Foot/calf sciatic numbness and calf spasms

[Soule]

A friend had two seperate l5s1 microdiscectomy(s)
Dating a little over a year ago and 6 months previous to that. She still had pretty severe sciatica and numbness down her whole right leg.

I had the same surgery myself about a decade ago so i knew the solution and I coached her through SSNLP about 6 months ago and it has been fucking MIRACULOUS.

This girl couldn’t reach past her knees 6 months ago and was extremely hesitant to do even bodyweight squats. After several months of yoga she had throbbing sciatica still and an extremely tight/painful/weak lower back.

After a slowly progressed NLP shes up to a 5x3@130 squat and a 5x1 @ 135 for conventional deadlifts. No back pain, no sciatic pain and stronger than shes ever been!

Only thing that bothers her is some numbness/spasming in her calf and foot. This hasn’t improved much in the last few months and she’s wondering if she should go see a specialist - any advice for this one?

[Will Morris]

A friend had two seperate l5s1 microdiscectomy(s)
Dating a little over a year ago and 6 months previous to that. She still had pretty severe sciatica and numbness down her whole right leg.

I had the same surgery myself about a decade ago so i knew the solution and I coached her through SSNLP about 6 months ago and it has been fucking MIRACULOUS.

This girl couldn’t reach past her knees 6 months ago and was extremely hesitant to do even bodyweight squats. After several months of yoga she had throbbing sciatica still and an extremely tight/painful/weak lower back.

After a slowly progressed NLP shes up to a 5x3@130 squat and a 5x1 @ 135 for conventional deadlifts. No back pain, no sciatic pain and stronger than shes ever been!

Only thing that bothers her is some numbness/spasming in her calf and foot. This hasn’t improved much in the last few months and she’s wondering if she should go see a specialist - any advice for this one?

What would you expect a "specialist" to say about this? If we assume, rightly so, that she had true indications for two microdiscectomies, it is reasonable to assume she had actual neurological injury. Previously injured nerves tend to be irritable for a very long time, and sometimes, this irritability is lifelong. If the goal for her is to return to a life without any pain, or to return to a position of completely normal somatic sensory perception, I would suggest that goal is not likely nor realistic.

[Soule]

Thanks for the response, Will. I know you’re a busy guy and I appreciate your time!

Not sure what sort of specialist she plans on seeking out, but I think she is concerned that her symptoms will worsen over time. I’ve told her not to worry and it’s more likely that the symptoms will lessen, but also that I’m not qualified to offer an opinion on nerve damage.

She has also stated that she has less balance and control over her right foot, but this has not been apparent in any of her barbell movements.

Is it your opinion that the numbness & spasm is from the previous nerve damage and not from a remaining obstruction/impingement? And If there is disc material causing this then it can be reabsorbed over time, correct?

[Will Morris]

Thanks for the response, Will. I know you’re a busy guy and I appreciate your time!

Not sure what sort of specialist she plans on seeking out, but I think she is concerned that her symptoms will worsen over time. I’ve told her not to worry and it’s more likely that the symptoms will lessen, but also that I’m not qualified to offer an opinion on nerve damage.

She has also stated that she has less balance and control over her right foot, but this has not been apparent in any of her barbell movements.

Is it your opinion that the numbness & spasm is from the previous nerve damage and not from a remaining obstruction/impingement? And If there is disc material causing this then it can be reabsorbed over time, correct?

Well, it is likely if she does consult a "specialist" it is going to end in her just being told that previous nerve impingement can, and oftentimes, causes longstanding issues similar to this.

You are in a bit of a predicament. It is extremely difficult, if not damn near impossible, to provide guidance like this to someone you have a friendly, or anything more intimate than a friendly, relationship with. These individuals tend to listen to you the least.

I speak generally here, but for the most part, we don't get bent out of shape with sensory issues with previous nerve root impingements. If we did microdiscectomies / epidural steroid injections / etc on everyone that reports numbness, the entire world would have active appointments pending at pain management clinics. Sensory disturbances are but a small piece of the puzzle when assessing radiculopathies / nerve impingement / nerve root impingement. Patient reported numbness and tingling gives you an idea that this MAY be a differential diagnosis, but other, more concrete, evidence of progressive neurological deficits (reduced or now absent reflexes, atrophy, fasciculations, pronounced weakness along a peripheral nerve or dermatome pattern) far outweigh sensory disturbances.

From a treatment standpoint, would you like to know what we do for spasm? We actually load that extremity. Loading the extremity reduces spasm, so barbell training would likely have a therapeutic effect on the spasm.

Again, generally speaking, many longitudinal radiology studies show herniated disc material being resorbed over time. These things herniate out, migrate back into the disc, herniate out again.....and, even then, only a very, very small percentage of these herniations can be blamed on a person's back pain. We are still likely in the 98-99% range of back pain being non-specific in nature.

[Soule]

I will relay this information to her - thanks again doc!

[Will Morris]

Happy to do my part. I really appreciate your participation on this board.