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  • Q&A with Australian Health Practitioners

    Am I in danger of permanent damage?

    Related Topics
    Back & Neck Pain Orthopaedics Pain
    I am a 51 year old male who has suffered for many years with lower back pain. With this back pain, I have had a numb spot on my left thigh for many years also. In the last 8 - 9 days I have now had pins and needles, increased numbness down to my foot, can not stand for no longer than 5 minutes without pain down my left leg starting from my lower back and the above symptoms increasing.

    I am always busy to visit a doctor and am afraid my time may have come because I am experiencing increased discomfort today. Should I have something done about this today? Am I in danger of causing more permanent and severe damage? When should I do and what can I expect?
    Gennaro
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    Dr Adam Gavine

    Chiropractor

    I am a chiropractor who specialises in Active Release Techniques and instrument assisted soft-tissue treatment. I have a keen interest in everything nutritional as I … View Profile

    Dear Gennaro

    Based on the description of your symptoms I suspect that you have a lumbar disc lesion (bulge, tear, herniation, sequestration) which is compressing or at least irritating the left exiting spinal nerve. The pins and needles (medically term paraesthesia), numbness and pain in your left lower limb are all due to the damaged disc and compressed spinal nerve. Greater than 80% of lumbar disc lesions occur at the L4-L5 and L5-S1 level. I would suggest that you have a left posterolateral disc herniation at the L4-L5 or L5-S1 disc based on the fact that the pain goes down to your foot.

    Now what should you do? Well, first of all you need to get an appropriate diagnosis. You can go to a GP or a chiropractor and they need to refer you for an MRI or CT scan (chiropractors can't refer for CT scans). I would suggest getting an MRI because the resolution is 10x better than a CT scan, and CT scans have high levels of ionizing (cancer causing) radiation, whereas MRI has no radiation. Don't bother with an X-ray, they don't show the discs and will be a waste of time and money in your case.

    Once you get the scan done, the report from the radiologist will indicate how severe the disc lesion is, if the report is not clear, then a quick call to the radiologist will answer the question. Based on these findings and recommendation of the radiologist, your practitioner will advise you as to whether your case can be treated non-invasively; if it can then you will need some ongoing manual therapy until you are better. If it can't be treated non-invasively you will need to get a referral to see a neurosurgeon to assess whether you require invasive surgery.
     
    To answer your other questions. You should get the MRI or CT scan immediately. Their is a potential that the compressed nerve can cause permanent nerve damage if it is compressed for too long. Nerves can sometimes recover from the damage but it takes months and months, and full recovery is not guaranteed. 

    Hope that helps, without scaring too much. 

    Dr Adam Gavine

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    Dr Ryan Hislop

    Chiropractor

    Ryan Hislop is the Clinical Director at the Orange Chiropractic Health and Wellness Centre. As an experienced and evidence-based diagnostician, Ryan works largely by medical … View Profile

    With neuropathies (any type of irritation to a nerve causing it to malfunction) it is pertinent to act on seeing to this as soon as possible. 

    As Dr Gavine mentioned, compression of a nerve can cause permanent damage if it is not resolved soon enough. 

    Please see to having someone look at this as soon as possible.

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