain in the leg does Slump test provoke?

Let me know how you get on.

Dr B


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